Norovirus in Children

Norovirus is one of the most common causes of gastroenteritis in the United States. While it is notorious for causing outbreaks of diarrhea and vomiting on cruise ships, not everyone realizes it can also cause outbreaks in schools and daycare centers. Most cases of norovirus occur between November and April.

Each year in the United States, norovirus causes up to:

• 21 million cases of gastroenteritis
• 2.2 million healthcare provider visits
• 465,000 ER visits
• 109,000 hospitalizations
• 900 deaths

Norovirus cases in children account for nearly 1 million medical care visits each year. Among very young children, norovirus can be life-threatening.

Norovirus causes about 58% of foodborne illnesses in the United States. In contrast, salmonella, which gets a lot more attention, only causes about 23% of cases.

If norovirus is so common, how come more people don't know about it? It is likely because most people don't actually know when they have norovirus. Instead, they blame their symptoms on food poisoning, the stomach flu, or some other gastrointestinal infection.

Norovirus Symptoms

Norovirus symptoms are very similar to other causes of gastroenteritis, including vomiting and watery diarrhea. Other symptoms might include:

• Nausea
• Stomach cramps
• Low-grade fever
• Body aches
• Fatigue

In most cases, norovirus symptoms only last a few days. However, in younger children and the elderly, symptoms can sometimes last longer and be more severe.

Causes

Norovirus is highly contagious and is spread by:

• Direct exposure to someone who is sick
• Having contact with something that has been contaminated with the virus
• Eating food or drinking water that has been contaminated
• Swimming in contaminated pools or lakes

The period between when people are exposed to norovirus and when they get sick (called the incubation period) is about 12 to 48 hours.

Diagnosis

In many cases, norovirus is diagnosed after a discussion with the healthcare provider about symptoms. Stool samples can be tested for norovirus, but this is not routinely done by most pediatricians because of the short course of the infection.

Treatment

There is no medicine to treat norovirus. Instead, treatment focuses on managing symptoms at home. Patients can take these steps to ease norovirus symptoms:

• Drink plenty of fluids.
• Eat bland—but healthy—foods.
• Rest as needed.

Fortunately, most people recover quickly from norovirus, with vomiting and diarrhea lasting just one to three days.

Complications

Dehydration is a leading complication of norovirus infection, and can be serious, particularly in young children and the elderly. Signs of dehydration to watch for in young children and babies can include:

• Lack of urination (or fewer wet diapers)
• Dark yellow or orange pee
• No interest in drinking
• A lack of tears when crying
• Sunken fontanelle (soft spot) in infants

Prevention

There is no cure for norovirus infections, so that makes it important to try to prevent infections before they happen. Like the flu and many other viral infections, people typically don't develop immunity to norovirus and can become infected more than once. To help avoid norovirus infection and keep the virus from spreading when you are sick, it can help to:

• Regularly wash your hands with soap and water.
• Thoroughly disinfect surfaces with a bleach-based household cleaner.
• Wash clothing that becomes contaminated after someone throws up or has diarrhea.
• Avoid preparing and cooking food for other people until you have been over your norovirus symptoms for at least two days.
• Avoid swimming in a pool if you have been vomiting or if you recently had diarrhea.
• Wash fruits and vegetables before eating them.
• Avoid raw oysters.

The World Health Organization has made the development of a norovirus vaccine a priority. A norovirus vaccine is already being tested in adults, but it is unclear when it will become available and if children can have it. Some experts have suggested a combined rotavirus and norovirus vaccine to help prevent both common causes of viral gastroenteritis.

A Word From Verywell

Parents know how difficult it can be when their child is sick. If your child has been diagnosed with norovirus, it's important to keep them comfortable and well-hydrated while the virus runs its course. Stay vigilant for signs of dehydration, particularly in infants and younger children, and contact your healthcare provider if you have questions or concerns.