As flu and RSV continue to circulate this winter, pediatric emergency doctors are also concerned about another familiar seasonal illness: a highly contagious stomach virus often referred to as the “winter vomiting bug.”
The illness — most commonly caused by norovirus — spreads differently than respiratory viruses and requires different prevention strategies, especially at home.
“Like all viruses, the biggest thing is hand-washing,” said Dr. Carlos Abanses, medical director of the Pediatric Emergency Department at St. Joseph’s Children’s Hospital in Tampa. "I always get asked what to do so the other kids don't get it in the household, and the biggest things could be washing them and kind of trying to keep them isolated to one little area."
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Unlike flu or RSV, which spread primarily through respiratory droplets, stomach viruses spread through contaminated hands, surfaces, food and close contact. Even brief contact with a contaminated surface can be enough to transmit the virus.
Children may vomit or have diarrhea in one part of the house, then move into another room and touch common items such as TV remotes, refrigerator handles or doorknobs, Abanses said. Others who touch those same surfaces can quickly become sick.
“Usually the stomach viruses, they can sometimes live on surfaces for 10 days to 14 days. So they actually live a little bit longer than even the flu viruses on surfaces.” Abanses said during an appearance on "Florida Matters Live & Local.". “So cleaning stuff really good, it's really important.”
Health experts note that norovirus circulates every year, most commonly during fall and winter months. While it does not receive the same level of routine reporting as flu or COVID-19, pediatricians and emergency departments expect to see an uptick each winter.
The surge kicked off a little earlier than normal, likely fueled by a newer variant that made the 2024–25 season especially harsh. Cases have been on the rise since mid-October across the country, especially in the Midwest and Northeast, according to wastewater monitoring and U.S. Centers for Disease Control and Prevention.
In Florida, statewide wastewater datas show norovirus levels have been mostly steady in recent weeks, but Orange County has experienced a noticeable rise, suggesting the virus may be more active locally.
What parents can do
Because stomach viruses spread easily, entire households can become sick within days if precautions aren’t taken.
According to the CDC, washing hands thoroughly with soap and water is the most reliable prevention. However, health experts note that alcohol-based hand sanitizers are not as effective against norovirus.
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That said, here are recommendations to reduce household transmission:
- Wash hands frequently with soap and water, especially after bathroom use and before eating or preparing food.
- Clean and disinfect surfaces that may be contaminated, using appropriate household disinfectants.
- Limit movement within the home by keeping sick children in one area if possible.
- Avoid sharing items such as towels, utensils and cups during illness.
Focus on hydration
For children who become ill, hydration is a major priority, according to the American Academy of Pediatricians.
"The most important thing with vomiting diarrhea is hydration, and it's really important just kind of keep kids really hydrated," he said. "And same thing with the flu when they have high fevers."
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Doctors may prescribe medications such as Zofran to help control vomiting if a child is unable to keep fluids down. However, medications to stop diarrhea are generally not recommended for children, according to CDC.
Parents should seek medical care if a child shows signs of dehydration or other concerning symptoms.
According to the CDC and the AAP, warning signs include:
- Decreased urination or very few wet diapers.
- Dry mouth or lips.
- Lethargy or unusual sleepiness.
- Inability to keep fluids down.
Other red flags include blood in the vomit or stool, severe abdominal pain, or a persistent high fever.
