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CDC – With the widespread outbreak of this illness, it is important to know what you are dealing with and what you need to do to prevent it. 

The Symptoms of Norovirus

Do you think you have the stomach flu or a stomach bug?

The most common symptoms of norovirus are:

• diarrhea
• vomiting
• nausea
• stomach pain

Other symptoms include:

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• fever
• headache
• body aches

Norovirus causes inflammation of the stomach or intestines. This is called acute gastroenteritis. A person usually develops symptoms 12 to 48 hours after being exposed to norovirus. Most people with norovirus illness get better within 1 to 3 days. If you have norovirus illness, you can feel extremely ill, and vomit or have diarrhea many times a day. This can lead to dehydration, especially in young children, older adults, and people with other illnesses.

Symptoms of dehydration include:

• decrease in urination
• dry mouth and throat
• feeling dizzy when standing up

Children who are dehydrated may cry with few or no tears and be unusually sleepy or fussy.

How Norovirus Spreads

This can happen if you:

• eat food or drink liquids that are contaminated with norovirus,
• touch surfaces or objects contaminated with norovirus and then put your fingers in your mouth, or
• have direct contact with someone who is infected with norovirus, such as by caring for them or sharing food or eating utensils with them.

If you get norovirus illness, you can shed billions of norovirus particles that you can’t see without a microscope. Only a few norovirus particles can make other people sick. You are most contagious

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• when you have symptoms of norovirus illness, especially vomiting, and
• during the first few days after you recover from norovirus illness.

However, studies have shown that you can still spread norovirus for two weeks or more after you feel better.

Norovirus spreads through contaminated food

Norovirus can easily contaminate food and water because it only takes a very small amount of virus particles to make you sick. Food and water can get contaminated with norovirus in many ways, including when:

• An infected person touches food with their bare hands that have feces (poop) or vomit particles on them
• Food is placed on a counter or surface that has feces or vomit particles on it
• Tiny drops of vomit from an infected person spray through the air and land on the food
• The food is grown or harvested with contaminated water, such as oysters harvested from contaminated water, or fruit and vegetables irrigated with contaminated water in the field

Norovirus spreads through contaminated water

Recreational or drinking water can get contaminated with norovirus and make you sick or contaminate your food. This can happen:

• 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 with not enough chlorine

For more information on healthy water and how water can get contaminated, visit www.cdc.gov/healthywater/.

Norovirus spreads through sick people and contaminated surfaces

Surfaces can get contaminated with norovirus in many ways, including when:

• An infected person touches the surface with their bare hands that have feces or vomit particles on them
• An infected person vomits or has diarrhea that splatters onto surfaces
• Food, water, or objects that are contaminated with norovirus are placed on surfaces
• Tiny particles of vomit spray through the air and land on surfaces or enter a person’s mouth, then he or she swallows it

Preventing Norovirus

You can help protect yourself and others from norovirus by washing your hands thoroughly with soap and water and following other simple prevention tips.

Practice proper hand hygiene

Wash your hands thoroughly with soap and water

• After using the toilet or changing diapers.
• Before eating, preparing, or handling food.
• Before giving yourself or someone else medicine.

Norovirus can be found in your vomit or feces (poop) even before you start feeling sick. The virus can also stay in your feces for two weeks or more after you feel better. It is important to continue washing your hands often during this time.

Hand sanitizer does not work well against norovirus. Handwashing is always best. Wash your hands with soap and water for at least 20 seconds. You can use hand sanitizers in addition to hand washing, but hand sanitizer is not a substitute for washing your hands with warm water and soap.

Handle and prepare food safely

Before preparing and eating your food:

• Carefully wash fruits and vegetables.
• Cook oysters and other shellfish thoroughly to an internal temperature of at least 145°F .

Be aware that noroviruses are relatively resistant to heat. They can survive temperatures as high as 145°F. Quick steaming processes that are often used for cooking shellfish may not heat foods enough to kill noroviruses.

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

People who are sick should not prepare or handle food.

When you are sick, do not prepare food or care for others

You should not prepare food for others or provide healthcare while you are sick and for at least two days after symptoms stop. This also applies to sick workers in restaurants, schools, daycares, long-term care facilities, and other places where they may expose people to norovirus.

Clean and disinfect surfaces

After someone vomits or has diarrhea, always thoroughly clean and disinfect the entire area immediately:

• Put on rubber or disposable gloves and wipe the entire area with paper towels, then disinfect the area using a bleach-based household cleaner as directed on the product label.
• 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 cleaning soiled laundry, taking out the trash, and washing your hands.

To help make sure that food is safe from norovirus, routinely clean and sanitize kitchen utensils, counters, and surfaces before preparing food.

You should use a chlorine bleach solution with a concentration of 1,000 to 5,000 ppm (5 to 25 tablespoons of household bleach [5% to 8%] per gallon of water) or other disinfectant registered as effective against norovirus by the Environmental Protection Agency (EPA). For more information, see EPA’s Registered Antimicrobial Products Effective Against Norovirus (Norwalk-like virus)

Wash laundry thoroughly

Immediately remove and wash clothes or linens that may be soiled with vomit or feces.

You should:

• Handle soiled items carefully without agitating (shaking) them.
• Wear rubber or disposable gloves while handling soiled items and wash your hands afterwards.
• Wash the items with detergent (cleaning agent) and hot water at the maximum available cycle length and then machine dry them at the highest heat setting.

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