Norovirus cases are surging. A doctor explains what to look for

(CNN) — A common stomach bug is surging, according to new data from the US Centers for Disease Control and Prevention.

In the week of December 5, there were 91 outbreaks of norovirus reported, up from 69 the previous week. In the same period in recent years, there generally were 65 or less outbreaks per week. (It might not seem like a lot, but many more cases probably go unreported.)

With cases on the rise, more people may want to know how norovirus is spread, what symptoms to expect and how long they can expect to be sick. What should they do if they think they may have it? At what point should they go to the doctor? What food safety tips can reduce the risk of spreading norovirus? And what else can be done to prevent the spread of it and other foodborne illnesses?

To help with these questions, I spoke with CNN wellness expert Dr. Leana Wen. Wen is an emergency physician and clinical associate professor at George Washington University. She previously was Baltimore’s health commissioner, with responsibilities that included overseeing infectious diseases as well as food safety.

CNN: What exactly is norovirus?

Dr. Leana Wen: Norovirus is the leading cause of foodborne illness in the US. According to the CDC, it is responsible for 19 million to 21 million illnesses every year. It results in over 2.2 million outpatient medical visits, 465,000 emergency department visits and 109,000 hospitalizations.

Also sometimes called the Norwalk virus or winter vomiting bug, norovirus is an extremely contagious virus. It is a common cause of illness outbreaks on cruise ships, where more than 90% of diarrheal illnesses are attributed to this virus. It also causes outbreaks in schools, day care centers, jails and other settings where individuals come into proximity with others.

CNN: How is norovirus spread?

Wen: Norovirus can be spread through direct contact with an infected person or through contaminated surfaces. If you share food or drink or utensils with an infected person, you could pick up the virus. You could also contract it by touching a surface that an infected person touched and then touching your mouth. In addition, the virus could be transmitted through tiny drops of vomit or fecal material that splatter onto surfaces.

CNN: What symptoms should people expect and for how long?

Wen: Symptoms of norovirus include nausea, vomiting, diarrhea and stomach cramps. Some people may also experience fatigue, low-grade fever, chills, headaches and muscle aches.

It’s common for people to go from feeling well to suddenly having gastrointestinal symptoms. These symptoms can be unnerving and unpleasant.

The good news is that most people improve within one to two days and recover completely, with no long-term health effects. There are, though, some people who become severely ill from norovirus, usually because they are unable to keep down fluids and become very dehydrated.

CNN: What should people do if they think they may have it?

Wen: There is no specific treatment for norovirus. As this is a virus, antibiotics that target bacteria won’t work. There is no directed antiviral against the norovirus, nor is there an approved vaccine to prevent it.

Most people will recover without medical intervention. The key is to try to keep down fluids to prevent dehydration, which can be a common side effect. Adults should drink water and most other fluids, including juice and sports drinks. Children can benefit from Pedialyte and other similar electrolyte solutions that are specifically formulated for kids with vomiting and diarrhea. Nursing moms should continue breastfeeding, even if they or their kids are experiencing gastrointestinal symptoms.

CNN: At what point should people go to the doctor?

Wen: People should contact their doctor if they have specific concerning symptoms, if they cannot keep up hydration, and if they are especially vulnerable to severe illness.

Those with typical norovirus symptoms can generally let the illness run its course. However, if they have blood in the stool, high fevers, shortness of breath or other unusual symptoms, they should consider consulting a medical professional — since what they have may not be norovirus. Those with norovirus should start feeling better in a couple of days after symptoms begin. If symptoms don’t improve, that’s another reason to visit the doctor.

In addition, it’s crucial to keep up hydration. If someone is vomiting so much that they are unable to keep down fluids, they should also see a health care professional. Families with babies who are no longer making the same number of wet diapers should also call their clinician.

Those who are especially vulnerable should have a lower threshold for contacting their health care provider. This includes babies and young children, older individuals and people with serious underlying medical conditions such as having kidney or heart disease and being immunocompromised. They may need a clinician to keep an extra close watch on them during their illness.

CNN: What food safety tips can reduce the risk of spreading norovirus?

Wen: People who have symptoms of vomiting, diarrhea and stomach cramping should not be preparing food. They shouldn’t handle food or plates or utensils for others until at least two days after their symptoms subside.

It’s also a good idea to wash your hands before eating. You may have touched a doorknob, elevator button, serving spoon or some other surface that an infected person touched.

If someone in the household has norovirus, be aware that the virus can spread easily through the family. Everyone should regularly wash their hands well with soap and water, especially before eating and after using the bathroom. Infected surfaces can be cleaned with solutions containing bleach to kill the virus.

In addition, be aware that there are other foodborne illnesses, too, such as E. coli, salmonella and listeria. There are additional precautions that can prevent the spread of these illnesses, too.

CNN: Please remind us what some of these precautions are.

Wen: Don’t drink raw milk or eat raw or undercooked meat. Use an internal thermometer and make sure that what you are cooking reaches the recommended temperature.

Don’t eat perishable food that has been left out for more than two hours. Be sure to wash vegetables and fruits well and keep them separated from raw meat.

Everyone preparing or serving food should wash their hands well. Do not prepare food or share meals with people while having gastrointestinal symptoms. If everyone practices good hand hygiene with frequent handwashing — and using hand sanitizer when running water isn’t easily accessible — we could reduce the chance of contracting and spreading norovirus and other gastrointestinal illnesses.

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