Steel Your Gut for Stomach Flu Season

Norovirus—or stomach flu—can really put your body through the ringer. Here’s what infectious disease experts recommend to outsmart the germs, stay healthy, and recover quickly.

By Lauren Gelman
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    Hello, stomach flu!

    Meet winter’s Public Enemy No. 1: norovirus, also known as stomach flu or the cruise ship virus. Norovirus is everywhere: Responsible for around 20 million illnesses in the U.S. every year, it's associated with more than two-thirds of outbreaks of gastroenteritis (infection of the stomach), almost half of gastroenteritis-related hospitalizations — and 86 percent of deaths. It's the most common culprit in children's stomach infections.

    You can catch norovirus from an infected person, a contaminated surface, or contaminated food and water (ick alert: It's spread by droplets of fecal matter and vomit). It'll aggravate to your stomach and intestines, which can cause intense pain and nasty vomiting and diarrhea that'll keep you within a 10-foot radius of a toilet for about a full day or two.

    Getting sick can often be inevitable if you're exposed to the germs. But these tips may help protect you and your family (and help you recover safely if you do fall ill).

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    Know your enemy

    It’s called the cruise ship virus for a reason—norovirus is so contagious that it can spread like wildfire, especially in a confined area like a cruise ship. “When people are acutely ill with norovirus, they shed up to 1 billion viral particles in each gram of stool,” says Robert Frenck, MD, an infectious disease expert and professor in the department of pediatrics at Cincinnati Children’s Hospital. “We have done studies that show as few as 1,000 viral particles can make you sick.” What’s more, infected people can continue to shed and spread the virus for up to six weeks after they contracted it, according to Mary Estes, a molecular virologist at Baylor College of Medicine in Houston, in Scientific American.

    Norovirus is also brilliant in that its very unpleasant side effects—diarrhea, vomiting—cause you to spread it to others, according to Stephen Prescott, MD, president of the Oklahoma Medical Research Foundation.

    “The best option for staying healthy, of course, is to not be exposed to norovirus in the first place,” he said on the OMRF website. “But if you or a loved one gets sick, isolation and common sense are the best ways to stop the spread.” Here’s how.

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    Use soap and water, not hand sanitizer

    Alcohol-based hand sanitizers may stop bacterial infections and even cold and some flu strains in their tracks. But when it comes to norovirus, they don’t do much good. That’s because alcohol in the sanitizer can rupture the "envelopes" around viruses like the flu, according to the New York Times. Norovirus doesn’t have such an envelope, so the alcohol doesn't destroy it.

    A CDC study of long-term care facilities published in 2011 found that those where the staff primarily used hand sanitizer to disinfect were six times more likely to have a norovirus outbreak than those where staffers lathered up with soap and water.


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    It's all about the bleach

    Norovirus is hardy and hard to get rid of; light cleaning won't do the trick (the virus can survive mild cleaners). "There is only one really good effective way to clean, and that’s with Clorox," Herbert DuPont, MD, past president of the Infectious Diseases Society of America and one of the original investigators who isolated the germ, told the New York Times. He recommends a concentrated solution of ¼ cup bleach and 2 ¼ cups of water for surfaces that may have been splattered with viral particles (tile floors, countertops, sinks toilets, etc.) For other surfaces, use the same solution diluted with 9 more cups of water. Let the bleach solution sit for 10 minutes before wiping away.

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    Don’t hand wash dishes

    Norovirus "lives quite some time on surfaces. It is hard to kill," Allison Aiello, PhD, associate professor of epidemiology at the University of Michigan School of Public Health, told NBC News. Hand-washed dishes are likely to spread the outbreak because you can't get the water hot enough if you wash by hand, Aiello said. So if someone in your house is ill, load up the dishwasher, even for water glasses or utensils you’d ordinarily just rinse in the sink.



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    Power up your laundry routine

    Washing machines notoriously harbor fecal matter, according to research from the University of Arizona, which means that doing laundry can actually spread germs to other clothes (and possibly people). "There's about a tenth of a gram of poop in the average pair of underwear," Charles Gerba, PhD, a professor of microbiology at the University of Arizona, told ABC News.

    Wash any clothes, towels, or sheets that have come into contact with vomit or stool right away. Use the hottest water cycle you can and bleach if possible. When a family member is actively doing battle with norovirus, you may also want to run an empty cycle with bleach in between washes to clean out the machine.

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    Clean those less-obvious spots

    Of course you'll scour your bathroom tiles, but don't overlook all the little places a sick family member has likely been in contact with. (Remember, norovirus has a one- to two-day incubation period, which means someone can start spreading the germs before they actually have symptoms). Since the virus can linger on hard surfaces for days, it’s important to clean (with a diluted bleach solution) such places as doorknobs, computer keyboards, remote controls, and phones, according to Good Housekeeping.


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    Refresh your carpet

    Norovirus can live on rugs for weeks, says Good Housekeeping, so if someone throws up on your carpet, pay to have it professionally cleaned. One study found that steam cleaning may be more effective than wet shampooing.

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    Incubate yourself

    Once the worst-of-the-worst symptoms subside, it's tempting to go back to work or send your kids back to school. But you may still  be contagious for a few days after you start feeling better, according to the CDC. Dr. DuPont suggested to the New York Times that people avoid others for at least a week after their symptoms subside.

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    Drink, drink, drink

    Once the bug takes hold, there’s not much you can do to get it out of your system, other than just riding out the symptoms. Staying hydrated, though, is key to avoid complications like hospitalization. Sip water, sports drinks, or juice to replace fluids and essential vitamins and minerals your body is shedding along with all that vomit and poop. Most healthy people who stay hydrated start to feel better within two to three days.

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    Count your genetic blessings

    If you seem to have evaded norovirus despite being exposed to it, you may have won the genetic lottery.  "About 20 percent of the general population is immune to norovirus, likely because they lack a receptor on their gut surface for the virus to bind," says Dr. Frenck. And of the other 80 percent of people who are susceptible, only about 70 percent will get sick when they are experimentally administered the virus, he says. So there may be other still-unknown factors that influence whether someone gets sick or how severe a case they develop.

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