Norovirus – what you
need to know
Norovirus is a very common viral infection which
causes diarrhoea and vomiting, but is usually a
mild illness.
In the vast majority of cases, you can selfcare at home and will get better in a few
days without having to go to hospital.
In fact, please try to stay away from hospital if
you are ill with a tummy bug, or have recovered
from one in the last few days. This is because you
could be infectious and pass the bug on to
patients who are already poorly.
This leaflet offers advice and information about
Norovirus, which we hope you will find useful.
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What to do if diarrhoea and vomiting
hits your household this winter
Every year many patients with
diarrhoea and vomiting arrive as
emergencies at ABM hospitals. But
even though their symptoms might
be very unpleasant, most don’t actually need
to be admitted to hospital.
In fact, coming into hospital with diarrhoea and
vomiting – which could be managed at home –
puts other patients who are already poorly at risk
of additional infection. That’s because the bug is
very contagious. It also places staff at
unnecessary risk of catching it!
Winter is a busy time in hospitals across Wales,
and it is important that staff time is used looking
after people who really need hospital care.
About diarrhoea and vomiting illness
When clinicians refer to what is commonly known
as the Winter Vomiting Disease, they call it
Norovirus Gastroenteritis. Norovirus is one of
the most common causes of diarrhoea and
vomiting in Wales and the rest of Europe. The
illness can occur at any time of the year, but
appears to be more common in winter months.
Although there are about 3,500 reported cases
annually in the UK, the true incidence is believed
to be about 1% of the population each year.
Although a relatively mild infection, Norovirus
infection can occur at any age because even if
you have it once, you are not immune.
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The incubation period for Norovirus
is anything from four hours to three
days, and symptoms usually last 1260 hours. The onset is sudden, and
those affected often feel very
nauseous and can start vomiting.
• Over half also suffer abdominal cramps;
• One in three have a headache, muscle pain, a
temperature and loss of appetite;
• Diarrhoea is usually mild and watery, with no
blood or mucus present.
People usually get over Norovirus within two or
three days, but remain infectious for 48 hours,
and even up to 72 hours after symptoms stop.
Antibiotics have no effect on viruses, including
Norovirus. There is no medication to treat
Norovirus - the illness needs to run its course.
What to do if you or a family member
gets a Norovirus infection
Admission to hospital is usually not necessary,
and should be considered only in the most
extreme cases, following medical advice.
The key to managing cases at home is
maintaining hydration, which can usually be
achieved through taking regular sips of fluid,
despite the vomiting. It’s also a good idea to
stock up on a supply of oral rehydration
solution at home, particularly if you have a baby
or young child. You can get it at any pharmacy
without prescription.
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Hygiene advice during an episode of
Norovirus infection
The Norovirus bug is
very easy to catch, but
there are still things
you can do to reduce
the risk of infection.
• Washing your
hands thoroughly
and regularly should be your number one
priority. Good hand hygiene is the best way to
stop the infection spreading. If you are ill, always
wash your hands after you’ve been sick or gone
to the toilet. If you are nursing a loved one, wash
your hands after attending to them.
• You can also pick up a Norovirus infection from
a contaminated surface. Use gloves when you
clean the toilet or any bowl which has contained
vomit. Then wash your hands afterwards.
• After an episode of diarrhoea or vomiting,
disinfect the toilet, the toilet seat, toilet/door
handle, taps, and any other bathroom surfaces
which were touched by hands before they were
washed. You can use a disinfectant that claims
effectiveness against Norovirus, or a weak
solution of household bleach. Wash soiled
clothing/towels separately on a hot cycle.
• Keep visitors to a minimum, and make sure
they follow the hand-washing rule as well.
• Remember to keep up the extra hygiene
practices until two or three days after the
symptoms have gone.
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Vulnerable patients
While Norovirus is an unpleasant, but relatively
mild, illness for most people, there are some
vulnerable groups who are more at risk of
complications, usually from dehydration.
These include the very young and the elderly, or
people with underlying health problems like
diabetes.
In some cases they may require medical help or
need to come to hospital, if advised by a doctor.
Children under five
Most children with Norovirus Gastroenteritis
get better quickly without treatment and
can be looked after at home safely.
However, severe diarrhoea
and/or vomiting can lead to
dehydration, which is when the
body doesn’t have enough
water, or the right balance of
salts, to carry out its normal
functions.
To avoid dehydration, give your
child regular drinks, but avoid
undiluted fruit juice and sugary, fizzy drinks.
Also continue to offer them a regular diet in
frequent, but smaller, portions. Avoid greasy
foods.
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It is important to continue to give infants breast
milk or formula, but give short, frequent feeds.
If your child shows signs of dehydration, you can
give your child a special fluid called oral
rehydration salt solution which is available at
pharmacies. It helps to replace the water and
salts lost from the body because of diarrhoea and
vomiting.
Symptoms of dehydration include:
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Seeming unwell
Being unusually irritable or lethargic
Passing less urine than normal
Dry mouth, eyes and lips
In babies, a sunken soft spot (fontanelle)
When to call your doctor
 Your child is less than six months old; or
is older, but has a fever of over 38.5°C
(101.5°F)
 Vomiting with great force
 Bloody or green slimy vomit
 Hasn’t passed urine in eight hours
 Bloody or slimy stools
 Might
have
swallowed
something
poisonous
 Is listless or unusually sleepy
 Has had continuous abdominal pain for
over two hours
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Elderly patients
Most elderly people with
Norovirus get better
within a few days without
any intervention.
But, like the very young,
they can be at greater risk of
dehydration, so elderly
people with Norovirus need
to be kept an eye on. It is
very important they keep hydrated, or to treat
dehydration if it has developed.
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As a rough guide, drink at least 200 mls
(about a cup) of fluids after each bout of
diarrhoea.
If you vomit, wait 5-10 minutes and then
start drinking again, but more slowly. For
example, a sip every 2-3 minutes.
You will need to drink even more if you are
dehydrated.
For most adults, fluids drunk to keep
hydrated should mainly be water.
It is best not to have drinks that contain a lot
of sugar such as cola or pop as they can
sometimes make diarrhoea worse.
Eat small, but regular, portions of light foods
Rehydration solution, available from
pharmacies, is recommended in people who are
frail, or over the age of 60, or who have
underlying health problems. It should be given
to counteract signs of dehydration.
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Symptoms of dehydration include:
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dizziness or light headedness
headache
tiredness
dry mouth, lips and eyes
dark, concentrated urine
passing only small amounts of urine
infrequently (fewer than three or four times a
day)
Left unchecked, dehydration can make patients
very ill, with worsening symptoms which
include low blood pressure, a weakened pulse,
sunken eyes and cool hands and feet.
If you are worried about worsening
dehydration, or any other symptoms of
Norovirus, contact your doctor for advice,
or ring NHS Direct Wales on 0845 4647.
Helpful Numbers
NHS Direct Wales:
0845 4647
GP Out of Hours Service:
0330 123 9180
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