A new strain of the norovirus—more commonly known as the dreaded stomach bug—could be the culprit driving a nationwide uptick in gastrointestinal sickness.
Known as GII.17, the strain has accounted for about 70% of the outbreaks in the United States this season, according to the Centers for Disease Control and Prevention (CDC).
Locally, MedStar Health Urgent Care reports that cases are up 5% to 10% compared to last year. On Jan. 3, the Virginia Department of Health reported that “norovirus activity is elevated in the region,” while CDC data shows a 36% increase in norovirus outbreaks nationwide.
The actual numbers may well be even higher, says Meredith Porter, medical director for Inova-GoHealth Urgent Care centers, which has locations in Arlington, Falls Church and McLean. Although a stool test can confirm an infection, most providers at urgent cares and hospitals make diagnoses based on symptoms, she says.
What’s more, “a lot of people may not seek care because they just hang in there for the one to three days of symptoms,” Porter says.
Those symptoms—body aches, diarrhea, fever, nausea, stomach cramps and vomiting—come on fast, usually within 12 to 48 hours of exposure, she says.
Although there’s no cure for norovirus, you can treat the symptoms. “We can give medications for the nausea and the vomiting,” Porter says. “We can give medications to slow down the diarrhea…. We just can’t treat the virus itself.”
What is Norovirus?
Norovirus is the No. 1 cause of food-borne illness in the country. You can get it from eating food or drinking liquids contaminated by an infected person. Some foods, such as raw or undercooked shellfish are naturally contaminated with norovirus. Outbreaks can occur at any time but are most common from November to April, according to CDC, which tracks about 2,500 reported cases of norovirus each year.
“It’s highly contagious,” says Jennifer Primeggia, a specialist in infectious disease and internal medicine at VHC Health and an Arlington Magazine 2023 Top Doctor. “It can knock out an entire household in one weekend.”
That’s because the virus can be transmitted in several ways: through direct contact, contaminated food or water, or airborne particles, although research shows the latter to be less common.
If it’s on your hands, hand sanitizer may not kill the virus, which also contributes to its rapid transmission.
“It only takes one or two particles of the virus for it to spread, [and] with hand sanitizers being only 99% effective, hand washing with warm water and soap is crucial to fully eliminate the risk,” says Amanda Joy, a physician assistant and associate medical director at MedStar Health Urgent Care. “It is important to scrub hands, in between fingers and under nail beds for 20 seconds.”
The virus can live on surfaces anywhere from days to weeks, so it’s important to clean high-touch surfaces, especially in kitchens and bathrooms.
Joy also recommends washing fruits and vegetables before cooking them. “Steaming without cleaning may not be adequate,” she cautions, “as the virus can survive in temperatures up to 145 degrees.”
What makes the virus extra tricky is that you can be contagious before you feel symptoms, and for up to two weeks after symptoms subside, Joy says. That’s why “maintaining proper hygiene practices is imperative for slowing or stopping the spread.”
What to Do If You Get Sick
“Unfortunately, we are all at risk, from babies to 100-year-olds,” Primeggia says, noting that the very young and very old are most at risk for complications.
Dehydration is the biggest concern. Symptoms to watch for include extreme thirst, dry mouth, urinating less, fatigue, and light-headedness or dizziness. “One to watch for in little ones is a decrease in tear production,” Porter says. “If those symptoms occur, you definitely want to seek [professional medical] care.”
Another reason to call a health care provider is to rule out other possible causes if symptoms don’t improve after three days, she adds.
The good news is that the virus is self-limiting, meaning it usually runs its course without interventions. People experiencing symptoms can stave off dehydration by drinking low-sugar sports drinks, Porter says, and stem the spread by staying home for at least 48 hours, if not longer.
How to Protect Yourself
At present, there is no norovirus vaccine, although Moderna is testing one using the same mRNA technology it used to develop its Covid vaccine.
For now, “one of the biggest ways to avoid getting norovirus is hand washing, hand washing, hand washing,” Porter stresses.
You can also reduce your risk of infection by cooking shellfish thoroughly, forgoing raw oysters, avoiding sharing food and utensils, and disinfecting food-prep areas.
“If I am running around doing things that get me exposed to the public, I do wear a mask, especially if I’m going into a public restroom,” Primeggia advises. “When I go out to the grocery store, for example, the first thing I do when I get home is I wash my hands with soap and water…and I also wash my fresh fruits and vegetables very carefully and thoroughly because I don’t know who touched them before me. In the evenings, I disinfect all the high-touch surfaces in my kitchen, my doorknobs, the laundry room, just to have a clean start to the next day.”
The bad news: Getting norovirus doesn’t make you immune to contracting it again. The good news is that cases likely spiked last month and may be on the decline.
“It’s probably going to take at least another couple of weeks to start to see things come down,” Primeggia says. “At Virginia Hospital Center, we had pretty consistent cases every week of December, but this past week, we are starting to see the beginning of a decrease, so we are optimistic.”