If you are feeling sick to your stomach, you have plenty of company.
The number of stomach bug cases is surging this winter and is surpassing case counts from previous years.
Officially known as norovirus, the stomach bug can bring a world of misery to households, schools and cruise ships in the form of diarrhea and vomiting — sometimes minor, sometimes severe.
Northeastern health experts describe the steps people can take to avoid the highly contagious illness — and to recover as quickly as possible if they come down with a bug.
“This particular norovirus this year seems to be a little nastier than some of the other ones we’ve seen, although none of them seem to be much fun,” says Neil Maniar, director of Northeastern’s master of public health program.
The total number of outbreaks reported during the 2024-25 seasonal year is already above the seasonal ranges reported since 2012, with only one exception, according to the Centers for Disease Control and Prevention.
And caseloads are still climbing.
“Norovirus can cause severe vomiting, diarrhea, just general GI upset,” says Brandon Dionne, Northeastern associate clinical professor of pharmacy and health systems sciences.
“It can also cause whole body fatigue,” he says.
Norovirus is unfortunately easy to pick up.
“It can be very contagious in close quarters, especially during the winter months when folks are indoors, making it much easier for these types of viral illnesses to spread,” Maniar says.
“Direct contact is the primary mode of spread through norovirus,” Maniar says.
People may touch a contaminated surface or shake hands with someone who is contagious and then touch their own mouth, hands or eyes and become infected, Maniar says.
It’s the reason why norovirus outbreaks are reported on cruise ships and other places where people share surfaces, he says.
“The best mode of protection against norovirus is washing your hands properly,” Maniar says.
“It’s not just spraying a little bit of (sanitizer) on your hands,” he says. “It’s really making sure that you properly wash your hands and that you wash your hands frequently.”
The CDC advises people to wash their hands with soap and water for 20 seconds, especially after touching common surfaces, shaking hands, caring for people who are sick and changing diapers.
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Those unlucky enough to get norovirus find there is no curative treatment for the virus.
“Mainly what we do is supportive care,” says Dionne, who also works in pharmacy at Brigham and Women’s Hospital in Boston.
To replenish fluids and electrolytes lost to vomiting and diarrhea, Pedialyte is a good choice after Gatorade and broth, he says.
In terms of over-the-counter medications, Imodium stems the flow of diarrhea and Dramamine might help a bit with nausea, Dionne says.
But people who can’t keep anything down after a day or two of vomiting, or two to three days of intense diarrhea, should call their doctor or go to an urgent care center to see about getting prescribed medication to treat the symptoms, he says.
“The most effective prescriptions are going to be prescription only,” Dionne says.
The anti-nausea prescription medication Zofran comes in dissolving tablets so people don’t have to worry about throwing them up, he says. “It just avoids the upset from swallowing a pill.”
The suppository phenergan is also sometimes prescribed to relieve acute vomiting episodes, Dionne says.
“You can’t really give someone an oral tablet if they’re vomiting because then they can vomit it back up,” he says.
Patients who are on the mend and can stomach some food should consider following the BRAT diet of bananas, rice, applesauce and toast to keep nausea from flaring up again, Dionne says.
Although people usually feel better after one to three days, the CDC says they should remain home for an additional two days after symptoms stop because they remain contagious for approximately another 48 hours.
People who are severely dehydrated may require IV fluids administered through either an urgent care center or hospital emergency department, Dionne says.