Norovirus
WHAT IS NOROVIRUS?
Norovirus is a viral infection that affects the stomach and intestines. It’s a common cause of acute gastroenteritis, which is an inflammation of the stomach and intestines.
It has the nickname ‘winter vomiting bug’ as it's more common in winter, but it can be caught at any time of the year. Norovirus causes vomiting and diarrhoea, but this usually goes away in about two days.
Norovirus & how to treat symptoms
Norovirus is very contagious and can be spread quickly from person to person causing an outbreak, particularly in places like hospitals, care facilities, and schools. Washing your hands regularly with soap and water can help to prevent norovirus from spreading; alcohol hand gels are not effective at preventing the spread.
Let’s delve into the symptoms of norovirus and learn how to recognise this common viral infection. Norovirus can be transmitted through close contact with someone who has norovirus, touching contaminated surfaces or objects, or by eating or drinking contaminated food or water. It can spread rapidly within closed environments, causing outbreaks which cause gastrointestinal symptoms.
The most common symptoms are:
• nausea (feeling sick)
• vomiting (being sick), sometimes projectile
• diarrhoea
The other symptoms that some people may also experience are:
• fever (high temperature) that can be checked with a thermometer
• headache
• painful stomach cramps
• aching arms and legs
The symptoms typically appear 12 to 48 hours after exposure, but you’ll usually start to feel better in about two days. The duration of norovirus symptoms can vary from person to person. These can be quite uncomfortable. Vomiting and diarrhoea may lead to dehydration if not properly managed. If you’re concerned about your symptoms, please seek medical advice and contact your GP.
As norovirus can lead to fluid loss due to vomiting and diarrhoea, it's crucial to watch out for signs of dehydration. Dehydration is when your body loses more fluid than you’re taking in. Signs of dehydration may include:
• feeling thirsty
• dark-coloured urine
• having a dry mouth
• producing less urine or urinating less often
• feeling dizzy or lightheaded especially when you stand up
• feeling more tired than usual- fatigue
• headaches
• heart palpitations- or a sensation of pounding or fluttering
• low blood pressure
• sunken eyes
In babies, signs of dehydration may include:
• sunken fontanelle (the soft spot on the top of the head)
• sunken eyes
• fewer or no tears when they cry
• not having many wet nappies
• being drowsy or irritable
Babies, children and older adults are more at risk of dehydration. It’s important to seek urgent medical advice if your baby or child is showing any of these signs. Also, speak to your GP urgently if you have signs of severe dehydration, such as feeling extremely thirsty, feeling unusually tired, having a fast heart rate, having dark-coloured urine or urinating less than normal.
While norovirus and rotavirus share similarities in symptoms, there are differences between the two, and both differ from food poisoning.
Rotavirus is primarily seen in infants and young children, but adults can also become infected. The virus is highly contagious and can spread easily through close contact with contaminated objects and infected people. Symptoms include diarrhoea, vomiting, fever and abdominal pain. It's important to note that a rotavirus vaccination is available routinely on the NHS as part of the childhood vaccination programme for babies aged eight weeks and 12 weeks and is recommended to prevent severe cases of infection.
Norovirus can affect individuals of all ages. It does have similar symptoms to rotavirus, however, there is no vaccination for norovirus. It can be unpleasant, but most people recover within a few days.
On the other hand, food poisoning is caused by consuming contaminated food or drinks. It can be caused by various bacteria, viruses or parasites present in the food. Food poisoning symptoms include nausea, vomiting, diarrhoea, stomach cramps and fever. The symptoms of food poisoning usually begin within one to two days of eating contaminated food, but symptoms can also start a few hours later, or even several weeks later.
It’s important to know the difference between these conditions. Check out the table below for a summary of the differences:
| Norovirus | Rotavirus | Food Poisoning | |
|---|---|---|---|
| Age affected | Any age | Primarily seen in infants and young children | Any age |
| Cause | Norovirus (a virus) | Rotavirus (a virus) | Bacteria, viruses or parasites present in contaminated food or drinks |
| Onset (incubation period) | 12-48 hours | About two days | Usually within a few days of eating the food that caused the infection. Sometimes a few hours, sometimes a few weeks |
| Vaccination? | No | Yes | No |
| Contagious? | Yes | Yes | Depends on the cause of the food poisoning (can be contagious if caused by certain bacteria, viruses, or parasites) |
| Nausea | Common | Common | Common |
| Vomiting | Common | Common | Common |
| Diarrhoea | Common | Common | Common |
| Stomach pains | Sometimes | Common | Common |
| Fever | Sometimes | Common | Common |
| Dehydration | Sometimes | Sometimes | Sometimes |
| Headache | Sometimes | Sometimes | Common |
| Chills | Sometimes | Common | Common |
| Muscle ache | Sometimes | Common | Common |
| Fatigue | Sometimes | Common | Common |
Getting norovirus when you’re pregnant shouldn’t harm your baby or you in the long term. It’s important to prioritise good hygiene practices to reduce the risk of contracting the virus.
As usual, having plenty of rest and staying hydrated is crucial, so make sure to drink plenty of fluids. If you’re pregnant and experience norovirus symptoms, it’s advisable to speak to your GP if:
• you can’t keep any fluids down
• diarrhoea or vomiting doesn’t go away within 48 hours
• you have any concerns
Make sure to speak to your doctor or pharmacist before taking any over-the-counter medicine during pregnancy.
When it comes to norovirus, there isn’t a specific cure or medication to target the virus itself. The primary focus is on managing the symptoms and preventing dehydration. Rest is important to allow your body to recover, and staying hydrated is crucial, so drink plenty of fluids. Here are some steps which can help:
• take paracetamol for any fever, aches and pains (if it’s suitable for you)
• stay at home and rest. Don’t go to work, and don’t send children to school or nursery until 48 hours after the diarrhoea and vomiting have stopped
To help reduce the risk of dehydration and treat dehydration, you can:
• drink fluids regularly (water or diluted squash are good options)
• drink enough during the day so your wee is pale and clear
• drink more if vomiting or having diarrhoea
• start with small sips if you find it hard to drink, then you can build it up and drink more
If someone in your care is dehydrated, you might not know how much they’re drinking, so you can help by:
• make sure they drink at mealtimes
• make drinking social, like sitting with them to have a drink, for example, social time having a cup of tea
• offering them food with high water content. Some ideas for adults and older children are soup, ice lollies, and fruits like melon or cucumber
• avoid giving fizzy drinks or fruit juice to children as it can make their diarrhoea worse
• babies should feed as usual, with breast milk or other milk feeds
If you are being sick or have diarrhoea this means you are losing fluid, so you need to replace the salts, minerals and glucose your body’s lost. A Boots pharmacist can advise on suitable products to help such as rehydration solutions you mix with water and drink. Rehydration treatments help relieve short-term diarrhoea and replace lost salts and fluids to help prevent dehydration. If you need medication someone who doesn't have norovirus symptoms should go to the pharmacy if possible, to avoid spreading the infection.
You can speak to a pharmacist about which one suits you or your child. If you have a fear of vomiting (emetophobia) please seek medical advice.
In most cases, norovirus resolves on its own within a few days without medical intervention. Antibiotics won’t help with norovirus, as it is caused by a virus. However, there are instances when it’s important to speak to your GP or 111. Avoid going to your GP as norovirus can spread to others very easily. You can speak to your GP by phoning. For example, if:
• you’re worried about a baby under 12 months
• your child stops breast or bottle feeding while they’re ill
• a child under five has signs of dehydration such as less wet nappies
• you or your child (over five) still have signs of dehydration after using oral rehydration sachets
• you or your child keep being sick and can’t keep fluid down
• you or your child have bloody diarrhoea or bleeding from the bottom
• you or your child have diarrhoea for more than seven days or vomiting for more than two days
• your baby or child is less responsive, feverish, or has pale or mottled skin
• your symptoms haven’t started to improve after a few days
• you or your child have a serious underlying medical condition like kidney disease and have diarrhoea and vomiting
It’s important to seek urgent medical advice (either 999 or going to A&E) if:
• you have blood in your vomit or have vomit that looks like ground coffee
• your vomit is green or yellow (green in adults & yellow-green in children)
• have a stiff neck when looking at bright lights
• have a sudden, severe headache or stomach ache
Additionally, it's best to speak to your GP if:
• you have underlying health conditions
• you have a weakened immune system
• you have severe symptoms
• you’re concerned about your symptoms
Due to its resilience, norovirus can survive on surfaces for extended periods and can also survive common disinfectants. Maintaining hygiene and cleaning can help to stop the spread of norovirus. You can maintain hygiene by:
• Frequent handwashing with soap and water, especially after using the bathroom, changing nappies or handling food. Please note, alcohol hand gels don’t kill norovirus
• Cleaning and disinfecting contaminated surfaces, such as worktops and door handles using a bleach-based household cleaner
• Washing any items or clothing that could’ve been contaminated separately on a hot wash (60C) to make sure the virus is killed
• Not sharing towels
• Flushing any poo or vomit in the toilet and cleaning the area with a bleach-based household cleaner
• Avoid eating raw, unwashed food
• Only eating oysters from a reliable source as they can carry norovirus
• If you’re infected with norovirus, it’s essential to stay home and avoid close contact with others until at least 48 hours after the symptoms have subsided. This helps prevent the spreading of the virus to others
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FREQUENTLY ASKED QUESTIONS
In most cases, it isn't necessary to contact the GP if you get norovirus, rest at home and drink water in small sips to prevent dehydration. Wash your hands often, avoid work or school and seek medical help if symptoms are severe, or concerning or if you have warning signs or symptoms (which are described above).
Antibiotics will not help treat norovirus; antibiotics fight bacteria whereas norovirus is a virus.
Although it’s called the ‘winter’ vomiting bug, you can get it any time of the year. However, it's most common during the colder months as we tend to mix more indoors and are more likely to come into contact with someone who may already have the virus.
Norovirus and food poisoning have similar symptoms, but there are differences. Food poisoning symptoms appear earlier and don't last as long as norovirus. Norovirus is caused by a virus, while food poisoning is caused by consuming contaminated food or drinks. Food poisoning can be caused by various bacteria, viruses or parasites present in the food.
Yes, norovirus is easily spread and can affect babies, children and adults. Children, babies and the elderly can be at higher risk of dehydration, if you suspect dehydration or have concerns, please seek medical advice.
DEALING WITH NOROVIRUS: ADVICE TO FOLLOW
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