There are many gastrointestinal infections that spread person-to-person, including E. coli, salmonella and listeria, but by far the most common is the norovirus.
Norovirus typically infects some 20 million people in the U.S. every year, and this winter has seen an increase in reported outbreaks.
The virus is highly transmissible, resistant to alcohol (the active ingredient in most hand sanitizers) and heat, and persists for many days on surfaces such as counters.
Places where people are in close quarters and sharing food preparation are particularly prone to outbreaks: cruise ships, nursing homes, schools and day care centers.
The symptoms: nausea, vomiting, cramps and diarrhea, usually begin very abruptly – you feel fine one minute and then all the symptoms hit you. If there is a fever, it is usually low-grade. The symptoms generally only last 2-3 days and most people recover uneventfully.
There is no specific treatment; antibiotics are of no use. The most important therapy is fluids to prevent dehydration. Adults can drink plain water, tea, sports drinks or light fruit juices. Children will benefit from pediatric-tailored electrolyte solutions.
While most healthy people will do fine at home taking frequent small amounts of fluid, an ER visit or even hospitalization may be needed if you cannot keep down liquids.
A persistent fever of 101 or more is unusual and warrants at least a call to your doctor. Blood in the stool is also not expected and should prompt medical attention.
The best way to avoid catching norovirus is good hand-washing before you eat or prepare food, and cleaning surfaces with bleach if they may have been exposed to virus particles.
Note that virus may be shed in the stool for up to two weeks, long after you have recovered, so be careful if you have had such symptoms to wash well after using the toilet and you had best not handle food.
Norovirus has also spread via shellfish and other food. Cook shellfish to an internal temperature of over 145 F and wash all fresh fruits and vegetables.
If you do catch it, remember that “this too shall pass.”
Edward Hoffer MD is Associate Professor of Medicine, part-time, at Harvard.
What Does The Doctor Say?
By Dr. Edward Hoffer