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Norovirus

Norovirus - when to see a doctor

As winter approaches, viruses spread between people more easily. If you have stomach bug symptoms, there's a good chance you've caught norovirus - one of the most common and contagious viruses in the UK. Norovirus is a nasty experience, so how do you know when it's serious enough to see a doctor?

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Norovirus treatment at home

Norovirus, also known as the winter vomiting bug, is a name for a group of viruses that can cause gastroenteritis - an infection of the gut. It can make both adults and children very ill for 2 - 6 days, but it usually clears up on its own and can be managed at home.

Dr Rosmy Barrios describes the common symptoms of norovirus: "The first signs of norovirus typically develop within 1 - 3 days of becoming infected. In most cases, people experience nausea, being sick (vomiting), a high temperature, and/or diarrhoea with watery poo."

While these symptoms are unpleasant, they are usually mild enough to treat at home. Advice on how to treat norovirus is straightforward, as Dr Hussain Ahmad explains:

"Norovirus treatment at home involves drinking lots of fluids to avoid dehydration. It typically passes within three days of contracting the virus." You should also eat as normally as possible.

When to see a doctor for norovirus

For most people, there are two main situations where you should see a doctor for norovirus. One is if your symptoms are so severe that you are dehydrated and it doesn't stop when you drink lots of water. The other is that your symptoms last for more than a few days.

It's important you get immediate medical attention if:

  • You have signs of serious dehydration - this includes having a very pale complexion, feeling drowsy, dizzy, or very weak, or not feeling fully conscious - where you are awake and in full control of your basic reflexes.

  • Your vomit is bloody.

  • There is blood in your poo.

  • Your temperature is 40°C or higher.

  • You have severe stomach pain.

It's usual for diarrhoea to last a little longer, but you should consult your doctor if this hasn't started to settle after three or four days - sooner if you are going to the toilet a lot through the day and the night. If you're too unwell to go to your GP surgery, or you are not sure the visit is needed, arranging an online consultation may be a good option - even if it's just to put your mind at ease.

While there's no specific medication that can be prescribed for norovirus, doctors can check for rare complications - such as inflammation in other parts of your body - and help treat dehydration, which if left can cause serious problems.

Other times adults should see a doctor

There are certain circumstances where you should seek medical attention for norovirus, especially if you're worried. It's recommended that you see your doctor if:

  • You are elderly.

  • You caught your norovirus infection abroad.

  • You have an underlying health problem and you're worried norovirus may affect your management of it. For example, this could be diabetes, kidney problems, or epilepsy.

  • You have a weakened immune system. This could be due to a health condition, like HIV infection, or caused by certain treatments, such as chemotherapy or immunosuppressant drugs.

  • You are pregnant.

These scenarios do not guarantee you'll be seriously affected by norovirus, but if you're worried it's always best to be safe.

Norovirus in children under five

It's one thing experiencing the severity of your own symptoms, and another trying to guess how bad norovirus is for your child. It can take slightly longer for a standard bout of norovirus to disappear in children. Vomiting may last up to three days, and diarrhoea up to seven days. If either last longer, you should take them to the doctor.

Children under five years aren't usually able to give you a clear idea with words, but Dr Ahmad says there are things you can do to work out if a visit to the doctor is needed.

"You should monitor how much fluid your child is drinking, how often they are sick, and how often they pee.

Young children need to be seen by a doctor urgently in the nearest A&E if:

  • They are unable to keep fluids down.

  • They are not peeing - less than two wet nappies in 24 hours or more than 12 hours since they last went for a pee in older children.

  • They are showing signs of dehydration such as a dry mouth, pale skin, sunken eyes, or unusual tiredness.

The same exceptional circumstances apply to children as they do adults, for example a visit to the doctor is advised if they have an underlying health problem, picked up the infection abroad, or have a weakened immune system.

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Norovirus in infants

If your child is under six months old, it's always worth a visit to the doctor as soon as you suspect they have norovirus - or any other type of infection or illness. This is to safely manage the risk of dehydration.

According to Dr Ahmad, there are also important signs that your baby is becoming dehydrated and needs immediate medical attention:

  • They are not willing to drink as much fluid as normal,

  • They are being sick after drinking.

  • They are producing fewer wet nappies than normal - fewer than two wet nappies in 24 hours

  • Their fontanelle dips more than usual - this is the soft spot on your baby's head.

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Norovirus 2023 - what to expect this winter

Norovirus and other viral infections can survive and spread more easily in the colder months. This is why we always expect a peak in winter, but in winter 2022-23 norovirus spread at a rate twice as high as that experienced in the last decade1.

"The increase in norovirus cases last winter was down to social distancing during the earlier COVID-19 pandemic limiting its spread, which decreased immunity in the general population - particularly in young children who may not have had the virus before," says Dr Ahmad.

Dr Barrios adds that it's possible people are tired from the hygiene restrictions during the COVID-19 pandemic, which last winter resulted in less careful hygiene practices.

It's difficult to predict whether we will experience a similar norovirus spike this winter 2023-24. "But we're hoping numbers won't be quite as high as we now have the benefit of immunity levels we didn't have earlier this year," adds Dr Ahmad.

Catching norovirus isn't inevitable, and we can form habits that help protect us. The Centers for Disease Control and Prevention recommends2:

  • Washing your hands often.

  • Rinsing your fruits and vegetables before eating them.

  • Cooking shellfish thoroughly.

  • Staying at home when you're ill for two days after symptoms stop.

  • Avoiding preparing food for others when you're ill.

Further reading

  1. GOV.UK: National norovirus and rotavirus report, week 42 report.

  2. Centers for Disease Control and Prevention: Norovirus.

Article history

The information on this page is peer reviewed by qualified clinicians.

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