Norovirus

Symptoms of norovirus 

Norovirus can be very unpleasant but it usually clears up by itself in a few days.

Symptoms of norovirus infection usually:

• begin 24-48 hours after infection
• last for 12-60 hours

You can normally look after yourself or your child at home.

Try to avoid going to your GP, as norovirus can spread to others very easily. Call your GP or GP out of hours services if you're concerned or need advice (see When to get medical advice below).

Norovirus infection can occur in people of all ages. You can get norovirus more than once because the virus is always changing. Due to this, your body is unable to build up long-term resistance to it.

If you have a norovirus infection, your symptoms may include:

• suddenly feeling sick
• projectile vomiting
• watery diarrhoea

Some people also have:

• a slight fever
• headaches
• painful stomach cramps
•  aching limbs

What to do if you have norovirus 

If you get sudden diarrhoea and vomiting (gastroenteritis), the best thing to do is to stay at home until you're feeling better. There's no cure for norovirus - you have to let it run its course.

You don't usually need to get medical advice unless there's a risk of a more serious problem (see When to get medical advice).

To help ease your own or your child’s symptoms:

• drink plenty of fluids to avoid dehydration - You need to drink more than usual to replace the fluids lost from vomiting and diarrhoea (as well as water, adults could also try fruit juice and soup)
• avoid giving fizzy drinks or fruit juice to children as it can make their diarrhoea worse - babies should continue to feed as usual, either with breast milk or other milk feeds
• take paracetamol for any fever or aches and pains
• get plenty of rest
• if you feel like eating, eat plain foods, such as soup, rice, pasta and bread
• use special rehydration drinks made from sachets bought from pharmacies if you have signs of dehydration, such as a dry mouth or dark urine
• adults can take antidiarrhoeal and/or anti-emetic (anti-vomiting) medication – these are not suitable for everyone though, so you should check the medicine leaflet or ask your pharmacist or GP for advice before trying them

Babies and young children, especially if they're less than a year old, have a greater risk of becoming dehydrated.

Norovirus can spread very easily, so you should wash your hands regularly while you're ill (always after using the toilet and before eating /preparing food).

You should also stay off work or school until at least 48 hours after the symptoms have cleared. This will help to reduce the risk of passing it on (see Preventing norovirus below).

• Looking after babies and children under five who have diarrhoea and vomiting

When to get medical advice 

You don't normally need to see your GP if you think you or your child has norovirus, as there's no specific treatment for it.

Antibiotics won't help because it's caused by a virus.

Visiting your GP surgery with norovirus can put others at risk. It is best to call your GP or GP out of hours service if you're concerned or feel you need advice.

Norovirus is one of the viruses that cause gastroenteritis – read more about gastroenteritis.

You should contact your GP if:

• your symptoms are severe – for example, if you're unable to keep down any fluids because you are vomiting repeatedly (vomiting lasts more than two days for adults, 24 hours for children under age 2, or 12 hours for children 1 year or younger)
• your symptoms don't begin to improve after a few days - (children with diarrhoea who have defecated (pooed) more than five times in the previous 24 hours, adults with diarrhoea lasting more than 10 days)
• there is a temperature of 38°C or more in children younger than 3 months of age
• there is a temperature of 39°C or more in children 3 months of age or older/adults
• your baby or young child has suspected food poisoning - usually other people who have eaten the same food will experience similar symptoms
• there is any blood in the diarrhoea
• you have symptoms of severe dehydration - (see symptoms of dehydration )
• you're pregnant
• you're over 60
• in the last few weeks you've returned from a part of the world with poor sanitation
• you have a long-term underlying condition, such as inflammatory bowel disease (IBD), heart valve disease, diabetes or kidney disease
• you have a weak immune system – for example, because of medication, cancer treatment or HIV

In these situations, your GP may send off a stool (poo) sample for analysis. They may sometimes prescribe antibiotics, or they may refer you to hospital so you can be looked after more closely.

How norovirus can be spread

Norovirus spreads very easily in public places such as hospitals, nursing homes and schools.

You can catch it if small particles of vomit or poo from an infected person get into your mouth, such as through:

• close contact with someone with norovirus – they may breathe out small particles containing the virus that you could inhale
• touching contaminated surfaces or objects – the virus can survive outside the body for several days
• eating contaminated food – this can happen if an infected person doesn't wash their hands before handling food

A person with norovirus is most infectious from the period just before their symptoms start until 48 hours after all their symptoms have passed.

Preventing norovirus 

It's not always possible to avoid getting norovirus, but following the advice below can help stop the virus spreading.

• stay off work or school until at least 48 hours after the symptoms have passed - you should also avoid visiting anyone in hospital during this time
• wash your hands often and thoroughly with soap and water, particularly after using the toilet and before eating or preparing food - don't rely on alcohol hand gels, as they do not kill the virus
• disinfect any surfaces or objects that could be contaminated - it's best to use a bleach-based household cleaner
• wash any items of clothing or bedding that could have become contaminated separately on a hot wash to make sure the virus is killed
• don't share towels and flannels
• flush away any infected poo or vomit in the toilet and clean the surrounding area
• avoid eating raw, unwashed produce and only eat oysters from a reliable source, as oysters can carry norovirus

More useful links

• Hand hygiene
• How to use your health services
• Preventing the spread of germs