It was 11pm and I had just fallen asleep when I heard a scream from my 4 year old son’s room. I headed downstairs to find a trail of vomit on the carpet and up the stairs, where it tried to make its way into my bedroom. The next few hours were a blur as I rushed back and forth to the bathroom. The second time he got sick, he vomited right on my hand, on my robe, in my hair. Even though I worked frantically scrubbing my hands and face with soap and water and getting all my clothes and bedding in the laundry, I knew I would be the next person to experience norovirus at home.
How can I be sure? Norovirus spreads quickly and efficiently.
Many factors contribute to its spread:
- Infectious dose: With only 100 (or fewer) viral particles, norovirus can infect the next person. Given that there are between 1-100 million particles in just 1 milliliter of vomit, only a small amount is needed to pass the infection.
- Stability in the environment: Norovirus is hardy due to its hard protein shell. It is resistant to extreme temperatures, lives for days to weeks, and is resistant to many common cleaning agents, including alcohol-based hand sanitizers. If an infected person vomits in the bathroom (or elsewhere), each contaminated surface should be cleaned with a disinfectant (usually bleach) that can effectively kill norovirus.
- Modes of transmission: Norovirus is spread via the fecal-oral route, aerobic particles from vomit, and any close contact with viral particles on a countertop or door handle.
As expected, after about 40 hours – the incubation period is over 12-48 hoursallowing the virus to spread rapidly in crowded locations – I got sick. Although norovirus has existed in the past, immune memory is often short-lived compared to some other viruses, and previous memory of a different strain may not be protective. My daughter’s symptoms followed 6 hours later from a rug I couldn’t sanitize, a doorknob I didn’t scrub well, or simply from playing with her brother the next day, who is still learning hand hygiene. Even if symptoms resolve quickly, people Keep getting rid of the virus. This means that one ineffective hand a day (or week) after illness can lead to continued spread.
Symptom management
My son was more miserable than my daughter, and asked for stomach medicine or a glass of water. I didn’t have any antiperspirants in the cupboard and his dry, red lips showed his dryness. I told him to take one sip from the cup next to his bed to start hydrating. Unfortunately, he dropped about 6 ounces, which he promptly vomited. We changed tactics to a small medicine cup with an ounce of pedialyte and then put a timer on for 15 minutes. Once he kept that down, we continued with small ounce cups every 5-15 minutes.
Age specific Oral therapy (ORT) therapy It’s best done with a liquid with salt and sugar – Pedialyte, a diluted sports drink, or even diluted apple juice. Oral antidotes may help with dehydration, especially if the patient has not had success with ORT at home. Protocols in medical settings that include early use of medications such as Ondansetron (Zofran) coupled with ORT are demonstrated Shorter visits and reduced usage From the fourth fluid. Likewise, anti-fatigue medications may help reduce fluid losses after acute illness while the intestinal track begins to heal. Some patients may be able to tolerate a normal diet within a day, while others may experience postpartum symptoms that require dietary modification while the gastrointestinal (GI) tract recovers.
Sharing this guidance with patients, or parents of patients, can guide their recovery.
Why are we seeing more cases this year?
Our house was just a microcosm of the existing environment. In January 2025, revised Norovirus positive It has been reported by US Laboratory Network to be more than double last season, and may have peaked earlier than previous seasons. This is due to the presence of a new strain, GII.17[P17]. In seasons when a new strain is circulating, a country can see a significant increase in cases compared to usual seasons, which is higher than normal.
Stay safe in the hospital
Norovirus spreads through households, in crowded settings such as day care facilities and cruise ships, through contaminated food and, unfortunately, in the workplace – including the hospital. Remember, only 100 islands of the virus are needed to spread to another person.
Take this scenario: You’ve just checked a baby dehydrated for norovirus and adjusted his diaper, which is teeming with the virus. After the visit, you can use an alcohol-based hand rub instead of soap and water. Particles stay on your hands. You can grab a handful of M&MS from the Break Room Candy Bowl before the next patient. Not only are you likely to become sick, but with the Candy Bowl contamination, the next few employees with M&MS symptoms are likely to become symptomatic as well.
How do you stop it spreading through a hospital?
- Practice meticulous hand hygiene. This is necessary. Wash hands with soap and water rather than an alcohol-based hand rub for a full 20-30 seconds after caring for patients with gastrointestinal disease, before eating, after using the bathroom, and before preparing food.
- Identify patients with gastrointestinal symptoms and follow hospital practices for testing and isolation. Isolation practices can be symptom-based, and testing can be used to identify trends in your community or outbreaks at your organization that may change infection prevention practices.
- Follow and share food safety guidelines. Eat and drink only in non-patient care areas. Avoid finger foods or shared snacks. Have hand hygiene available in hospital break rooms.
- Pay attention to your personal protective equipment. Use standard precautions to protect yourself when changing diapers. If you mask while caring for patients, change your mask after caring for a patient who has gastroenteritis or is actively vomiting, as it can become contaminated.
- Make sure your care areas are easy to clean. Reduce clutter and provide readily available disinfectants with the Norovirus claim.
- Stay home when sick. Make sure your practice has a strong turnover policy that supports employees who stay home when sick. If possible, ask staff to report gastrointestinal symptoms to understand if you have spread it to the hospital.
Avoiding norovirus is possible
Remarkably, in our household of Norovirus sufferers, my husband has remained unharmed—or at least asymptomatic. how? He recalled my vivid descriptions of hidden norovirus spread in the workplace: bowls of popcorn and bags of soda, contaminated with one unwashed hand, infecting an entire group. Motivated by this knowledge, he practiced impeccable hand hygiene, ran loads of laundry, and disinfected every surface he touched.
His efforts served as a reminder that although norovirus is known, its spread is not inevitable. With vigilance and prevention, even norovirus can be contained.
Lori Handy, MD, MSCE, He is Associate Director of the Vaccine Education Center and an attending physician in the Division of Infectious Diseases at Children’s Hospital of Philadelphia (CHOP). She is also an assistant professor of clinical pediatrics at the Perelman School of Medicine.
