7 Norovirus Symptoms That Experts Say Are Signs You May Have the Stomach Flu

A note from Cleveland Clinic

Stomach Flu

Stomach flu, viral gastroenteritis, is a viral infection in your digestive system. It causes gastrointestinal symptoms like vomiting and diarrhea. It’s usually brief, but can be very contagious.

Overview

What is stomach flu?

Stomach flu is a viral infection that affects your stomach and intestines. The medical term is viral gastroenteritis. “Gastro” means stomach and “enter” means small intestine. “Itis” means inflammation, which is usually due to an infection. And “viral” means that a virus has caused the infection.

Stomach flu causes gastrointestinal (GI) symptoms like diarrhea, abdominal cramps and nausea. You might also call it a “stomach bug.” A stomach bug isn’t always a virus — sometimes it’s bacteria or a parasite — but in any case, the symptoms are similar. You might not be able to tell if your bug is a virus or not.

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Why is viral gastroenteritis called “stomach flu?”

Stomach flu isn’t related to “the flu” (influenza), which is a viral infection in your respiratory system. Different viruses cause the two conditions, and they affect different body systems. It’s not clear how the nickname “stomach flu” developed or why it’s been associated with influenza, but we can speculate.

Both are common viral infections that circulate during the same “flu season,” so people might use “flu” to simply mean, “I’m sick”. “Stomach flu” might be a way of saying, “I’m sick, and it’s the stomach one”. Even though a stomach bug isn’t always a virus, it’s likely to be, so “stomach flu” is a good guess.

How common is stomach flu?

Viral gastroenteritis is extremely common worldwide, but it’s hard to estimate exactly how many people get it each year. Many different viruses cause it, and most people don’t get clinically tested for it. Experts estimate that norovirus, the most common cause, infects 685 million people every year.

Symptoms and Causes

What are stomach flu symptoms?

The most common stomach flu symptoms are:

These symptoms come from inflammation in your stomach and intestines. (Although the name, gastroenteritis, refers to your stomach and small intestine, inflammation can spread to your large intestine, too). Inflammation is your immune system activating to fight the virus.

If your infection is more severe, or if your immune system reacts more strongly to it, you may have what are known as systemic symptoms. These symptoms come from inflammation in other body systems outside of your digestive system. This is the next level of immune response to the virus.

Systemic symptoms may include:

What does the beginning of stomach flu feel like?

For many people, stomach flu symptoms seem to come on suddenly and out of nowhere. You might throw up or have diarrhea many times on that first day. Symptoms occur one to two days after you were exposed to the virus. Fortunately, they’re usually over just as quickly, resolving in one to two days.

What are the stages of stomach flu?

The stages of stomach flu infection are:

1. Exposure. You’re most likely to get the stomach flu from someone in your community, especially in a closed environment like a school, nursing home or cruise ship. Since symptoms take some time to develop, you might hear about an outbreak later, after you were exposed.
2. Incubation. Once you’ve contracted the virus, it’ll begin replicating inside your body. This is the incubation period. You won’t have symptoms until the virus replicates enough to alert your immune system. This usually takes a few days, depending on the virus.
3. Acute infection. Viral gastroenteritis is an acute infection, which means it’s sudden and temporary. When your immune system registers the threat, it activates an inflammatory response to clear the virus. This is what causes symptoms of illness. When it succeeds, the symptoms will stop.
4. Recovery. You’ll notice your symptoms lessening when your immune system has won the battle against the virus. Eventually, your symptoms will stop, and you’ll feel better. But you may continue to shed the virus in your poop (stool) for a few days, which means you’re still contagious.

How long does stomach flu last?

Stomach flu usually only lasts a few days, but it may last up to a week or two in severe cases. People with weaker immune systems may have a harder time defeating the virus, and it may take longer.

Is stomach flu contagious?

Yes, it’s very contagious. You should limit your contact with others when you have it. If you live with others, make sure to wash your hands often and disinfect shared surfaces, especially in the bathroom.

How long is the stomach flu contagious?

You’re most contagious during the acute phase of the infection (when you have symptoms) and for a few days after. However, you may still be a little contagious for up to two weeks after recovering.

What causes stomach flu?

Many different viruses can infect your gastrointestinal system, causing gastroenteritis.

The most common ones are:

• Norovirus. This is the leading cause of stomach flu in adults, estimated to account for 50% of cases worldwide. It’s more resistant than others to temperature and disinfectants.
• Rotavirus. Rotavirus is the leading cause of stomach flu in children worldwide. Most get it before age 3, which is why most adults are immune. There’s now a vaccine.
• Astrovirus. Astroviruses mostly affect children younger than 3. They commonly spread through daycare centers. But they can also spread through elder care homes.
• Adenovirus. Adenoviruses more often cause respiratory infections, but they can cause gastrointestinal infections if you accidentally ingest them. They infect all ages.

How does stomach flu spread?

Stomach flu usually spreads by the “fecal-to-oral route”. The virus lives in the poop — and vomit — of infected people. Microscopic traces of infected poop or vomit may linger on people’s hands or surfaces. These traces can transfer to food and water sources. You might ingest the virus through contaminated food or water, or by touching an infected person or surface and then touching your mouth.

Who gets stomach flu?

Anyone can get stomach flu, but certain people are more vulnerable. If you have a weaker-than-average immune system, you might be more likely to get an infection or get a more severe infection.

You might have a weaker immune system if you have a chronic disease that affects immunity or take immunosuppressant medications. Infants and elderly people are also more susceptible to infections.

What are the possible complications of stomach flu?

For most people, stomach flu is uncomplicated and self-limited. It goes away shortly by itself. But those with weaker immune systems may have a more severe infection and be more likely to experience complications.

The most likely complication is dehydration. This happens when you lose too many fluids and electrolytes from diarrhea or vomiting, and you can’t drink enough or drink fast enough to replace them.

People with weaker immune systems (especially children) are more likely to become dehydrated, and it can be especially dangerous for them. Stay alert for signs of dehydration, such as:

• Thirst.
• Lack of urine (pee) or dark-colored urine.
• Lack of poop or hard, dry poop.
• Weakness or malaise.
• Sunken eyes.
• Crying without tears.
• Dehydration headache.
• Dry lips and tongue.

Diagnosis and Tests

How do healthcare providers diagnose stomach flu?

Healthcare providers often diagnose gastroenteritis based on your symptoms. They won’t know if it’s viral or which virus it is without doing a lab test to find out. But most of the time, this isn’t necessary. Since there isn’t any specific medicine for stomach flu, there’s no need to identify it, or the virus.

Management and Treatment

How do you get rid of stomach flu?

Your immune system gets rid of stomach flu through its own natural processes. It just takes a few days to do its work. Your symptoms, while unpleasant, are a sign that your immune system is working. There’s no medicine for stomach flu. Antibiotics don’t work on viruses — they’re for bacterial infections.

The best thing you can do to help your immune system do its work is to stay home and rest, stay hydrated and eat a little if you can. Give your body the energy it needs to fight the infection. To stay hydrated, take small sips throughout the day, before you feel thirsty, or suck on ice chips.

What helps stomach flu go away faster?

Some research shows that taking probiotics may help stomach flu go away faster. Probiotics are helpful bacteria that live in your gastrointestinal system. Having enough helpful bacteria in your gut is part of having a healthy immune system. Ask a healthcare provider if probiotics might help you.

What should you eat when you have stomach flu?

What you eat won’t improve stomach flu, but it can make it worse. Foods high in fat, sugar, caffeine or dairy milk might make you more likely to throw up or have diarrhea. You might have little appetite or feel nauseous at the thought of food. Focus on foods that are easy to digest and give you a quick dose of energy, like fruit juice popsicles, broths and saltine crackers. The salt can help replace your electrolytes.

Can healthcare providers treat severe symptoms or complications?

Healthcare providers can treat dehydration with intravenous fluids. This is a way of delivering hydration directly to your bloodstream, bypassing your digestive system. In some cases, healthcare providers may prescribe medications to reduce vomiting or diarrhea. They don’t prescribe these for children, though.

When should I see a healthcare provider about stomach flu?

Contact a healthcare provider if:

• Your symptoms haven’t improved after four days.
• You’ve had a high fever (above 102 degrees Fahrenheit or 39 degrees Celsius) for four days.
• You haven’t been able to pee or poop for two days.
• You suspect dehydration.
• You have blood in your poop.
• You have severe abdominal pain.

Prevention

How can stomach flu be prevented?

You can reduce your risk of getting stomach flu or spreading it to others by practicing good hygiene.
This includes:

• Handwashing. Good handwashing is the most important defense against stomach flu viruses since hand sanitizer isn’t always effective. It’s especially important after going to the bathroom or changing a diaper and before coming into contact with food.
• Cleaning. Wash and disinfect any surfaces or materials that you or the infected person has touched. Use bleach and water (up to 25 tablespoons per gallon) to disinfect surfaces, especially in the bathroom. Use the high heat setting on your washing machine for bed linens and clothes.
• Safe food handling. Food may be contaminated with stomach flu viruses, bacteria or other organisms. Safe food prep can help reduce this risk. People already infected with stomach flu should avoid handling food for others, if possible.

Outlook / Prognosis

When will I feel better?

For most people, symptoms get better in a few days. Contact a healthcare provider if they aren’t improving. People with weaker immune systems may need treatment for dehydration or medications to reduce their symptoms. It’s also possible that you have a different condition if you aren’t improving.

When can I return to work or school?

It’s best to say isolated until two days after your symptoms have stopped. This is the time when you’re most contagious. Even though your body has overcome the infection, you’ll still shed the live virus in your poop. If any trace of that poop comes into contact with another person, they could get sick.

Additional Common Questions

What’s the difference between stomach flu and the flu (influenza)?

Stomach flu isn’t related to “the flu” (influenza), which is a viral infection in your respiratory system. The flu vaccine won’t protect you from stomach flu. Different viruses cause these two conditions, and they affect different body systems. Most of their symptoms are different, though a few may overlap.

Influenza causes respiratory symptoms like congestion, a sore throat or a runny nose. Stomach flu causes gastrointestinal symptoms, like diarrhea, nausea and vomiting. Both may cause “systemic symptoms” like fever and fatigue. Children may have some gastrointestinal symptoms with both.

What are “flu-like symptoms?”

People probably mean different things when they use this phrase. They might be referring to symptoms of influenza. Or they might be referring to systemic symptoms, which are more common with viral infections in general than with other types. Some people might mean gastrointestinal symptoms.

What’s the difference between stomach flu and food poisoning?

Stomach flu and food poisoning are both infections that cause gastroenteritis, with similar symptoms. The different names describe the different origins of the infection. Viral gastroenteritis comes from a virus, while food poisoning comes from eating food that’s contaminated, either by a virus or something else.

Food poisoning can cause stomach flu if you get the virus from food. This is common, and in this case, both names describe the same condition. But other types of contamination can also cause food poisoning, like bacteria. Bacterial food poisoning has a few small differences from stomach flu.

A note from Cleveland Clinic

Almost everyone gets stomach flu at some point. Since many different viruses can cause it, you may get it more than once. Children in daycare centers and schools and people in care facilities are more at risk of getting it from their communities, and they may experience more severe symptoms with it.

For most people, stomach flu is unpleasant but brief. But for some, it can be dangerous. If you care for a child or older person with stomach flu, watch for signs of dehydration and stay in touch with a healthcare provider. Take steps to protect yourself from the virus and to prevent it from spreading to others.

7 Norovirus Symptoms That Experts Say Are Signs You May Have the Stomach Flu

Here’s how long a stomach bug may last — and how you can prevent it from spreading within your home, according to our experts.

• Also known as the stomach flu or bug, norovirus often triggers painful gastrointestinal symptoms as well as fever, aches and headaches within days of exposure.
• Symptoms may last up to 72 hours after they begin, but this timeline may vary and depends on how you choose to recover at home.
• While there isn’t a specific medication for norovirus, frequently washing your hands and cleaning common areas in your home — including the bathroom and kitchen — are essential to keep it from spreading.

Federal health agents are warning Americans that annual cases of norovirus have recently been on a surge here in the United States, per data released by the Centers for Disease Control and Prevention (CDC). Highly viral, norovirus can trigger painful bouts of nausea, vomiting and diarrhea in those who touch contaminated surfaces or share direct contact with someone who is sick, highlighting the need once more for stringent handwashing.

According to CDC figures, more than 200 outbreaks of norovirus — which is sometimes referred to as the stomach flu or stomach bug, though it has no official ties to influenza — have occurred between August 1, 2022 and early January 2023. This is an increase compared to just 172 outbreaks during the same period last year, per the CDC; and positive norovirus cases continued to spike well into the end of February. And it’s likely that total norovirus cases are well underreported given that medical testing is required for a formal diagnosis, as CDC figures place real-time norovirus cases closer to 20 million each year.

Norovirus tends to surge in the wintertime as more people head indoors, spending time at home fighting off other seasonal illnesses. And because norovirus is spread silently via microscopic virus particles — largely when people accidentally touch an infectious surface and put fingers inside their mouth, or share food or drinks with sick individuals — it can easily rip through whole households at once, explains Ali Alhassani, M.D., pediatrician at Boston Children’s Hospital and head of clinical at Summer Health, a digital pediatric care platform.

“Norovirus is highly contagious and only takes a small amount of virus to infect, [so] it makes sense that all of these factors combined have led to an uptick in cases recently,” Dr. Alhassani tells Good Housekeeping.

You may end up being unlucky enough to come into contact with norovirus by eating or drinking something that’s contaminated, prompting foodborne illness soon after. But one important aspect of preventing this one-off case from affecting loved ones in your household lies in disinfecting high-touch surfaces in your bathroom and in the kitchen, explains Carolyn Forté, the Good Housekeeping Institute‘s Home Care and Cleaning Lab Executive Director.

Read on to learn more about common norovirus warning signs, treating the illness effectively and how you may work to prevent others in your family from getting sick, too.

Common norovirus symptoms

Many associate the stomach flu with gastrointestinal issues that can make everyday life (and even eating!) feel impossible, causing immense pain for days on end. But federal health experts are keen to note that norovirus may also cause other flu-like symptoms, which should clue you into speaking with your doctor to see if norovirus may be to blame. If you’re experiencing headaches or body aches alongside stomach discomfort for days on end, there’s a chance that norovirus is at play.

This year’s norovirus outbreaks have proved consistent with years past, meaning Americans can continue to look for these two particular subsets of symptoms if they’re concerned they’re experiencing a norovirus illness.

“Norovirus symptoms [primarily] include nausea, vomiting, diarrhea, stomach cramping, and sometimes fever, headache and body aches,” Dr. Alhassani explains. “These symptoms are relatively consistent with other strains of years past.”

Diarrhea and vomiting can be particularly concerning, as they may easily lead to dehydration, which can prompt a worsening condition due to things like dizziness and dry mouth. Younger children may not be able to express their thirst at this time, either, and caregivers will see a lack of tears during frustrated cries if this is the case as well.

Since someone can experience a few of the hallmark symptoms of norovirus infections as standalone issues, you may be wondering if your GI discomfort is norovirus-related or something more fleeting. There isn’t a bonafide way to tell, but doctors say that the easiest way to distinguish between norovirus and lesser gastrointestinal distress is how long the issue persists.

“Norovirus symptoms usually appear 12 to 48 hours after exposure, but temporary upset stomach symptoms appear much faster — within a couple of hours,” Dr. Alhassani adds. “However, symptoms from an upset stomach will subside within 24 hours at most, which isn’t the case for norovirus infections.”

To recap, this is the full list of potential norovirus symptoms as noted by CDC officials:

• Fever
• Headache
• Body aches
• Stomach pain
• Nausea
• Vomiting
• Diarrhea

It’s crucial to remember that norovirus — which is just one example of enterovirus, a group of viruses that may impact the gastrointestinal tract — may require hands-on medical care and, in some cases, hospitalization if symptoms are severe and left unchecked.

How long does norovirus last?

Unlike other discomforting issues like food sensitivity or poor food quality, norovirus illness doesn’t usually produce immediate symptoms; it may be a few days before the symptoms listed above present in impacted individuals. Dr. Alhassani says most cases of norovirus cause symptoms to become apparent between 12 and 48 hours after exposure.

Not all illnesses caused by norovirus are the same, meaning some individuals may have more severe symptoms based on their own exposure as well as any preexisting health conditions. If you are currently experiencing norovirus sickness, you should expect to feel extremely ill and to experience continuous gastrointestinal issues throughout the day. Feeling continuously nauseous or experiencing chronic diarrhea is expected, for example, until the sickness has run its course.

How does norovirus spread?

Put simply, norovirus can spread through feces, vomit and other bodily excretions — and more often, through small virus particles that remain transmissible on a contaminated surface. CDC officials note that those who are impacted can “shed billions of norovirus particles” that are naked to the eye, and only a relatively small amount of these viral particles can infect another otherwise healthy individual.

People are most contagious when they are experiencing symptoms, as well as during the first few days of recovery when symptoms have largely subsided, according to published research.

Because viral norovirus particles may easily contaminate surfaces — including food that may be placed on sullied surfaces in the kitchen — keeping your hands properly washed if you are sick is crucial. Your family will also need to keep an eye on the rest of your home; both Clorox and Lysol make products that can effectively kill traces of norovirus on surfaces when used according to manufacturer’s directions, our Good Housekeeping Cleaning Lab experts say.

“Food prep and food contact surfaces are important as are most high-touch areas in both the bathroom and the kitchen, including faucet handles, appliance handles, cabinet and drawer pulls, light switches, and shower knobs,” explains Forté. “And most of these products recommend rinsing after using them on food contact surfaces, like countertops and a baby’s high chair tray. Make sure you check the usage directions about food contact surfaces.”

Using a cleaning product versus a disinfectant spray requires different approaches — but whichever product you use at home to keep norovirus from spreading, be sure you thoroughly clean the surfaces first, then keep them wet with the disinfectant for the required time. For example, Purell’s Multi-Surface Disinfectant requires a surface to remain wet with cleaner for 30 seconds to one minute to fully disinfect.

“Follow the usage directions on products by keeping the surface wet for the required time to be sure the product is completely killing germs,” Forté adds.

Lastly, it’s important to note that hand sanitizer doesn’t always work to eliminate norovirus risk, and shouldn’t be substituted for handwashing, according to the CDC.

How to treat norovirus at home

The only way to confirm if you are experiencing a norovirus infection is to seek out medical care from your doctor or a qualified urgent care clinic, where a PCR test will confirm the virus’ presence. There isn’t a particular medication used to treat norovirus alone, but further medical attention may be necessary to treat severe dehydration caused by chronic vomiting and diarrhea.

Staying well hydrated while you are recovering is essential, working in plenty of water and other fortifying beverages to help your body recover, Dr. Alhassani adds. Using over-the-counter products like Tylenol or Advil may ease non-gastrointestinal issues as you recover.

“Eating foods that are easier to digest — think items like crackers, toast, rice, and potatoes, for example — are helpful with GI distress,” he says. “Most importantly, practicing good hand hygiene will help prevent illness and keep other people inside the home from catching it as well.”

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Zee Krstic is a health editor for Good Housekeeping, where he covers health and nutrition news, decodes diet and fitness trends and reviews the best products in the wellness aisle. Prior to joining GH in 2019, Zee fostered a nutrition background as an editor at Cooking Light and is continually developing his grasp of holistic health through collaboration with leading academic experts and clinical care providers. He has written about food and dining for Time, among other publications.