Cases of norovirus, commonly called "winter vomiting disease," are spreading across the United States earlier than usual this season, with levels rising since mid-October according to wastewater surveillance data.

The Current Surge

National monitoring programs from Stanford and Emory University have detected notable increases in Louisiana, Michigan, and Indiana. The CDC reported 153 norovirus outbreaks between August and mid-November, marking an ahead-of-schedule surge for the typical season that runs from November to April.

Despite the early timing, current outbreak trends remain lower than last year's 235 outbreaks during the same period.

Why Cases Are Rising Now

Several factors contribute to the current increase in norovirus infections:

Seasonal patterns: Cold weather drives people indoors where the virus spreads more easily in close quarters at schools, workplaces, and social gatherings.

Holiday travel: Crowded transportation and increased social gatherings create ideal conditions for transmission.

Environmental conditions: The virus survives better in cool, dry air, while lower vitamin D levels and drier air can weaken immune defenses during winter months.

Understanding the Norovirus

Norovirus is a highly contagious virus that primarily affects the gastrointestinal system. While many associate it with cruise ship outbreaks, the virus commonly spreads in schools, nursing homes, and other communal settings.

The virus spreads through contaminated food, water, hands, and surfaces. Only a tiny amount of the virus is needed to cause infection, and it can survive on surfaces for several days.

Recognizing the Symptoms

Norovirus symptoms typically appear 12 to 48 hours after exposure and develop rapidly. Common signs include:

• Vomiting and diarrhea (often the first symptoms)
• Stomach cramps and nausea
• Abdominal pain
• Low-grade fever
• Headaches and fatigue
• Body aches​

Most symptoms resolve within one to three days.

Prevention Strategies

Protecting yourself from norovirus requires consistent hygiene practices:

Wash hands thoroughly: Use soap and water rather than alcohol-based sanitizers, which are less effective against norovirus.

Avoid sharing: Don't share food, drinks, or utensils with others.

Disinfect surfaces: Clean high-touch areas with bleach-based cleaners, as the virus can survive on surfaces for extended periods.

Handle contaminated items carefully: Wash affected clothing and bedding on hot cycles if someone in your household becomes sick.

What to Do If You Get Sick

There are no medications to eliminate norovirus, so treatment focuses on managing symptoms:

Hydration and Rest:

• Stay hydrated: Drink small amounts of fluid (one to two tablespoons at a time) to replace what's lost and reduce nausea. Electrolyte solutions can be helpful.
• Rest adequately: Avoid physical exertion during the first 24 to 48 hours when symptoms are most severe. Gradually resume normal activities as energy returns.

Dietary Management:

• Wait until vomiting stops for several hours before attempting to eat solid foods
• Start with bland foods like toast, bananas, rice, or boiled chicken when you feel able to eat
• Avoid dairy products, caffeine, alcohol, and fatty or spicy foods until fully recovered

Hygiene and Prevention of Spread:

• Stay home: Avoid contact with others to prevent spreading the virus
• Wash hands thoroughly with soap and water (not hand sanitizer, which is less effective against norovirus) after using the bathroom and before touching anything
• Clean and disinfect contaminated surfaces immediately with bleach-based cleaners
• Wash contaminated clothing and linens separately in hot water
• Avoid preparing food for others for at least 48-72 hours after symptoms resolve

​

Medication Guidance:

• Avoid anti-diarrheal medications unless directed by a doctor, as they may prolong the infection
• Use fever reducers like acetaminophen if needed, but avoid aspirin in children

When to Seek Medical Care:

Seek immediate medical attention if you experience:

• Signs of severe dehydration: dry mouth, dizziness, decreased urination, dark urine
• Bloody stool or vomit
• High fever (above 40°C/104°F)
• Symptoms lasting more than several days
• Inability to keep any fluids down
• Severe weakness or if you have serious preexisting medical conditions

Note: Infants, elderly, and immunocompromised individuals should consult a doctor earlier, as they're at higher risk for complications.

The Bottom Line

With holiday gatherings and winter activities in full swing, taking preventive measures is essential. Proper handwashing, careful food handling, and staying home when sick can help protect yourself and others from this highly contagious virus.