Viral Gastroenteritis (Stomach Flu): Symptoms and Treatment

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Viral gastroenteritis can cause nausea and vomiting. You can get the virus that causes it from other people or through contaminated foods, drinks, or surfaces. Washing your hands often may help prevent it.

Viral gastroenteritis is an inflammation and irritation of your intestines caused by one of a number of viruses, most commonly norovirus or rotavirus. This illness is also known as the stomach flu.

This highly contagious illness spreads through close contact with people who have the virus or through contaminated food or water.

It can easily spread in close quarters, such as:

• childcare facilities
• schools
• nursing homes
• cruise ships

This article will help you understand more about viral gastroenteritis including symptoms, causes, treatment, and prevention.

Symptoms of gastroenteritis usually begin shortly after infection. For example, symptoms caused by norovirus typically develop within 12 to 48 hours. Symptoms from adenoviruses may be delayed 3 to 10 days after contact.

Depending on which type of virus you’ve contracted, symptoms can last anywhere from 1 to 14 days. Symptoms often start suddenly over the course of 1 or 2 hours.

Symptoms can include:

• loose, watery diarrhea more than 3 times per day
• fever or chills
• nausea and vomiting
• headache, muscle aches, or joint aches
• sweating or clammy skin
• abdominal cramps and pain
• loss of appetite

Diarrhea caused by viral gastroenteritis isn’t usually bloody. Blood in your stool could be a sign of a more severe infection.

You should seek emergency medical treatment if:

• diarrhea has lasted for 2 days or more without getting less frequent
• your infant develops diarrhea
• blood is present in your diarrhea
• you show or see signs of dehydration, such as dry lips or dizziness

In addition to the above symptoms, you should seek emergency attention for your child if they have the appearance of sunken eyes or if they aren’t making tears when they cry.

Viral gastroenteritis is caused by a number of different viruses. It’s easy for these viruses to spread in group situations. Some of the ways the virus is transmitted include:

• eating contaminated food or drinking contaminated water
• being in close contact with someone who has the virus
• sharing utensils or other items with someone who has the virus
• touching contaminated surfaces
• not washing hands properly, especially food handlers

Viral gastroenteritis affects people of all ages all over the world. But some factors can increase the risk of contracting viral gastroenteritis. People who are at a higher risk include:

• children under the age of 5
• older adults, especially those who live in nursing homes or assisted living facilities
• people with a compromised or weakened immune system
• those who are often in group settings, such as schools, dormitories, day care, religious gatherings, and other indoor group settings

Other factors that may increase the risk of becoming ill with viral gastroenteritis include:

• being malnourished, especially low levels of vitamin A or zinc
• recent travel to developing countries
• antibiotic or antacid use
• anal intercourse

Several different types of viruses can cause viral gastroenteritis. The most common include:

• norovirus
• rotavirus
• adenovirus
• astrovirus

Let’s look at each of these viruses in more detail.

Norovirus

Norovirus is highly contagious and can affect anyone at any age. It spreads through contaminated food, water, and surfaces, or by people who have the virus. Norovirus is common in crowded spaces.

Norovirus is the leading cause of gastroenteritis in the United States and worldwide. Most outbreaks in the United States occur between November and April.

Symptoms include:

• nausea
• diarrhea
• fever
• body aches

According to the Centers for Disease Control and Prevention (CDC), most people who become ill with norovirus start to feel better within 1 to 3 days of symptom onset.

Rotavirus

Rotavirus commonly affects infants and young children. Those who contract it can then pass the virus to other children and adults. It’s usually contracted and transmitted via the mouth.

Symptoms typically appear within 2 days of infection and include:

• vomiting
• loss of appetite
• watery diarrhea that lasts anywhere from 3 to 8 days

A rotavirus vaccine was approved for infants in 2006. Early vaccination is recommended to prevent severe rotavirus illnesses in infants and small children.

Adenovirus

The adenovirus affects people of all ages. It can cause several types of illness, including gastroenteritis. The adenovirus can also cause common cold-like symptoms, bronchitis, pneumonia, and pink eye (conjunctivitis).

Children in daycare, especially those under 2 years of age, are more likely to get adenovirus.

Adenovirus is passed through the air via sneezing and coughing, by touching contaminated objects, or by touching the hands of someone with the virus.

Symptoms associated with adenovirus include:

• sore throat
• pink eye
• fever
• coughing
• runny nose

Most children will feel better within a few days of experiencing adenovirus symptoms. However, symptoms such as pink eye may last longer than a few days.

Astrovirus

Astrovirus is another virus that commonly causes gastroenteritis in children. Symptoms associated with astrovirus include:

• diarrhea
• headache
• mild dehydration
• stomach pain

The virus most often affects people in late winter and early spring. It’s transmitted through contact with a person who has the virus or via an infected surface or food.

Symptoms usually appear within 2 to 3 days after initial exposure, and the virus will usually go away within 1 to 4 days.

The main complication of viral gastroenteritis is dehydration, which can be quite severe in babies and young children. Viral gastroenteritis accounts for over 200,000 childhood deaths worldwide per year.

Other complications of viral gastroenteritis include:

• nutritional imbalances
• body weakness or fatigue
• muscle weakness

Dehydration can be life threatening. Call your doctor if you or your child have these symptoms:

• diarrhea lasting more than a few days
• blood in the stool
• confusion or lethargy
• dizziness or feeling like you’re going to faint
• nausea
• dry mouth
• an inability to produce tears
• no urine for more than 8 hours or urine that is dark yellow or brown
• sunken eyes
• sunken fontanel on an infant’s head

Dehydration that accompanies viral gastroenteritis can lead to several complications of its own. These include:

• brain swelling
• coma
• hypovolemic shock, a condition that occurs when your body doesn’t have enough fluid or blood
• kidney failure
• seizures

To prevent complications, get immediate medical attention if you or your child have symptoms of dehydration.

Viral gastroenteritis can spread easily. However, there are some steps you can take to lower your risk of contracting the virus or passing it to others.

Prevention tips

• Wash your hands often, especially after using the bathroom and before food preparation. If necessary, use hand sanitizer until you can access soap and water.
• Don’t share kitchen utensils, plates, or towels if someone in your household is sick.
• Don’t eat raw or undercooked foods.
• Wash fruits and vegetables thoroughly.
• Take special precautions to avoid contaminated water and food when traveling. Avoid ice cubes and use bottled water whenever possible.
• Ask your doctor if you should have your infant vaccinated against rotavirus. There are two vaccines, and they’re generally started around 2 months old.

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Viral gastroenteritis is an inflammation and irritation of your intestines caused by one of several types of viruses.

Vomiting and diarrhea are among the most common symptoms. You can get viral gastroenteritis from other people or through contaminated foods, drinks, or surfaces.

Generally, viral gastroenteritis symptoms come on suddenly and pass quickly. If diarrhea lasts longer than 48 hours, be sure to follow up with your doctor.

It’s also a good idea to get medical attention if your infant or young child develops diarrhea because it can lead to serious complications due to dehydration.

What Are They and How Long Does a Stomach Flu Last?

• Also known as the stomach flu or bug, norovirus often triggers painful gastrointestinal symptoms as well as fever, aches and headaches within days of exposure.
• Symptoms may last up to 72 hours after they begin, but this timeline may vary and depends on how you choose to recover at home.
• While there isn’t a specific medication for norovirus, frequently washing your hands and cleaning common areas in your home — including the bathroom and kitchen — are essential to keep it from spreading.

Federal health agents are warning Americans that annual cases of norovirus have recently been on a surge here in the United States, per data released by the Centers for Disease Control and Prevention (CDC). Highly viral, norovirus can trigger painful bouts of nausea, vomiting and diarrhea in those who touch contaminated surfaces or share direct contact with someone who is sick, highlighting the need once more for stringent handwashing.

According to CDC figures, more than 200 outbreaks of norovirus — which is sometimes referred to as the stomach flu or stomach bug, though it has no official ties to influenza — have occurred between August 1, 2022 and early January 2023. This is an increase compared to just 172 outbreaks during the same period last year, per the CDC; and positive norovirus cases continued to spike well into the end of February. And it’s likely that total norovirus cases are well underreported given that medical testing is required for a formal diagnosis, as CDC figures place real-time norovirus cases closer to 20 million each year.

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Norovirus tends to surge in the wintertime as more people head indoors, spending time at home fighting off other seasonal illnesses. And because norovirus is spread silently via microscopic virus particles — largely when people accidentally touch an infectious surface and put fingers inside their mouth, or share food or drinks with sick individuals — it can easily rip through whole households at once, explains Ali Alhassani, M.D., pediatrician at Boston Children’s Hospital and head of clinical at Summer Health, a digital pediatric care platform.

“Norovirus is highly contagious and only takes a small amount of virus to infect, [so] it makes sense that all of these factors combined have led to an uptick in cases recently,” Dr. Alhassani tells Good Housekeeping.

You may end up being unlucky enough to come into contact with norovirus by eating or drinking something that’s contaminated, prompting foodborne illness soon after. But one important aspect of preventing this one-off case from affecting loved ones in your household lies in disinfecting high-touch surfaces in your bathroom and in the kitchen, explains Carolyn Forté, the Good Housekeeping Institute‘s Home Care & Cleaning Lab Executive Director.

Read on to learn more about common norovirus warning signs, treating the illness effectively and how you may work to prevent others in your family from getting sick, too.

Common norovirus symptoms

Many associate the stomach flu with gastrointestinal issues that can make everyday life (and even eating!) feel impossible, causing immense pain for days on end. But federal health experts are keen to note that norovirus may also cause other flu-like symptoms, which should clue you into speaking with your doctor to see if norovirus may be to blame. If you’re experiencing headaches or body aches alongside stomach discomfort for days on end, there’s a chance that norovirus is at play.

This year’s norovirus outbreaks have proved consistent with years past, meaning Americans can continue to look for these two particular subsets of symptoms if they’re concerned they’re experiencing a norovirus illness.

“Norovirus symptoms [primarily] include nausea, vomiting, diarrhea, stomach cramping, and sometimes fever, headache and body aches,” Dr. Alhassani explains. “These symptoms are relatively consistent with other strains of years past.”

Diarrhea and vomiting can be particularly concerning, as they may easily lead to dehydration, which can prompt a worsening condition due to things like dizziness and dry mouth. Younger children may not be able to express their thirst at this time, either, and caregivers will see a lack of tears during frustrated cries if this is the case as well.

Since someone can experience a few of the hallmark symptoms of norovirus infections as standalone issues, you may be wondering if your GI discomfort is norovirus-related or something more fleeting. There isn’t a bonafide way to tell, but doctors say that the easiest way to distinguish between norovirus and lesser gastrointestinal distress is how long the issue persists.

“Norovirus symptoms usually appear 12 to 48 hours after exposure, but temporary upset stomach symptoms appear much faster — within a couple of hours,” Dr. Alhassani adds. “However, symptoms from an upset stomach will subside within 24 hours at most, which isn’t the case for norovirus infections.”

To recap, this is the full list of potential norovirus symptoms as noted by CDC officials:

• Fever
• Headache
• Body aches
• Stomach pain
• Nausea
• Vomiting
• Diarrhea

It’s crucial to remember that norovirus — which is just one example of enterovirus, a group of viruses that may impact the gastrointestinal tract — may require hands-on medical care and, in some cases, hospitalization if symptoms are severe and left unchecked.

How long does norovirus last?

Unlike other discomforting issues like food sensitivity or poor food quality, norovirus illness doesn’t usually produce immediate symptoms; it may be a few days before the symptoms listed above present in impacted individuals. Dr. Alhassani says most cases of norovirus cause symptoms to become apparent between 12 and 48 hours after exposure.

Not all illnesses caused by norovirus are the same, meaning some individuals may have more severe symptoms based on their own exposure as well as any preexisting health conditions. If you are currently experiencing norovirus sickness, you should expect to feel extremely ill and to experience continuous gastrointestinal issues throughout the day. Feeling continuously nauseous or experiencing chronic diarrhea is expected, for example, until the sickness has run its course.

How does norovirus spread?

Put simply, norovirus can spread through feces, vomit and other bodily excretions — and more often, through small virus particles that remain transmissible on a contaminated surface. CDC officials note that those who are impacted can “shed billions of norovirus particles” that are naked to the eye, and only a relatively small amount of these viral particles can infect another otherwise healthy individual.

People are most contagious when they are experiencing symptoms, as well as during the first few days of recovery when symptoms have largely subsided, according to published research.

Because viral norovirus particles may easily contaminate surfaces — including food that may be placed on sullied surfaces in the kitchen — keeping your hands properly washed if you are sick is crucial. Your family will also need to keep an eye on the rest of your home; both Clorox and Lysol make products that can effectively kill traces of norovirus on surfaces when used according to manufacturer’s directions, our Good Housekeeping Cleaning Lab experts say.

“Food prep and food contact surfaces are important as are most high-touch areas in both the bathroom and the kitchen, including faucet handles, appliance handles, cabinet and drawer pulls, light switches, and shower knobs,” explains Forté. “And most of these products recommend rinsing after using them on food contact surfaces, like countertops and a baby’s high chair tray. Make sure you check the usage directions about food contact surfaces.”

Using a cleaning product versus a disinfectant spray requires different approaches — but whichever product you use at home to keep norovirus from spreading, be sure you thoroughly clean the surfaces first, then keep them wet with the disinfectant for the required time. For example, Purell’s Multi-Surface Disinfectant requires a surface to remain wet with cleaner for 30 seconds to one minute to fully disinfect.

“Follow the usage directions on products by keeping the surface wet for the required time to be sure the product is completely killing germs,” Forté adds.

Lastly, it’s important to note that hand sanitizer doesn’t always work to eliminate norovirus risk, and shouldn’t be substituted for handwashing, according to the CDC.

How to treat norovirus at home

The only way to confirm if you are experiencing a norovirus infection is to seek out medical care from your doctor or a qualified urgent care clinic, where a PCR test will confirm the virus’ presence. There isn’t a particular medication used to treat norovirus alone, but further medical attention may be necessary to treat severe dehydration caused by chronic vomiting and diarrhea.

Staying well hydrated while you are recovering is essential, working in plenty of water and other fortifying beverages to help your body recover, Dr. Alhassani adds. Using over-the-counter products like Tylenol or Advil may ease non-gastrointestinal issues as you recover.

“Eating foods that are easier to digest — think items like crackers, toast, rice, and potatoes, for example — are helpful with GI distress,” he says. “Most importantly, practicing good hand hygiene will help prevent illness and keep other people inside the home from catching it as well.”

Read More:

• How to Completely Disinfect Your Toilet

Zee Krstic

Health Editor

Zee Krstic is a health editor for Good Housekeeping, where he covers health and nutrition news, decodes diet and fitness trends and reviews the best products in the wellness aisle. Prior to joining GH in 2019, Zee fostered a nutrition background as an editor at Cooking Light and is continually developing his grasp of holistic health through collaboration with leading academic experts and clinical care providers. He has written about food and dining for Time, among other publications.

Coronavirus disease 2019 (COVID-19) – Criteria

This section is available free of charge

World Health Organization: Severity of COVID-19[79]World Health Organization. COVID-19 clinical management: living guidance. 2021 [internet publication].
https://www.who.int/publications/i/item/WHO-2019-nCoV-clinical-2021-1

Mild disease

• Symptomatic patients who meet the COVID-19 case definitionwithout signs of hypoxia or pneumonia.

• Symptoms include fever, cough, fatigue, anorexia, shortness of breath and myalgia. Other non-specific symptoms include sore throat, nasal congestion, headache, diarrhea, nausea/vomiting, and loss of smell/taste. The following additional neurological manifestations have also been reported: dizziness, agitation, weakness, convulsions, or signs of a stroke. Fever or cough may not be as common in children as in adults.

• Atypical symptoms (eg, fatigue, decreased alertness, decreased mobility, diarrhoea, loss of appetite, delirium, absence of fever) may occur in the elderly and those with immunosuppression.

• Symptoms of physiological adjustments during pregnancy and adverse effects of pregnancy (eg, shortness of breath, fever, gastrointestinal symptoms) or other illnesses (eg, malaria) may overlap with symptoms of COVID-19.

Moderate illness

• Adolescents or adults: Clinical signs of pneumonia (fever, cough, shortness of breath, rapid breathing) but no signs of severe pneumonia, including oxygen saturation in room air (SpO₂) ≥ 90%.

• Children: Clinical signs of mild pneumonia (eg, cough or difficulty breathing plus rapid breathing and/or retraction of the intercostal spaces) and no signs of severe pneumonia. Rapid breathing is defined as:

  • Age <2 months: ≥ 60 bpm

  • Age 2-11 months: ≥ 50 bpm

  • Age 1-5 years: ≥ 40 bpm 900 03

• Diagnosis can be based on clinical findings, but chest imaging can help diagnose and identify or rule out pulmonary complications.

Severe illness

• Adolescents or adults: clinical signs of pneumonia (fever, cough, shortness of breath, rapid breathing) plus one of the following:

  • Respiratory rate > 30 bpm.

  • Severe respiratory distress

  • SpO₂ ≤90% when breathing room air.

• Children: clinical signs of pneumonia (cough or panting) plus at least 1 of the following: 6 Severe respiratory distress (eg, rapid breathing, snoring , very pronounced retraction of the intercostal spaces)

• General warning signs: inability to breastfeed or drink, lethargy or unconsciousness, or convulsions

• 5 years: ≥40 breaths per minute).

Critical illness

• Acute respiratory distress syndrome (ARDS), sepsis, septic shock, acute thrombosis, or multisystem inflammatory syndrome in children.

National Institutes of Health: Clinical Classification of COVID-19[479] National Institutes of Health. Coronavirus disease 2019 (COVID-19) treatment guidelines. 2021 [internet publication].
https://covid19treatmentguidelines.nih.gov

Asymptomatic and subsymptomatic infection

Mild disease

• People who have any signs and symptoms (eg, fever, cough, sore throat, malaise, headache, muscle pain, nausea , vomiting, diarrhea, loss of taste and smell) without dyspnoea or abnormal chest imaging findings.

Moderate disease

Severe disease

Critical illness

Persistent symptoms or organ dysfunction after acute COVID-19

• People who have persistent symptoms and/or organ dysfunction after an acute illness. Also called post-COVID syndrome or long-term COVID. See the Complications section for more information.

Case definition

There are several case definitions:

• WHO: public health surveillance for COVID-19 – interim guidance
  Opens in new window

• CDC: coronavirus disease 2019 (COVID-19) 2020 interim case definition
  Opens in new window

• ECDC: case definition for coronavirus disease 2019 (COVID-19)
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