Norovirus: What You Need to Know About Symptoms, Prevention, and Treatment

With an increase in norovirus this winter, a primary care physician explains how to protect yourself from the gastrointestinal viral illness and how you can treat symptoms at home.

Published February 22, 2024

Diseases & Conditions • Story By Camille Bautista-Fryer

While the fall and winter seasons can bring an uptick of colds or the flu, cases of another common viral illness — norovirus — are rising in the United States, according to data from the Centers for Disease Control and Prevention. The national rate of positive tests for norovirus, a contagious virus that can cause vomiting and diarrhea, reached 12% the week of February 17, 2024, with the highest rates in the Northeast.

"Norovirus is also known as the 'stomach flu,' but it's not related to the flu or influenza virus," says Dr. TingTing Wong, an attending physician and infectious disease specialist at NewYork-Presbyterian Brooklyn Methodist Hospital and NewYork-Presbyterian Medical Group Brooklyn. "It impacts the stomach and colon and is very contagious, but for people who are generally healthy, they're sick for about two to three days and feel better afterwards."

Dr. Wong spoke with Health Matters to share what you need to know about norovirus and how to treat yourself at home if you're experiencing symptoms.

What is norovirus?
Dr. Wong: Norovirus is a group of viruses that cause gastroenteritis, or a stomach infection, that can lead to vomiting and diarrhea, among other symptoms.

It's the most common cause of stomach viruses in elderly populations and children, but anyone can get it.

Norovirus symptoms usually resolve within 48 to 72 hours. In patients who are severely immunocompromised, like transplant recipients or people undergoing chemotherapy, there is greater risk for developing severe disease that can last longer.

How does it spread?
Norovirus is easily transmissible between person to person through viral particles, including saliva, vomit, or stool. You can get it by sharing contaminated food, drinks, or utensils, and outbreaks can stem from food preparation by an infected person. Contact with contaminated surfaces can also contribute to infection.

What are the symptoms?
The symptoms include:

Stomach cramps or pain
Nausea
Vomiting
Diarrhea
Fever
Headache
General malaise, or fatigue

How to Treat Norovirus at Home

Norovirus resolves on its own without specific treatment or medication. Here's what you can do to help with recovery at home.

Drink fluids
"When your body is ill, you most likely won't want to eat and that's OK," says Dr. Wong. "But it's important to hydrate, and not only with water. Drink fluids with electrolytes, like sports drinks or pediatric electrolyte solutions for children, and avoid caffeine."
Watch out for signs of dehydration
"Check your urine color and make sure it is clear or clear-yellow. If it's dark, you're not drinking enough," says Dr. Wong.  For young children or babies, caregivers should check for wet diapers throughout the day. Other ways to gauge dehydration in young children: check whether their lips are chapped and if you press down on their fingernail, the color should return within one to two seconds if they are well hydrated.
Rest
Rest and sleep are mainstays for your body to recuperate. Try to remain in bed and make sure you're taking it easy.
Ease back into eating
"Generally by day two or three, you may start feeling hungry if your nausea has improved," says Dr. Wong. "It's a good sign that your body is recovering." It's recommended to go on a bland diet with foods that are easier on your digestive system like BRAT, which stands for bananas, rice, applesauce, and toast. You can also try a clear broth. "It's OK to take in a little more salt when you're sick, because it'll help your body retain water," says Dr. Wong.  "Avoid greasy and spicy foods and dairy products."

How can you protect yourself?
There are two important measures you can take.

First, practice proper hand hygiene. Hand-washing is the most effective prevention. Using soap and water, wash your hands thoroughly for at least 20 seconds. It's been shown that soap and water is even more effective than alcohol-based hand sanitizer.

Second, disinfect surfaces. It's a good idea to wipe down surfaces with disinfectants, such as a bleach-based household cleaner , particularly before and after preparing food. It's also recommended to thoroughly wash clothing if a family member has had norovirus.

How can you tell the difference between norovirus and food poisoning or other gastrointestinal-related illnesses?
For most people, it's actually very hard to tell the difference between norovirus and food poisoning because of the similar gastrointestinal symptoms. The timeline of norovirus is a big indicator.

With food poisoning, there are bacteria like Escherichia coli or Campylobacter that can cause a spectrum of illnesses ranging from a 24-hour bug to something more severe. There are some food poisoning illnesses that can transmit into your blood and cause severe sepsis, or infections. In contrast, norovirus generally causes mild symptoms and lasts no more than 48 to 72 hours.

When is it time to see a doctor?
If you're experiencing symptoms and your diarrhea, fatigue, or general sense of well-being is not getting better within two to three days, that's a red flag to seek medical care. Other symptoms such as blood in the stool or increasing fever are also indicators to call a physician.

Additional Resources

Learn more about norovirus.
If you are not feeling well, NewYork-Presbyterian's Virtual Urgent Care can help address non-life-threatening symptoms, such as fever, cough, upset stomach, or nausea. Learn more at nyp.org/urgentcare.