In probably one of the most requested articles from my support group of all time, I think I may finally possess enough knowledge to write an article about norovirus in a way that will truly do it justice!
Over the years, I’ve learned enough about norovirus that I almost feel like I’ve gone to school to study it! Between my own personal research, talking with those who do actually study norovirus (and other viruses like it), and just having an understanding of science in general, I’ve amassed quite a large amount of knowledge on norovirus.
As a former emetophobic (that still feels weird to say), knowing the facts about norovirus actually truly helped demystify it, and ultimately allowed me to feel calmer going into the winter months. Plus, this information is useful to have for non-emets as well, because families with kids tend to get the hit the hardest.
I figured, why not do this article in the form of modified FAQ? All of the points below are frequently asked, and commonly unknown, questions that come across my group.
What Is Norovirus?
Norovirus, also known as the Norwalk virus (fun fact: It’s called this because the first recorded case of norovirus was in Norwalk, OH in 1968!), is a gastrointestinal illness that causes vomiting, diarrhea, stomach pain and cramps. It can also cause fever, chills, headache, weight loss and fatigue. Because of the severity of the symptoms, people who get norovirus also struggle with dehydration, which can cause other major side effects.
For those that are more interested in the science, norovirus is actually a type of Norwalk-like virus which can be categorized by non-enveloped, single stranded RNA viruses. According to the CDC, there are currently 6 recognized norovirus genogroups (GI, GII, GIV), but within these groups there are a total of 25 different genotypes. The most common cause of norovirus outbreaks around the world has been the GII.4 genotype.
How Is It Spread & How Do I Get It?
The easy answer is that norovirus is spread by vomit and diarrhea particles, but it of course gets a little more scientific than that. Without getting too in depth, a person can only spread the virus if it is either shedding in their stool or if they are actively sick (as in, vomiting and having diarrhea).
Because the virus is transmitted via vomit and diarrhea, it should come to no surprise that the way it’s spread is by people who do not properly wash their hands after going to the bathroom, and by improper decontamination of affected areas. It takes as little as 18 particles of norovirus to make you sick, so hand hygiene and proper decontamination is extremely imperative.
You can get norovirus in the following ways:
- By touching a contaminated surface and putting your hands in your mouth (without washing your hands).
- By sharing food/drink/utensils with an actively sick and contagious person.
- By eating/drinking contaminated food/water.
- By getting vomit/diarrhea in your mouth.
- By inhaling the viral mist that arises from throw up.
Now, before you panic, let me explain what viral mist means. Viral mist essentially means that particles from the throw up that can get you sick rise in the air after hitting whatever surface it falls on. Many people when they hear this assume that airborne means it’s free floating through the atmosphere and will ultimately get you sick. That’s actually not true!
When it comes to norovirus, the particles are far too heavy to stay suspended in the air for long, so even if the virus is acted on by an outside force (think a fan, the wind, etc), it won’t stay suspended and float for miles. They will quickly fall to the surface, which would mean that in order to catch it via viral mist, you would need to be right by the pile, as it hit, and also take a huge deep breath in.
Infections via viral mist are actually extremely rare, and if you get sick from someone, it’s more likely because of poor hand hygiene or improper decontamination.
This then leads us to the most ways you CANNOT get norovirus:
- By simply sharing the same space as someone who is sick.
- By using the same bathroom as someone who is sick.
- By walking past a pile of throw up on the ground.
- Sharing food or drink with someone, or kissing them, before symptoms are showing.
- From a cut/wound, or cracked skin.
- From simply touching your face, eyes or ears.
Just being near someone who is sick, or walking past throw up will not be enough to transmit the virus. The virus would need to be ingested in some way, and simply occupying the same space or walking past throw up isn’t enough to make you sick.
What’s The Incubation Time For Norovirus?
From the moment exposure happens and you’ve ingested the particles, norovirus can take anywhere from 12-72 hours to present symptoms. Most commonly, though, symptoms will present themselves in about 24 hours. During this time, a person may or may not be contagious, which sounds silly to say but the CDC and other scientists who study this virus are unsure whether someone is contagious during the incubation period.
If someone is contagious, however, it is through their stool. If you catch it from someone who has not presented symptoms, you did so from them not using proper hand hygiene. Or, it was a total coincidence that you both got sick around the same time! After all, correlation does not imply causation.
I’ve Got It, Now What?
So you, a family member, or a roommate have norovirus. What do you do, and what else do you need to know? Well, the most important aspect to tackling this virus is understanding it’s timeline.
From the moment symptoms start, most people will be actively sick for 12-48 hours. At this point, they will be their most contagious because they will be actively spreading the virus through throwing up and their diarrhea. Once symptoms stop, a person is still actively contagious for 48 hours. This contagious period is usually through the stool, and is a result of improper hand washing and bad decontamination.
After the 48 hour window has passed, a person may or may not be contagious for another 2 weeks following. Again, the strange wording is because many people who study the virus have confirmed the virus is still shed in the stool for up to 2 weeks, but they cannot determine if that virus is active (meaning contagious).
What Can I Do To Avoid Spreading Norovirus?
There are a lot of ways you can stop the spread of norovirus, even if someone in your home already has it:
- Properly isolate the person/people who is/are sick. This is useful because it contains the sick person to one area and limits exposure to other family members. While this is not always possible, properly avoiding additional and unneeded exposure is a great way to stop the spread. Don’t bunker them down and dead bolt them away, but keeping them in one room, versus having them bounce from place to place is incredibly smart.
- Do not cook/prepare food while sick! This should be a no brainer, but almost 50% of food borne illnesses are norovirus. If you are sick, stay out of the kitchen – it can absolutely wait. Same goes for chefs in restaurants and bakeries, or any person who works in fast food.
- Practice good hand hygiene. Wash your hands for 20 seconds with soap and water before eating and/or preparing food, after using the restroom, or after coming in contact with someone who is sick. It doesn’t matter if you use cold or warm water, but 20 seconds is the key number! If you struggle with knowing how long that is, just sing happy birthday twice.
- Clean affected areas with a diluted bleach solution. Depending on what you are cleaning this will change, but here’s what you need to know. For stainless steel or food/mouth items, use 1 tablespoon of chlorine bleach in 1 gallon of water. For non-porous surfaces (think tile floors, counter tops, sinks, toilets, etc), use one third cup of chlorine bleach in 1 gallon of water. For porous surfaces (like wooden floors), use one and two-thirds cups of chlorine bleach in 1 gallon of water. Leave the solution on the area for 10 to 20 minutes, then rinse with clean water. You can also use bleach in your washing machine wash sheets, clothes and towels that may have vomit or diarrhea on them. Use the bleach as directed for clothes on the bottle. It’s also important you get true, chlorine bleach, as other bleaches may not kill norovirus.
- Do not go back to school or work until symptoms have subsided. Ideally, you should wait for the 48 hour period is up after symptoms stop, but in today’s world that’s sometimes hard. Once you go back to work, make sure you practice good hand hygiene to avoid the spread to other co-workers.
How Can I Protect Myself & My Family?
So, this question is something that many people ask and the short, easy answer is: the best way to protect yourself and your family is effective hand washing. There have been plenty of commonly passed around methods for magical protections against norovirus, but the bottom line is there is no scientific evidence that those methods work.
Many people turn to alcohol based sanitizers for their winter month protection, but unfortunately, due to the nature of norovirus (being a non-enveloped virus) they do not work. Truthfully, I just tell people to avoid hand sanitzers all together, as typically they kill the good bacteria as well as the bad bacteria, which actually makes us more susceptible to sickness.
There are not surefire ways to avoid the virus. Even hand washing is not 100%, but it does help. Many people wonder if there will ever be a vaccine, and that answer is a solid maybe. Scientists are currently working on a vaccine, but it’s been hard to pin down. Viruses, by nature, are not really “cureable”, at least the vast majority aren’t.
According to the CDC, making sure that this vaccine actually would do anything of value is going to be the hardest part. How long does a person have immunity from norovirus, if any at all? Does this immunity extend to other strains? These questions have to all be answered before a vaccine can even be considered.
Can I Become Immune To Norovirus?
Following up the end of the last section, understanding the immunity of norovirus is greatly understudied. The most popular strain of norovirus that makes its way around the globe does offer a small window of immunity, I think 16 weeks at most. However, it’s not something that stays forever, and it’s not something that has been totally confirmed.
An interesting fact, however, is that there is a gene that makes you immune. The rs601338(A;A) gene, when switched on, causes genetic immunity to the infection. It’s actually been shown that 1 in 5 people in the UK hold this gene, but it’s not all rainbows and butterflies for people with this gene. While they do avoid the dreaded winter stomach bug, they have a greater susceptibility to influenza, and other types of bacteria.
You can read more about that gene and what it does here. But, be warned, it’s a bit scientific, but it’s quite the fascinating read!
Got questions that I didn’t answer here, or want clarification on a point that I made ? Leave a comment below and I’ll do my best to answer them!
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