Learn how to recognize, prevent, and treat norovirus in kids with expert advice from Dr. Chase Parsons. Stay prepared this peak season with essential tips for keeping your little ones safe and healthy.

 

 

You’ve likely heard the term Norovirus a lot recently, as cases rise across the United States. Norovirus is the leading cause of vomiting and diarrhea in the United States. According to the Centers for Disease Control (CDC), an average of 465,000 people visit the emergency room annually, and norovirus is responsible for over a million pediatric medical care visits per year. By age five, 1 in 7 children will visit an outpatient clinic due to norovirus.

 

We asked pediatric hospitalist, Dr. Chase Parsons, the expert who leads our Ultimate Safety Class, to fill us in on all things Norovirus. 

 

What is Norovirus?

A:  The most general term here is “gastroenteritis” which is an inflammation of the stomach and intestines due to an infection. While this inflammation is most commonly because of a virus it can also be caused by bacteria. That being said, the most common cause of gastroenteritis in children under 5 is a virus called norovirus

 

Interestingly, when this virus was first discovered it was known as “winter vomiting disease” because of its seasonality in the colder months and vomiting as the primary symptom. While all ages can become infected and symptomatic, children are especially at risk. Due to a child’s small size (and lower circulating fluid/blood volume), it’s much easier for them to become substantially dehydrated. With severe norovirus symptoms, children may need interventions like intravenous fluids to maintain adequate hydration. 

 

What are the symptoms of norovirus?

 

Symptoms of norovirus usually last 1-3 days. Most kids with this virus develop the following symptoms: 

  • Nausea
  • Vomiting
  • Abdominal pain & cramps
  • Fever 
  • Some children also experience diarrhea with these symptoms

 

Are cases on the rise? 

Norovirus cases ARE on the rise this year. The data from the CDC shows that the current peak of positive tests in January of 2025 is higher than the positive test rate that we saw during the peak of norovirus in March of 2024, and rates are continuing to go up. About 70% of cases this year are due to a new strain of the virus which scientists believe is causing this surge.  

 

Is norovirus a seasonal virus, or can you catch it any time of year?

Outbreaks of norovirus (and really other types of gastroenteritis) are more common in the wintertime because kids are indoors more frequently. This gives the virus more opportunity to spread, particularly in settings where close contact is common, like schools, daycares, and healthcare settings.  The virus is also more stable in cold, dry conditions, which enhances its transmission in the winter months. 

 

How does norovirus spread? Is it contagious?

Norovirus is pretty contagious, mainly for two reasons: 

1. It’s not eliminated by standard cleaning products or alcohol-based hand sanitizer

2. Only a small amount of virus is needed for transmission

Norovirus spreads by the “fecal-oral” route (we know, it sounds gross and it is). This means its main route of transmission occurs when someone infected by the virus uses the bathroom (or changes an infected baby’s diaper), and the viral particles end up in the mouth of someone else, who then becomes infected with norovirus.

 

Norovirus spreads quickly and easily in a number of ways, including: 

  • Having direct contact with someone with norovirus. This includes things like caring for them, sharing food or utensils with them, or eating food handled by them.
  • Eating food or drinking liquids that are contaminated with norovirus.
  • Touching contaminated objects or surfaces and then putting your unwashed fingers/hands in your mouth.

 

It takes 1-2 days for someone infected with norovirus to begin having symptoms, and that’s when you are at the highest risk for spreading it, but you can still spread norovirus for 2 weeks or more after you feel better.


What are the best ways to prevent the spread of norovirus?

Soap and water!  Washing your hands with soap and water is the best way to prevent the transmission of norovirus - for yourself or your kiddos. You should wash your hands with soap and water for at least 20 seconds after changing a diaper or using the toilet, before preparing or eating food, and before giving your child or yourself medicine. Alcohol-based hand sanitizers aren’t as helpful as plain soap and water for this infection.  

 

If there are surfaces in your home that may have become contaminated by a sick person, here’s how to disinfect them. Use gloves and clean with a chlorine bleach-based solution (you can use a ratio of 10 tablespoons of household bleach per gallon of water) or a disinfectant that is certified as effective for norovirus. Take a look at your disinfectant wipes from the big brands - many do not contain bleach and are not effective against norovirus. Remember to wash your hands thoroughly after disposing of the gloves.

 

Another way to prevent the spread of norovirus is keeping your sick child home. Your child shouldn’t return to daycare until their stools are no longer runny (contained in their diaper or no longer having accidents) and their bowel movement frequency is no more than two per day above their normal frequency. Sick children should stay home for at least 48 hours after vomiting or diarrhea has stopped.

 

How can I treat & comfort a child sick with norovirus?

Hydration, hydration, hydration!  For home management of norovirus or any viral gastroenteritis, I recommend oral rehydration.  

  • For breastfed babies under the age of one continue breastfeeding unless directed otherwise by your pediatrician. 
  • If your baby is formula fed, you can try diluting the formula by 50% with an electrolyte solution like Pedialyte, which may be more easily tolerated. 
  • If your child is over the age of 1, half-strength apple juice is a good oral solution to try (meaning you mix apple juice with the same amount of water). Give some sips every 10-15 minutes if your child can tolerate it; if they vomit, wait 30 minutes before trying again. If they’re able to do sips every 10-15 minutes for a few hours without vomiting, or they start to feel hungry and have been tolerating liquids, you can try foods that contain lots of liquid, like popsicles or soup.

 

Once your child is able to start taking solid foods again, give them (mostly) what they want - no need to go to a strict “BRAT” diet (which stands for Bananas, Rice, Applesauce, and Toast), but try to avoid high-fat or fried foods. Complex carbs, fruits, vegetables, and lean meats are a good place to start.  

 

There aren’t any medicines you should be giving your child at home for gastroenteritis. Some medications that slow GI transit and are advertised to decrease diarrhea can have side effects that range from sleepiness to serious colon issues. Always check with your pediatrician before using any medications to treat norovirus. 

 

What about probiotics, will they help with Norovirus?

Some studies do suggest that probiotics could help with diarrhea caused by a viral infection (they may decrease the duration of diarrhea by ~12 hours), but other studies show that they make no difference. I don’t recommend them as they’re expensive, they have little to no benefit, and rehydration and oral nutrition should take priority.  

 

When should I seek medical care for my baby, toddler or child if I suspect they have norovirus? 

First, if your child is under 4 months of age and has a fever, it is important to take your child to see a healthcare professional right away. 

 

For children over 4 months old, while mild dehydration can usually be treated at home, if it becomes more severe you’ll want to seek professional medical care.  

 

Call your pediatrician or head to the emergency department (if your pediatrician is unavailable and doesn’t have an after-hours line or on-call doctor),  if your child experiences any of these symptoms:

  • A significant decrease in urination. If your child has not wet their diaper or hasn’t gone to the bathroom for 6 hours.
  • Fewer tears when crying
  • A decrease in responsiveness
  • Try this “nail bed” test I demonstrate in Tinyhood’s Ultimate Safety Class.
    • Squeeze your child’s nail bed.
    • When you squeeze, the nail bed should turn white. Almost immediately after you let go, the color should return to their nail bed.
    • If it takes longer than one second for the color to return, it may indicate dehydration. I recommend calling your doctor.

 

Do any symptoms in babies and children require a trip to the emergency department or calling for emergency help?

 

If your child has norovirus symptoms and is also experiencing any of these symptoms, call 911 or bring them to the nearest emergency department.  

  • Seems more sleepy than normal
  • Has cool but sweaty hands or feet
  • Has sunken looking eyes
  • Has no urine for more than 12-24 hours
  • If they are under one year of age and the soft spot on their head seems sunken 

If your child ever becomes unresponsive, call 911 and begin CPR immediately. 


Norovirus is never fun to deal with as a parent, but often can be treated at home. Remember to check your child for signs of dehydration, and do not hesitate to seek medical care if you have any concerns.


For more on Norovirus, along with treating other upcoming seasonal illnesses like fevers, the common cold, the flu, and croup, check out our Ultimate Safety Class, led by Dr. Parsons.