’Tis the season to escape the cold by staying indoors, increasing our togetherness — that’s why stomach flu cases peak during the winter months. This highly contagious viral infection afflicts 20 million Americans annually with severe vomiting and diarrhea, causing more than 900 deaths.
Outbreaks are surging, with rates 12% higher than in previous years, and the Northeast is the hardest hit, reporting a test positivity rate of 13%. Experts attribute the rise primarily to the lingering effects of the COVID-19 pandemic. Lockdowns and social isolation limited exposure to various viruses, including norovirus, which causes stomach flu, weakening natural immunity and increasing susceptibility to illness.
An infected person sheds billions of viral copies into their stool and saliva, but it takes only 10 norovirus particles to sicken caregivers who unwittingly ingest the virus due to poor hand washing. Contaminated surfaces also spread norovirus, which survives up to a week on kitchen counters, utensils and raw food — most commonly fruits and vegetables.
Stomach flu is different from “the flu,” an upper respiratory infection caused by the influenza virus. It is also not the same as food poisoning, a bacterial or parasitic illness that sickens the victim within six hours of eating contaminated fare.
Norovirus symptoms develop 24 hours after exposure: In addition to vomiting and diarrhea, intestinal cramps, low-grade fever and body aches are common. While most people get better in a few days, they remain contagious for up to a week. Children between 6 and 18 months, adults over 65, and the immunosuppressed are at risk for dehydration — a potentially fatal complication.
If you become sick, drink at least eight glasses of clear liquids daily in small frequent sips. Try flat soda, apple juice, herbal tea or broth. Other choices include flavored gelatin, popsicles and ice chips. Liquid probiotics found in kombucha may help by repopulating the gut with beneficial bacteria. Avoid medications like antidiarrheals without consulting your health provider. Once symptoms improve, you can gradually resume normal eating, starting with the BRAT diet — bananas, rice, applesauce and toast.
You can’t see, taste or smell norovirus, so throw away any food handled by a sick person. Thoroughly scrub untouched fruits and vegetables, and cook food completely. Hand sanitizers do not prevent the spread of stomach flu, but proper hand washing is effective: Scrub with soap and water for at least 20 seconds — the length of time it takes to sing “Happy Birthday to You” twice. Sanitize surfaces with chlorine bleach, wearing protective gloves. Wash bedding and towels frequently and empty the trash often.
Call your medical provider if vomiting persists beyond 24 hours or diarrhea for more than 48 hours; if you see blood in your vomit or stool; or if you experience severe abdominal pain.
Dr. Mary Jenkins, a contributor to the Herald and member of its board of directors, retired after nearly 40 years as a family practice physician in New York state.
