It’s norovirus season – here’s how to make sure the winter vomiting bug doesn’t strike you down

A new vaccine is in the works to help prevent norovirus – with cases rising, here’s how to stay safe in the meantime

As winter draws in and the parties ramp up, an unwelcome visitor encroaches. Norovirus, also known as the winter vomiting bug, threatens every UK household, with an estimated 3.7 million people in the UK contracting the virus every year, and 200,000 people dying from it worldwide. And this week, new figures show that cases are up almost a fifth in a fortnight – more than double the numbers for England and Wales since pre-Covid levels.
The bug is brutal, highly contagious, and has huge consequences – often closing hospital wards and taking children and parents out of school and work.
Thankfully, in October 2024, it was announced that the world’s first vaccine is being developed in the UK to treat norovirus. Sadly, however, it won’t be available until 2026 so we won’t be able to get our (hopefully sanitised) hands on it yet.
“Norovirus can mutate easily, similar to other viruses like influenza and Covid,” says Lucy Thorne, a lecturer in molecular virology at Imperial College London. “A vaccine can provide beneficial short-term protection, and it might be the case that you may need a booster every year, especially for high-risk groups.”
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Norovirus is a virus that causes diarrhoea, sickness, and stomach pain, and the most common cause of acute gastroenteritis, an inflammation of the stomach and intestines. It is most contagious from the start of symptoms until 48 hours after all symptoms have stopped.
The infected person may feel very sick and vomit often, sometimes without warning, many times a day. Strangely, sometimes people infected with norovirus have no symptoms at all, but can still pass the virus to others.
They are not pleasant and are two-fold. Norovirus typically causes diarrhoea and projectile vomiting – often at the same time, which has earned it the nickname of the “Two Bucket Disease”, says Thorne. This is accompanied by stomach cramps, muscle aches and fever.
In small children it can also cause seizures linked to having a high fever. “It’s not known exactly how the virus causes the seizures, but it infects and damages the cells that line your intestines.”
Norovirus can be contracted and spread after having direct contact with someone who’s been infected by the bug, or touching a surface that has been contaminated by an infected person, and then putting your hand near your mouth.
“It is spread through projectile vomit onto surfaces,” says Thorne. “Small particles of vomit, that become aerosolised [turn into a fine mist], can carry the virus up to 9ft. This creates a huge area that would need decontaminating if vomit isn’t contained.
Thorne adds: “It’s also spread by the faecal-oral route, which means from poo to mouth, most likely by an infected person’s hands contaminating surfaces so that someone else picks it up and touches their mouth.”
Extremely. Studies on volunteers have told us that you need as little as 20 viral particles to become infected. To give that some context: one teaspoon of infected faeces can contain up to five billion virus particles, which in theory could produce enough of the virus to infect everyone on the planet.
Thorne says: “Of course this doesn’t happen, but it shows you how important it is to try and contain it and how crucial hygiene is to clear and inactivate the virus. It’s very stable, can persist on surfaces and stay infectious for several weeks, which gives it more chance of being picked up by someone or contaminating food.”
For most healthy adults, symptoms will last one to three days before the infection clears naturally. “It’s most dangerous for the very young and elderly, who are at risk of dehydration and complications, and people with compromised immune systems. They can develop chronic infections which can last for years with serious complications,” says Thorne.
The virus can continue to spread, even after your symptoms have cleared, so keep up the hygiene in your household for at least a week after. Many disinfectants won’t kill it and alcohol doesn’t kill norovirus – use bleached water.
The CDC recommends a solution that contains anywhere from five to 25 tablespoons of household bleach per gallon of water, or other disinfectants approved by the Environmental Protection Agency. If your symptoms persist for longer than three days, it’s important to see a doctor.
Ideally, the person who’s sick should stay in a separate room – even use a separate bathroom, if possible. You should also avoid sharing everyday items, including towels, bedding and dishes. The person who is sick shouldn’t be the one cooking meals for the rest of the household.
Thorne advises: “The best way to protect yourself is through really good hand hygiene, washing your hands with hot soapy water before you eat, or if you have been around someone who has symptoms that match norovirus.
“Also cleaning your house thoroughly after someone has been ill – and in a wider area than just the spaces that have been immediately in contact – imagine 9ft around wherever the infected person has been.
“Not keeping your toothbrushes on a shelf near the toilet is also a good idea if someone is ill!”
Experts also recommend avoiding taking ibuprofen on an empty stomach, as it can upset the stomach lining.
The foods that are most often linked to norovirus include leafy greens, fresh fruits and shellfish. Many norovirus outbreaks linked to food happen in restaurants or at catered events when infected workers touch ready-to-eat foods. Outbreaks stem from food that’s contaminated on a farm, such as oysters harvested from contaminated water or fruit, and vegetables that are sprayed with contaminated water in a field, the Centre for Disease Control (CDC) reports.
“Cooking can inactivate the virus, so it’s often only a problem when eaten raw. It has also been linked in some cases to salads and some fruits that have been washed in contaminated water or touched by infected food handlers, but this is much less common,” says Thorne.
“Avoid foods which are harder to digest like fatty and fried food, heavy proteins like steaks and spicy food. They need a lot of work to disintegrate,” says Ahmed Albusoda, a gastroenterologist at Princess Grace Hospital. “When the bowel is inflamed, it becomes very sensitive, so you want food which is simple to digest.
“Also avoid milk and dairy products as the virus can kill the bacteria which helps you digest them – this may make you more sensitive and bloated.
“Focus on food like plain white rice, banana, bread or toast which is easily digested and helps improve the consistency of the stool.
“Stay hydrated and sip on water every hour to replenish what your body is losing. It’s also important to replace the electrolytes lost through dehydration which can be done by sipping sports drinks or rehydration solutions.”
“There is no cure for norovirus right now, but doctors will help treat the symptoms. For infections in immunocompromised individuals, norovirus can be serious and long term. In this case, you should seek professional help to support hydration, nutrition and discuss potential treatment options,” says Thorne.
“People can still remain infectious even after a couple of weeks – so even if you feel better you still need to be careful. It’s your responsibility to limit its spread and avoid contact with people,” says Dr Albusoda. “This way, it has less impact on the community and people’s health until hopefully the vaccine comes along.”
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