What are the symptoms of a norovirus infection? How is it treated? How does norovirus spread from person to person. Answers to these questions and more.

Distinguishing Stomach Flu from Other Illnesses

It’s easy to confuse the stomach flu, or gastroenteritis, with other illnesses like influenza or food poisoning. Kelli Miller, an Advanced Practice Nurse, explains the key differences. The stomach flu is primarily caused by viruses, mainly norovirus, which accounts for over 50% of cases. Bacteria like salmonella and E. coli can also be to blame. Unlike the seasonal flu, getting a flu shot does not prevent you from getting the stomach flu.

The symptoms of the stomach flu include stomach pain, nausea, vomiting, and diarrhea. You may also experience a low-grade fever, chills, and muscle aches. These symptoms can start as soon as 12 hours after exposure and can last anywhere from 1 to 14 days.

How can you tell if it’s the stomach flu versus food poisoning? Miller says the timing of the symptoms is the key. With food poisoning, the symptoms tend to occur within hours of eating something questionable. If others who ate the same thing also get sick, it’s likely food poisoning. If you’re the only one who got sick, it’s more likely a viral illness like the stomach flu.

COVID-19 can also cause gastrointestinal symptoms like nausea, vomiting, and diarrhea in about 20% of cases. But these symptoms usually develop in the first couple of days, before other respiratory or cold-like symptoms appear.

Treating the Stomach Flu at Home

There’s often no specific medical treatment for viral gastroenteritis, the official term for the stomach flu. Antibiotics are not effective against viruses and should be avoided, as overusing them can contribute to antibiotic-resistant bacteria.

Instead, Miller recommends the following self-care steps to treat the stomach flu at home:

Stay Hydrated

Drink plenty of fluids to prevent dehydration, including water, sports drinks, and for babies and young children, oral rehydration solutions like Pedialyte. Avoid sugary drinks like juices and sodas, as they can make diarrhea worse.

Eat the Right Foods

If you don’t have much of an appetite, stick to liquids for a short time. When you’re ready to eat, go for boiled starches like potatoes, noodles, rice, and plain cereals with salt. Crackers, bananas, soup, and boiled vegetables are also good options. Avoid dairy products, caffeine, alcohol, and fatty or highly-seasoned foods.

Get Plenty of Rest

The illness and dehydration can be tiring, so make sure to get lots of rest.

Consider Medication for Adults

Adults under 65 with diarrhea, no fever, and no blood in their stool can try over-the-counter medications like loperamide (Imodium) or bismuth subsalicylate (Pepto-Bismol) for 1-2 days, if they are not allergic. Children and adults over 65 should check with their healthcare provider before taking any medications.

Understanding Norovirus Transmission

The stomach flu, or viral gastroenteritis, is highly contagious and spreads through the “fecal-oral” route. This means the virus from infected feces or vomit finds its way into someone’s mouth, either by touching a contaminated surface and then their face, or by consuming contaminated food or water.

What makes norovirus, the primary culprit, so problematic is that it can survive for days on household surfaces. This is why the stomach flu often spreads quickly through families, schools, nursing homes, and other close-contact settings.

To prevent the spread of norovirus, thorough and frequent handwashing is crucial, especially after using the bathroom and before preparing or eating food. Cleaning contaminated surfaces with a bleach-based disinfectant is also important.

When to Seek Medical Attention

Most cases of the stomach flu can be managed at home with rest and proper hydration. However, there are some signs that indicate the need for medical care:

• Severe dehydration, with symptoms like excessive thirst, dizziness, or little to no urination
• High fever
• Blood in the stool
• Symptoms lasting more than 2 days in adults or 1 day in children
• Inability to keep any fluids down

Seeking prompt medical attention is especially important for young children, older adults, and those with underlying health conditions, as they are at higher risk of complications from the stomach flu.

Preventing the Spread of Norovirus

In addition to the self-care measures mentioned earlier, there are a few other steps you can take to help prevent the spread of norovirus and other stomach bugs:

1. Stay home when you’re sick and avoid close contact with others until your symptoms have fully resolved.
2. Wash your hands thoroughly and frequently, especially before eating and after using the bathroom.
3. Disinfect contaminated surfaces with a bleach-based cleaner.
4. Avoid preparing food for others while you’re ill.
5. Practice good hygiene and sanitation in public places, such as using hand sanitizer and avoiding touching your face.

By taking these precautions, you can help limit the spread of highly contagious stomach viruses and get back on the road to recovery more quickly.

Key Takeaways

In summary, the stomach flu, or viral gastroenteritis, is a common and highly contagious illness caused primarily by norovirus. Its symptoms include nausea, vomiting, diarrhea, and sometimes fever, chills, and muscle aches. While unpleasant, the stomach flu can usually be managed at home through proper hydration, a bland diet, and plenty of rest.

To prevent the spread of norovirus, it’s crucial to practice good hygiene, disinfect contaminated surfaces, and stay home when sick. Seeking medical attention is advised if symptoms are severe or persist for more than a couple of days. By understanding the nature of the stomach flu and taking the right precautions, you can get through this unpleasant experience and get back to feeling your best.

Have the Stomach Flu? 4 Ways to Treat Symptoms at Home

There’s almost nothing worse than being bent over a toilet throwing up. And, sadly, it can be hard to know what caused you to be there in the first place. Kelli Miller, ANP, UnityPoint Health, lists the symptoms of the stomach flu and how long it lasts, plus ways to feel better, so you can get out of the bathroom and get back to normal.

Stomach Flu Symptoms

Miller says it’s easy to get confused about the difference between influenza, or “the flu,” and gastroenteritis, better known as “the stomach flu.” The stomach flu is caused by a number of viruses, mainly norovirus, which accounts for more than 50 percent of all cases, and others, like rotavirus. Bacteria, such salmonella and E. coli, can also be to blame. Getting the flu shot does not prevent you from getting the stomach flu, but it does prevent you from getting influenza.

“Stomach flu symptoms include stomach pain, nausea, vomiting and diarrhea,” Miller says. “A low-grade fever, chills and muscle aches aren’t uncommon to experience as well. Symptoms can start as little as 12 hours after exposure.”

These symptoms can last anywhere from one to 14 days, and unfortunately, the stomach flu is extremely contagious.

“The stomach flu is spread by the fecal-oral route, which means the viruses from infected feces or vomit find their way into our mouths from either touching a contaminated surface and then touching your face or eating/drinking contaminated foods and/or water. Compared to other viruses, noroviruses can live for days on household surfaces, which is why they spread easily,” Miller says.

Stomach Flu vs. Food Poisoning

Miller says the clinical symptoms of the stomach flu and food poisoning overlap quite a bit, as you can have vomiting, diarrhea, abdominal discomfort and fever with either one. She says the easiest way to determine the cause of your discomfort is to look back at your recent history.

“If your symptoms are caused by food poisoning, they tend to occur within hours after eating something. If you can recall eating something questionable, or if others who ate the same thing as you and have similar symptoms, you probably have food poisoning. If you are the only one who got sick, you more than likely picked up a viral illness,” Miller says. 

Stomach Flu vs. COVID-19

To make matters even more confusing, some people with COVID-19 (about 20% according to studies) experience stomach issues including nausea, vomiting and/or diarrhea. Most people with those symptoms usually report developing them in the first couple of days and then go on to experience other respiratory or cold-like symptoms like fever, headache, cough and fatigue.

If you experience nausea, vomiting and/or diarrhea, keep an eye out for other symptoms that may follow. If you notice a progression in the illness, talk with your doctor about getting tested for COVID-19. Remember, if you’re feeling sick, stay home and continue to wash your hands frequently.

How to Treat the Stomach Flu at Home

Miller says there’s often no specific medical treatment for viral gastroenteritis. Antibiotics aren’t effective against viruses and overusing them can contribute to the development of antibiotic-resistant strains of bacteria. She recommends treating the stomach flu with the following self-care steps:

• Keep drinking the right fluids. You’ll need to drink enough fluids to prevent dehydration. In addition to water, older children and adults can drink sports drinks, like Gatorade, Power Aid, while babies and young children can have an oral rehydration solution, such as Pedialyte. If your child is vomiting, you can try to give your child a few teaspoons of fluid every few minutes. Babies who breastfeed can continue to breastfeed. But, you should avoid drinks with increased sugar content, such as juices or sodas, which can make diarrhea worse.
• Eat the right foods. If you don’t have an appetite, you should resort to drinking only liquids for a short period of time. Boiled starches (potatoes, noodles, rice, wheat and oats) and plain cereals with salt are recommended, if you have watery diarrhea. You may also try crackers, bananas, soup and boiled vegetables.
• Avoid heavy foods. On the other hand, you should avoid certain foods until you are feeling better. These include dairy products, caffeine, alcohol, nicotine and fatty or highly-seasoned foods.
• Get plenty of rest. The illness or dehydration can make you feel tired.

“Adults under 65 years old with a new bout of diarrhea, with no fever or blood in bowel movements, can take medicine to stop diarrhea, such as loparmide (Imodium) or bismuth subsalicyclate (Pepto Bismal) for one to two days, if they’re not allergic to these medications. Children and adults over the age of 65 should check with their health care provider before taking any over-the-counter medicines,” Miller says.

As contagious as it is, keeping your family from catching the stomach flu can be tricky. Miller offers these tips to protect against the viral infections that cause gastroenteritis:

• Immunize little ones. Infants can be immunized with the rotavirus vaccine. This is offered at 2, 4 and 6 months old during well-child visits.
• Simply wash your hands. Wash your hands often to stop the spread of germs. Hand sanitizer works after being in public as well.
• Give your home the once-over. Use household cleaning products to disinfect surfaces and objects, like countertops, doorknobs, handles, sinks, toilets, computer keyboards and phones.
• Separate your laundry loads. Wash laundry of those recovering from the stomach flu in different loads than the rest of your family.
• Keep your distance. Try to keep your children, especially newborns, away from anyone who is sick. If someone in your family is sick, stay home and do not go to work, school or day care. You should be symptom-free for 48 hours before returning.

When the Stomach Flu Requires a Doctor

While most stomach illnesses pass on their own, there are cases when medical attention is necessary. Miller recommends watching for signs of severe dehydration:

• Increased thirst
• Dry mouth
• Headache
• Confusion
• Increased heart rate over 100 beats per minute
• Increased breathing rate
• Dizziness, including when standing from a sitting or laying position
• Passing out
• Fatigue
• Dark yellow or amber colored urine
• No urination within the past six to eight hours (during the day)

In addition to severe dehydration, Miller also says the following are causes for concern, and if you experience these, contact your provider:

• Bloody stool/rectal bleeding or blood in vomit
• Vomiting for more than 24 hours
• Fever greater than 104 degrees
• Weight loss
• Severe abdominal pain
• Prolonged symptoms lasting more than a week
• Are currently pregnant

Lastly, call your baby’s doctor right away if your baby:

• Has vomiting lasting several hours
• Hasn’t had a wet diaper in six hours
• Has bloody stools or severe diarrhea
• Has a sunken soft spot (fontanel) on the top of his or her head
• Has a dry mouth or cries without tears
• Is unusually sleepy, drowsy or unresponsive

If any of these symptoms are present, evaluation by a health care professional is needed right away, and IV hydration may need to be administered or possible admission to the hospital.

Norovirus

Category: Infections and Parasites

Topic: Viral Infections

Noroviruses are a group of viruses that can cause gastroenteritis (inflammation of the stomach and intestines) with diarrhoea, stomach pain and vomiting. Common names used for gastroenteritis due to Norovirus are ‘gastric flu’ or ‘stomach flu’, ‘winter vomiting’ and ‘viral gastro’.

Noroviruses are found in the faeces or vomit of infected people. People can become infected with the virus in several ways, including:

• eating food or drinking liquids that are contaminated with Norovirus
• touching surfaces or objects contaminated with Norovirus, and then placing their hand in their mouth
• small airborne particles from projectile vomiting
• having direct contact with another person who is infected and showing symptoms (for example, when caring for someone with illness, or sharing foods or eating utensils with someone who is ill).

Anyone can become infected with these viruses. There are many different strains of Norovirus, which makes it difficult for a person’s body to develop long-lasting immunity.

Norovirus illness can recur throughout a person’s lifetime.

People working in day-care centres or nursing homes should pay special attention to children or residents who have Norovirus illness. This virus is very contagious and can spread rapidly throughout such environments.

Signs and Symptoms: 

Symptoms of Norovirus illness usually begin about 24 to 48 hours after ingestion of the virus, but they can appear as early as 12 hours after exposure.

The symptoms of norovirus illness usually include nausea, vomiting, diarrhoea, and some stomach cramping. Sometimes people also have a low-grade fever, chills, headache, muscle aches, and a general sense of tiredness. The illness often begins suddenly and the infected person may feel very sick. The illness is usually brief, with symptoms lasting only about 1 or 2 days, but can last longer. In general, children experience more vomiting than adults.

Treatment: 

Currently, there is no antiviral medication that works against norovirus and there is no vaccine to prevent infection. Norovirus infection cannot be treated with antibiotics. This is because antibiotics work to fight bacteria and not viruses.

Norovirus illness is usually brief in healthy individuals. When people are ill with vomiting and diarrhoea, they should rest and drink plenty of fluids to prevent dehydration. Dehydration is the most serious health effect that can result from Norovirus infection, and it is a particular concern in young children, the elderly, and people with weakened immune systems.

Prevention: 

Noroviruses are very contagious and can spread easily from person to person. Both faeces and vomit are infectious. Particular care should be taken with young children in nappies who may have diarrhoea.

People infected with Norovirus are contagious from the moment they begin feeling ill. If your job involves handling food or beverages or you are a childcare or health care worker you must not return to work until 48 hours after recovery (i.e. until 48 hours after you last vomited or 48 hours after your bowel motions return to normal), as this is generally regarded as the period when people are infectious.

The virus can be present in faeces at low levels for several weeks after recovery, so it is important for people to continue to use good handwashing and other hygienic practices.

People infected with Norovirus should not prepare food while they have symptoms and for 48 hours after they recover from their illness. Food that may have been contaminated by an ill person should be disposed of properly.

You can decrease your chance of coming in contact with noroviruses by following these preventive steps:

• frequently wash your hands, especially after toilet visits, changing nappies and before eating or preparing food
• carefully wash fruits and vegetables, and steam oysters before eating them
• flush or discard any vomit or faeces in the toilet and make sure that the surrounding area is kept clean
• use a detergent and warm water to wipe down the area where vomit was present so that no evidence of vomit is visible
• thoroughly clean and disinfect contaminated surfaces immediately after an episode of illness using detergent and water followed by a bleach-based household cleaner
• immediately remove and wash clothing or linens that may be contaminated with virus (use a hot cycle in the washing machine).

Health outcome: 

Anyone can become infected with these viruses. There are many different strains of Norovirus, which makes it difficult for a person’s body to develop long-lasting immunity. In addition, because of differences in genetic factors, some people are more likely to become infected and develop more severe illness than others.

Norovirus disease is usually not serious, although people may feel very sick and vomit many times a day. Most people get better within 1 or 2 days, and they have no long-term health effects related to their illness.

Sometimes people are unable to drink enough liquids to replace the liquids they lost because of vomiting and diarrhoea. These people can become dehydrated and may need special medical attention. This problem with dehydration is usually only seen among the very young, the elderly, and people with weakened immune systems. There is no evidence to suggest that an infected person can become a long-term carrier of Norovirus.

Other resources: 

• Clean Up for Gastroenteritis Outbreak Prevention (PDF 716KB)

Help and assistance: 

For further information, please contact your local doctor, community health centre or nearest public health unit, or contact the Queensland Health information line 13HEALTH (13 432584).

If you are in an emergency situation, call 000

Stomach does not regret: doctors told about the intestinal form of “Omicron” | Articles

When infected with the Omicron coronavirus strain, nausea, diarrhea, loss of appetite develop much more often than with Delta, Russian doctors have recorded . According to the observations of specialists from the Research Institute of Gabrichevsky Rospotrebnadzor, about 30% of patients complain of frequent, watery stools. And more often than not, children suffer from such problems. In some infected people, the disease occurs exclusively in the intestinal form, without the usual cough and runny nose. In such cases, the diagnosis can be made only with the help of special tests, the doctors emphasized. Therefore, if atypical symptoms appear, it is necessary to immediately contact medical institutions, experts advised.

Got to the guts

Although there is now a decline in the incidence of coronavirus in Russia, researchers continue to analyze the symptoms of the new Omicron strain. And today there is still no accurate data on the features of its course. However, it is already known that with the spread of Omicron, gastrointestinal symptoms (nausea, diarrhea, loss of appetite) began to appear much more often than with infection with the Delta strain. This was reported to Izvestia by the Deputy Director for Clinical Work of the Moscow Research Institute of Epidemiology and Microbiology named after V.I. G.N. Gabrichevsky Rospotrebnadzor, doctor of medical sciences Tatyana Ruzhentsova.

– With the very first Wuhan strain, we also noted many cases accompanied by diarrhea . Now there are more of them. According to our observations, about 30% of patients complain of frequent, watery stools, 4-6 times a day , she said. – Some of them, more often in children, have a decrease in appetite, nausea.

Photo: TASS/Elena Afonina

According to Tatyana Ruzhentsova, in the youngest patients the disease is often accompanied by vomiting, which is especially pronounced on the first day of illness.

At the same time, in some cases, doctors can talk about the intestinal form of the coronavirus caused by Omicron, which occurs without respiratory symptoms. Most often, the infection occurs in this way in children of the first three years of life.

– But the isolated intestinal form is rare. Most patients with severe gastrointestinal symptoms also have respiratory symptoms: redness and itching in the throat, nasal congestion and discharge, coughing, Tatyana Ruzhentsova noted.

Diagnostic difficulties

Intestinal symptoms of the disease when infected with Omicron are manifested in more than 50% of patients , Ekaterina Melnikova, head of the clinical diagnostic department of the clinical hospital on the Yauza of the Medscan Group of Companies, gastroenterologist Yekaterina Melnikova, told Izvestia.

“An objective assessment of the statistical data does not allow the fact that many patients, on their own or on the recommendation of a doctor, start taking antibacterial drugs from the first symptoms of the disease,” the specialist explained the difference in estimates of the manifestation of intestinal symptoms.

Most often, patients report episodes of recurrent diarrhea, rarely nausea, not accompanied by pain. These unpleasant effects pass within a few days, the physician said. However, in general, the Omicron strain most often manifests itself with respiratory symptoms and intoxication, she added.

Photo: RIA Novosti/Aleksey Sukhorukov

“Symptoms are possible only from the gastrointestinal tract, but this is more likely to be an exception,” said Ekaterina Melnikova. – Patients with chronic diseases of the gastrointestinal tract are at increased risk of exacerbation of the existing pathology against the background of a transmitted infection.

New mutations of the virus allowed it to be more contagious, and the duration and severity of the disease decreased, which also reduced the frequency of seeking medical help, Tatyana Nalegach, a therapist at the NAKFF medical clinic, told Izvestia. Therefore, it is more difficult to analyze the next rise in the incidence.

– Manifestations of “Omicron” are similar to the usual seasonal colds and flu. Brief GI symptoms occur with a range of respiratory infections such as adenovirus and rotavirus , which can be misleading. But still, most often, following from our observations, Omicron affects the respiratory system, – said Tatyana Nelegach.

As for other specific manifestations of Omicron registered in the world, these are eczema of various localizations, dry skin, urticaria, skin rash and the so-called covid fingers – cyanosis of the phalanges of the hands and feet, the experts explained.

People who often fall ill, as with the flu, suffer from headaches, chills, severe weakness, the Moscow Research Institute of Epidemiology and Microbiology named after V. I. G.N. Gabrichevsky Rospotrebnadzor. At the same time, an accurate diagnosis can only be established with the help of special tests, the doctors emphasized. Therefore, it is imperative to contact medical institutions, experts pointed out.

Diarrhea due to coronavirus infection

Coronavirus patients often “stomach ache” when there may not be other manifestations of covid. Gastroenterologist Victoria Malozemova explained how the virus enters the gastrointestinal tract, whether it is possible to check what it has damaged, and then fix it all.

– Victoria Anatolyevna, Rospotrebnadzor reported that the gastrointestinal tract, like the upper respiratory tract, is the entrance gate for coronavirus. How does it pass through a natural powerful barrier to harmful microorganisms – the stomach?

— On the mucosa of the gastrointestinal tract, as well as on the bronchi, there are specific receptors that are sensitive to coronavirus, this is already an established fact. They are found in the stomach, duodenum, and rectum. Nature has created barriers in our body that protect against the effects of foreign agents such as viruses and bacteria. For example, protective immunoglobulins work on the oral mucosa, then, getting into the stomach, the virus meets with gastric juice, which is a rather aggressive acidic environment.

Our defense mechanism can be weakened due to chronic diseases (not only of the gastrointestinal tract), due to the use of drugs that reduce the protective barrier of the mucous membranes, against the background of stress, chronic fatigue, malnutrition.

For example, in patients with chronic stomach diseases, the acidity of the gastric juice decreases, which leads to a weakening of the defense against the penetration of viruses.

In gastroenterology, this is called a hypoacid or anacid state. The virus binds to receptors on the gastrointestinal mucosa and causes increased epithelial permeability syndrome: normally, our epithelial cells in the mucosa are connected by tight junctions, they prevent the penetration of dangerous substances and particles. The virus breaks these contacts, and the sensitivity of the mucosa changes – the work of the stomach and intestines is disturbed.

— How does “gastric covid” manifest itself?

– The leading symptom in this situation is diarrhea, followed by bloating, cramps, nausea and vomiting in prevalence. Both we in the hospital and our colleagues in the country and abroad are seeing that diarrhea is becoming one of the leading symptoms of covid. We have had patients with severe diarrhea that is difficult to treat, they have had a colonoscopy (visual examination of the bowel with an endoscope) to see what is going on. We found erosive and ulcerative lesions of the stomach and intestines, which are caused by the virus. In some, they may become the first manifestation of the disease, in others they occur later, in others they become a consequence of exposure to drugs used in treatment.

— And if a person suffers from irritable bowel syndrome (IBS), how can he understand why he is vilifying: because of his chronic illness or because of infection with the coronavirus?

– Only for PCR testing for coronavirus. But in the hospital, we see such exacerbations caused by the coronavirus. I mean, it’s all connected. There are also combinations of coronavirus with other serious autoimmune intestinal diseases: ulcerative colitis (NUC), Crohn’s disease.

— Why are changes most often detected during and after covid in the duodenum?

— Because the duodenum is part of the small intestine, and, as I said, there are many receptors in it that the coronavirus can contact. A complete examination of the intestine is rarely done – a colonoscopy is sent in extreme cases, and a duodenal 12 can be examined for FGDS. But if we see erosive changes in the duodenum with coronavirus, we can assume that there are also such changes in the entire intestine.

— Is it true that when the manifestations of the disease begin with the gastrointestinal tract, then there is a great chance that it will proceed relatively easily – without a threat to life.

– True, if the virus involved only the intestines in the pathological process. The problem is that most often the liver suffers in parallel. Her defeat is usually manifested by nausea, bitterness in the mouth, vomiting of bile. But often with a coronavirus infection, it happens that these symptoms are absent, and we see the lesion by laboratory parameters.

— Is that why those who undergo clinical examination after suffering COVID are prescribed a biochemical blood test for the so-called liver indicators — ALT and AST? Why are they examined six months after the illness?

— When a patient is admitted to the hospital, a complete biochemical study is performed, including liver parameters. And when they are discharged, we check them again and prescribe the necessary medications. And in outpatient treatment, this study is not included in the clinical recommendations, so it is carried out if the patient has specific complaints. To be honest, I would recommend doing such a study either during the period of illness, or immediately after receiving a negative test.

The liver is a kind of blood depot, in which it is filtered, as it were, all viral particles that enter the blood pass through it. In addition, in the liver there is an extensive network of capillaries that the virus and its toxins infect (this is a feature of the coronavirus, we do not see such changes in the liver with ordinary SARS or influenza). And the analysis of liver parameters demonstrates how intense the process of intoxication caused by the coronavirus is. And if they are not normal, then the inflammatory process continues against the background of toxicological effects.

— What to do if the indicators exceed the norm?

– There are agents that protect the mucosa and promote its healing when there are ulcers or erosions. And there are medications recommended to correct liver values. Usually, if a person sees a doctor on time and fulfills his appointments, the condition will normalize, but this may not happen quickly.