Reviewed by GPhC Pharmacist at Priory Pharmacy Clinical Team, York
Quick answer: Norovirus, often called the winter vomiting bug, causes sudden nausea, vomiting and diarrhoea, and sometimes a high temperature, headache and aching limbs. It is unpleasant but usually clears up by itself in 2 to 3 days. The most important thing is to drink plenty of fluids to avoid dehydration, and a pharmacist can recommend oral rehydration sachets and paracetamol to help you feel more comfortable. Norovirus spreads very easily, so stay off work or school until you have had no symptoms for 48 hours, and avoid visiting hospitals and care homes. Wash your hands with soap and water, because alcohol hand gels do not kill norovirus, clean surfaces with a bleach-based product, and wash contaminated clothes and bedding on a hot wash. Contact NHS 111 if you are worried about a baby or young child, you have signs of dehydration, there is blood in your vomit or poo, or vomiting lasts more than 2 days. In York, ask your local pharmacy for advice on managing symptoms and keeping your household well.
Few bugs empty a classroom or office quite like norovirus. It’s the most common cause of sickness and diarrhoea in the UK, and it peaks in the colder months, which is why it’s often called the winter vomiting bug. It’s unpleasant, but most people get better within 2 to 3 days. The main things are to stay hydrated and to stop it spreading to everyone else at home.
What are the symptoms?
Norovirus usually starts suddenly, often 1 to 2 days after you’ve caught it. Symptoms include:
- feeling sick, often followed by vomiting
- diarrhoea
- stomach cramps
- a high temperature
- a headache and aching arms and legs
How does it spread?
Norovirus is highly contagious. Only a tiny amount of the virus is needed to make someone ill. It spreads through:
- close contact with someone who has it
- touching surfaces or objects that have the virus on them, then touching your mouth
- eating food prepared by someone who is infected
It can survive on surfaces for days, which is why outbreaks are common in schools, nurseries, care homes, hospitals and cruise ships.
Staying hydrated
Vomiting and diarrhoea make you lose fluids quickly. To stay hydrated:
- take small, frequent sips of water or diluted squash, rather than large gulps
- try oral rehydration sachets, available from The Priory Pharmacy, which replace lost salts and sugars
- give children ice lollies or small sips from a spoon if they won’t drink
- keep breastfeeding or bottle-feeding babies, and offer small amounts more often
When you feel ready to eat, start with plain foods such as toast, crackers, rice or pasta.
Signs of dehydration
Watch out for:
- dark yellow, strong-smelling pee, or not peeing much
- feeling dizzy or lightheaded
- a dry mouth, lips and eyes
- feeling very tired
In babies and young children, look for fewer wet nappies, a sunken soft spot on the head, few or no tears when crying, and unusual drowsiness or irritability.
The 48-hour rule
You’re most infectious while you have symptoms and for 48 hours after they stop. So:
- stay off work, school or nursery until 48 hours after your last episode of vomiting or diarrhoea
- don’t prepare food for other people during this time
- avoid visiting hospitals and care homes for at least 48 hours
If you work with food or in healthcare, check with your employer, as stricter rules may apply.
Cleaning up properly
Hand gel won’t do the job, because alcohol doesn’t kill norovirus. Instead:
- Wash your hands thoroughly with soap and warm water, especially after using the toilet and before eating.
- Clean up any vomit or diarrhoea straight away, wearing disposable gloves if you have them.
- Disinfect the area and frequently touched surfaces, such as toilets, taps, door handles and remotes, with a bleach-based cleaner.
- Wash contaminated clothes and bedding separately on a hot wash.
- Give each person their own towel, and don’t share flannels.
Medicines
There’s no cure for norovirus, and antibiotics won’t help. Paracetamol can ease a high temperature and aches. Some adults can take medicine to slow diarrhoea, but it isn’t suitable for everyone, including children. Ask your pharmacist before taking anything, especially if you have other health conditions.
When to get help
Call NHS 111 or your GP if:
- you or your child have signs of dehydration
- a baby under 12 months has diarrhoea or vomiting
- vomiting lasts more than 2 days, or diarrhoea more than 7 days
- you have a long-term condition such as kidney disease or diabetes and you’re worried
- you can’t keep any fluids down
Call 999 or go to A&E if you’re vomiting blood or what looks like coffee grounds, have green vomit, have bloody diarrhoea or bleeding from your bottom, have a stiff neck and pain looking at bright lights, or have sudden, severe tummy pain.
Norovirus is miserable but usually brief. Focus on fluids, rest and good hygiene, and stay at home until 48 hours after your symptoms stop. For rehydration sachets and advice, ask the team at The Priory Pharmacy in Acomb or call 01904 404101.
This article is for general information only and isn’t a substitute for professional medical advice. If you’re concerned about your health or the health of someone you care for, speak to a pharmacist or GP, or call NHS 111.
Frequently Asked Questions
The main symptoms of norovirus are suddenly feeling sick, vomiting and diarrhoea, which often start without warning. Some people also have a high temperature, a headache and aching arms and legs. Symptoms usually begin 1 to 2 days after you pick up the virus and, although they can be very unpleasant, most people start to feel better within 2 to 3 days.
Norovirus spreads very easily and you are most likely to pass it on while you have symptoms. You can still spread it for at least 48 hours after your vomiting and diarrhoea have stopped, which is why it is important to keep washing your hands and avoid contact with others during this time. The virus can survive on surfaces and objects for several days, so cleaning your home properly also helps to stop it spreading.
There is no specific treatment for norovirus, but you can usually look after yourself at home. Drink plenty of fluids, such as water or diluted squash, taking small sips if you feel sick, and get plenty of rest. You can take paracetamol to ease a temperature, aches or pains, and eat when you feel able to. If you are breastfeeding or bottle feeding a baby, keep feeding as usual and offer small sips of water between feeds.
Wash your hands often with soap and water, especially after using the toilet and before eating or preparing food, as alcohol hand gels do not kill norovirus. Clean toilet seats, flush handles, taps and other surfaces with a bleach-based household cleaner, and wash any contaminated clothing or bedding separately on a hot wash. Avoid preparing food for other people while you are ill and do not share towels or flannels with anyone in your household.
Stay off work, school or nursery until you have not been sick or had diarrhoea for at least 48 hours, even if you feel well enough to return sooner. During this time, try not to visit hospitals or care homes, where norovirus can spread quickly and cause serious problems for vulnerable people. Children should follow the same 48-hour rule before going back to school or nursery.
Contact NHS 111 or your GP if you are worried about a baby under 12 months, your child stops breastfeeding or bottle feeding, or a child under 5 has signs of dehydration such as fewer wet nappies. You should also get advice if you still have signs of dehydration after using rehydration sachets, you have bloody diarrhoea, vomiting lasts more than 2 days or diarrhoea lasts more than 7 days. Call 999 or go to A&E if you are vomiting blood, have green or yellow-green vomit, or have a sudden severe headache or stomach pain.
A pharmacist can recommend oral rehydration sachets to help replace the fluids and salts lost through vomiting and diarrhoea, and advise on medicines to ease your symptoms. For adults, they may suggest a medicine to stop diarrhoea for a few hours, although these are not suitable for children. If you take regular medicines, such as those for diabetes or high blood pressure, ask a pharmacist whether being dehydrated affects how you should take them. Antibiotics will not help because norovirus is caused by a virus.