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Norovirus: Leading Cause of Vomiting and Diarrhea

Norovirus: Leading Cause of Vomiting and Diarrhea

Recent headlines about the Norovirus outbreak on a cruise ship have drawn nationwide attention to a very common virus. Norovirus, which is highly contagious, causes vomiting and diarrhea in people of all ages. It is commonly referred to as the stomach flu, stomach bug, or gastroenteritis (inflammation of the stomach and intestines).

Norovirus is the leading cause of vomiting and diarrhea in the U.S. Each year, norovirus:

  • Causes 20 million cases of gastroenteritis

  • Contributes to about 56,000 to 71,000 hospitalizations and 570 to 800 deaths, mostly among young children and the elderly

Infected food workers cause about 70% of reported norovirus outbreaks from contaminated food.

Transmission: The virus is found in the stool and vomit of infected people and can be shared by:

  • Eating food or drinking liquids that are contaminated with norovirus

  • Touching surfaces or objects contaminated with norovirus, then putting your fingers in your mouth

  • Having direct contact with someone who is infected with norovirus, such as by caring for them or sharing food or eating utensils with them

Recreational or drinking water can get contaminated:

  • At the source, such as when a septic tank leaks into a well

  • When an infected person vomits or poops in the water

  • When water isn’t treated properly, such as not enough chlorine

Symptoms: Usually develop 12 to 48 hours after exposure. Most people improve within 1 to 3 days.

  • Diarrhea

  • Nausea/Vomiting

  • Stomach pain

  • Fever

  • Headache

  • Body aches



  • Decreased urination

  • Dry mouth

  • Feeling dizzy when standing up

  • Children: cry with few or no tears and are unusually sleepy or fussy

Diagnosis is made by lab testing a stool or vomit sample.

Treatment: Drinking plenty of fluids. Hospitalization may be required for severe dehydration.


Hand Hygiene:

  • Wash hands thoroughly with soap and water, especially after using the toilet or changing diapers and before eating, preparing, or handling food

  • Washing hands with soap and water is more effective against norovirus than using hand sanitizer

Handle and prepare food safely:

  • Carefully wash fruits and vegetables before preparing and eating them

  • Noroviruses are relatively resistant to heat. They can survive temperatures as high as 145°F

  • Food that might be contaminated with norovirus should be thrown out

  • Keep sick infants and children out of areas where food is being handled and prepared

Clean and disinfect surfaces:

  • After someone vomits or has diarrhea, thoroughly clean and disinfect the entire area immediately. Disinfect the area using a bleach-based household cleaner. Leave the bleach disinfectant on the affected area for at least five minutes then clean the entire area again with soap and hot water. Finish by taking out the trash and washing your hands

  • Use a chlorine bleach solution (5 to 25 tablespoons of bleach per gallon of water) or other disinfectant registered as effective against norovirus by the EPA (read the label)

  • Routinely clean and sanitize kitchen utensils, counters, and surfaces before preparing food

Wash laundry thoroughly:

  • Immediately remove and wash clothes or linens that may be contaminated with vomit or stool

  • Handle soiled items carefully without agitating them (as this can spread norovirus) and then wash your hands

  • Wash the items with detergent and hot water at the maximum available cycle length, then machine dry them at the highest heat setting

Rotavirus, like norovirus, causes vomiting and diarrhea but is most commonly found in infants and young children. Currently there is no vaccine for norovirus. Rotavirus does have a vaccine (liquid into mouth) available for children up to 8 months old.

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