Norovirus, sometimes referred to as the stomach flu, sucks.
Unfortunately, if you’re the parent of young children, there’s a good chance you know that already. If you don’t, there’s a good chance you will.
Norovirus, which is not related to influenza, tends to hit in large numbers — cruise ship outbreaks have made headlines in the last few years, and more recently norovirus hit the Winter Olympics in Pyeongchang. Each year, this undesirable bug sends 70,000 people to the hospital; it’s the most common cause of foodborne-disease outbreaks, the Centers for Disease Control and Prevention (CDC) says.
The fact is, children appear to be the perfect host for this tenacious virus: They gather in large numbers at preschools, schools, day care centers, playgrounds; they don’t yet have a seasoned immune system; they play together in close quarters; and, let’s face it, they don’t always practice the highest levels of personal hygiene.
How it's spread
Extremely contagious, the norovirus spreads through contact with an infected person, contaminated food or water, or by touching contaminated surfaces. Unfortunately, the very symptoms that make norovirus so unpleasant are also the same symptoms that make it so quick to spread among youngsters.
In a fascinating piece on the norovirus over at National Geographic, Carl Zimmer explains why this may be so:
Some studies indicate that during a norovirus infection, our stomachs slow down the passage of food into the intestines. In other words, they seem to load up the stomach in preparation for vomiting. Every particle of that stored food is a potential vehicle for noroviruses when it comes flying out of the mouth.
Other studies show just how easily the disease launches itself onto, and eventually into, new hosts. It can, scientists say, become aerosolized by a toilet flush when diarrhea or vomit is present. It can be breathed in by simply being around an area where vomiting has occurred, even after it has been cleaned up. One study has even mapped an outbreak of norovirus in a restaurant, tracing it back to a single vomiting incident — and showing that diners on the other side of the room became infected by aerosolized particles.
(Given the importance of understanding the transmission process, scientists have even created a vomiting robot to help them understand more about how norovirus spreads.)
So what does all this theoretical knowledge mean for parents of young children and, really, anyone who wants to stay healthy?
Fortunately, there are several steps you can take to reduce the risk of infection, and to control its spread once it occurs:
Wash hands regularly: Washing hands often should be a tenet of good hygiene, whether you fear an outbreak of norovirus or not. Wash hands thoroughly with soap and hot water before eating, after using the toilet and after changing diapers. Consider also washing your child’s hands before and after school, preschool or play dates. If you are in the midst of an infection at your house, wash hands after any contact with the infected person or contaminated surfaces.
Use hand sanitizer: Alcohol rubs can help reduce the risk of infection, but they are not a replacement for thorough hand washing.
Disinfect surfaces: The CDC recommend a solution of household bleach in water (roughly 5–25 tablespoons of household bleach per gallon of water) as an effective surface disinfectant for the norovirus. Be sure to disinfect all surfaces immediately after an incident of vomiting or diarrhea. It may be helpful to also invest in bleach-based disinfecting wipes and use them whenever you fear a surface may have been contaminated.
Try not to breathe: OK — breathing is probably not optional, even when it feels like your household has come down with the plague. However, it is worth noting how easily the virus can be breathed in, and taking due caution to avoid unnecessary risk. Close the toilet seat before you flush; turn your head away if comforting a vomiting child; don’t hang around areas where vomiting or diarrhea has occurred, even after it has been cleaned up.
Wash everything thoroughly: Clothes, bedding, toys and other items that may have been contaminated should be immediately washed with regular detergent on the longest cycle available. The CDC recommends wearing rubber gloves when you do this. Follow up by drying the items in the dryer, not on a clothesline.
Keep your child home: It goes without saying that a child with norovirus should not be in school. Even after the vomiting has subsided, you should keep your child home for a minimum of 24 hours, and check with your school for its policy. Some schools and day care centers may even shut down if an outbreak is too widespread. (Incidentally, you should also follow the same advice — if you get sick, do not go to work until the symptoms have been clear for at least 24 hours — longer if you work with children, the elderly or with food preparation.) And consider asking your school, preschool or day care to make hand washing compulsory when children are signed into school, if it isn’t already.
Managing norovirus symptoms
For all the sensible advice to avoid unnecessary contact with a sick person, there’s no escaping the fact that you are a parent, and sometimes you just have to comfort a sick child. (Photo: Kaspars Grinvalds/Shutterstock)
Prevention and control are one thing; there’s science-based advice for that. But how you comfort a 3-year-old who has been vomiting for 12 hours straight, and who is desperate for a drink of water, is another story.
Here are a few things I’ve learned the hard way:
Avoid dehydration: Dehydration is probably the biggest risk from norovirus. Unfortunately, avoiding it is easier said than done when your body seems intent on ejecting any fluids you put in it. Try giving the infected person very small amounts of Pedialyte, coconut water or just plain water — no more than a tablespoon at first if vomiting is still regular — and gradually upping the amount as vomiting subsides.
Replace nutrients: With our toddler’s most recent bout of vomiting (yes, we are veterans of norovirus), she became so dehydrated that she suffered leg cramps. As she was able to keep more food and fluid down, we were able to give her multivitamins and a banana to replace calcium and potassium that may have been lost during her illness.
Comfort them profusely: For all the sensible advice to avoid unnecessary contact, there’s no escaping the fact that you are a parent. When a child is vomiting, in pain, and doesn’t know why, they need someone there to tell them it will be OK. Sure, look the other way and try not to breathe in the bug. Sure, slather everything with bleach immediately after. But most of all, hold back their hair, stroke their back, tell them you love them and remind them it will be over soon.
Allow as much screen time as they need: Many of us parents are wary of allowing too much TV or iPad time for our children. Trust me, however, an outbreak of norovirus is not the time to get too strict about this. Given that they’ll most likely be knocked out and vomiting for the next 24 to 48 hours, I recommend allowing as much Dora, Thomas or "Yo Gabba Gabba" as it takes to distract them from the unpleasant reality they are in.
Know when to go to the doctor: The last time our daughter got sick, we decided there was little point in taking her to the doctor. It was clearly a norovirus-like bug, she didn’t seem in any danger, and we were confident it would pass quickly. We didn’t think it was necessary to expose others to the virus. However, after 24 hours straight of vomiting every half hour, and being unable to keep a single droplet of liquid down, we began to get concerned about dehydration. We took her to the doctor, and the doctor was able to prescribe anti-nausea medication that allowed her to recuperate some lost fluids and begin the road to recovery. As mentioned above, she was still in pain from stomach cramps, leg cramps and diarrhea for the next day or so — but it at least stemmed the tide of vomiting.
Ultimately, dealing with norovirus appears to be a common feature of being a parent these days. However, by learning a little bit about how it spreads, what causes it and what you can do to lessen the risk, there’s a good chance you can help keep this menace in check.
Here’s a video with more tips for preventing and dealing with norovirus:
Editor's note: This story has been updated since it was originally published in April 2013.