Norovirus in Kids: Symptoms, Hydration, Cleanup and When to Call the Doctor

Quick answer: norovirus is a very contagious stomach virus that causes sudden vomiting, watery diarrhea, nausea and stomach pain, usually for one to three days. The main risk for children is dehydration, so offer small, frequent sips of an oral rehydration solution and watch for few tears, dry mouth, little urine and unusual sleepiness. Antibiotics do not work against viruses. Wash hands with soap and water, because hand sanitizer is less reliable against norovirus, and disinfect surfaces with a bleach solution or an EPA-registered product labeled for norovirus. Call the doctor if your child cannot keep fluids down, has blood in the stool or shows signs of dehydration.

When one child in a family catches a stomach bug, it often moves through the house within days. Norovirus is the usual culprit, and it has a reputation for good reason. It spreads quickly in schools, child care centers, restaurants and homes, and it shows up most often in the cooler months. Knowing what to expect, how to keep a sick child hydrated and how to clean up properly makes the experience much less frightening. This guide is part of our family health and safety guide, and it covers symptoms, home care, cleanup and warning signs.

Sources: Centers for Disease Control and Prevention (CDC) pages on norovirus symptoms, prevention, cleaning and disinfecting; American Academy of Pediatrics (AAP) HealthyChildren.org guidance on vomiting, diarrhea and oral rehydration; National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) information on viral gastroenteritis. This article is general information, not medical advice. Call your child’s doctor with specific concerns.

What Is Norovirus?

Norovirus is a group of viruses that cause gastroenteritis, which is inflammation of the stomach and intestines. People often call it the stomach flu, although it is not related to influenza, the virus that causes the flu. The CDC reports that norovirus is the leading cause of vomiting and diarrhea from acute gastroenteritis in the United States, causing roughly 19 to 21 million illnesses each year.

Anyone can catch it, and you can catch it more than once because there are many types and immunity does not last forever. Young children, older adults and people with weakened immune systems are at greater risk of complications, mainly because of dehydration.

Norovirus Symptoms in Children

Symptoms usually start suddenly, often 12 to 48 hours after exposure. Common signs include:

• Vomiting: often the first symptom in children, and often severe at the start
• Watery diarrhea: can last longer than the vomiting
• Nausea and stomach cramps: many children say their tummy hurts
• Low-grade fever: possible, though not always present
• Headache and body aches: more common in older children
• Tiredness: a child may want to lie on the couch all day

For most healthy children, symptoms last one to three days. A child may feel tired and have a lower appetite for several days after the vomiting stops.

How Norovirus Spreads

Norovirus is hardy and highly contagious. A very small amount of virus is enough to make someone sick. It spreads in several ways:

• Direct contact with an infected person, such as caring for them or sharing food and drinks
• Touching contaminated surfaces such as doorknobs, toys, countertops and bathroom fixtures, then touching the mouth
• Eating or drinking contaminated food or water, including food prepared by someone who is ill
• Droplets and particles that spread during vomiting

The CDC notes that people are most contagious while they have symptoms and during the first few days after they feel better, and that the virus can remain in the stool for two weeks or more. That is why careful handwashing continues to matter after your child recovers.

Why Dehydration Is the Main Concern

Most norovirus infections get better without treatment. The real danger, especially in babies and young children, is losing more fluid than they take in. Children can become dehydrated faster than adults because their bodies are smaller.

Signs of dehydration in children

• Dry mouth or sticky saliva
• Crying with few or no tears
• Fewer wet diapers or going many hours without urinating
• Sunken eyes, or a sunken soft spot on a baby’s head
• Unusual sleepiness, limpness or irritability
• Cool, blotchy or very pale skin
• Dizziness when standing, in older children

If you notice these signs, call your child’s doctor promptly. Severe dehydration is an emergency.

How to Treat Norovirus at Home

There is no medicine that cures norovirus. Home care aims to replace fluids, ease discomfort and rest.

Start with fluids

• Use an oral rehydration solution (ORS): products made for rehydration contain the right balance of water, sugar and salts. The AAP recommends them for children with vomiting and diarrhea.
• Offer small amounts often: a teaspoon or tablespoon every few minutes works better than a full cup, which can trigger more vomiting. Increase the amount slowly as the child tolerates it.
• Wait after vomiting: many pediatricians suggest giving the stomach a short rest, such as 15 to 30 minutes, before trying fluids again.
• Continue breastfeeding or formula: infants should keep nursing or taking formula in smaller, more frequent feedings unless the doctor says otherwise.
• Skip sugary drinks: full-strength juice and soda can make diarrhea worse and do not replace salts well.

Food

Once vomiting settles, children can go back to a normal diet as soon as they are hungry. The old advice to follow a strict bland diet for days is no longer standard. Many children prefer simple foods such as toast, rice, bananas, crackers, yogurt or soup at first. Do not force food.

Medicines

• Antibiotics do not work against viruses.
• Anti-diarrhea medicines are not recommended for young children without a doctor’s approval.
• Fever reducers may be used following the label and your child’s doctor’s advice, based on weight and age.
• Anti-nausea medicine may be prescribed in some cases, but ask your child’s doctor first.

Always check with the doctor or pharmacist before giving any medicine, especially to babies and toddlers. Our guide to fever in kids and when to call the doctor explains how to handle temperature concerns.

When to Call the Doctor

Call your child’s doctor or seek urgent care if you see any of the following:

• Your child cannot keep any liquids down for many hours, or the vomiting is continuous
• Signs of dehydration listed above
• Blood in the vomit or stool
• Green or yellow-green vomit
• A fever above the level your doctor has told you to call about, or any fever in a very young baby
• Severe stomach pain, a swollen belly or pain that stays in one spot
• Diarrhea lasting longer than several days
• Your child has a chronic condition, a weakened immune system or is under three months old
• Your child seems very sleepy, confused or hard to wake

Trust your instincts. If your child looks very ill, call or go in right away. If you believe it is an emergency, call 911.

How Long Is a Child Contagious, and When Can They Go Back?

Children are most contagious when sick and for a few days after. Many schools and child care centers ask that children stay home until they have gone 24 to 48 hours without vomiting or diarrhea. The CDC recommends staying home for at least two days after symptoms stop for people who handle food, and the same rule is a helpful guide for children. Check your school’s own policy. Our guide on when to keep your child home from school covers common rules and how to decide.

Cleaning Up After Vomiting and Diarrhea

Norovirus can survive on surfaces for days or even weeks, and ordinary cleaners do not reliably kill it. Follow the CDC approach.

Protect yourself

• Put on disposable gloves and, if you can, a mask while you clean.
• Wipe up vomit or stool right away with paper towels, and place them in a plastic bag.
• Wash your hands with soap and water afterward.

Disinfect

• Use a bleach solution: the CDC lists a chlorine bleach solution of 1,000 to 5,000 parts per million, which is about 5 to 25 tablespoons of regular household bleach per gallon of water. Let it stay on the surface for the time listed on the product, then rinse surfaces that touch food.
• Or use an EPA-registered disinfectant: look for products on the EPA list of disinfectants effective against norovirus.
• Do not mix bleach with ammonia or other cleaners. This can create toxic gas.
• Ventilate the area while you clean.

Laundry and soft items

• Wash soiled clothes, towels, sheets and stuffed animals right away, using the longest cycle and the warmest water the fabric allows.
• Dry them on high heat.
• Handle dirty laundry carefully and avoid shaking it.

Toys and shared surfaces

• Clean and disinfect toys that have been in a sick child’s mouth or hands.
• Wipe doorknobs, faucets, light switches, remote controls and bathroom surfaces.
• Dispose of anything that cannot be cleaned.

Handwashing Matters More Than Sanitizer

The CDC recommends washing hands thoroughly with soap and running water for at least 20 seconds, especially after using the toilet or changing diapers and before preparing or eating food. Alcohol-based hand sanitizer can be used as an addition but does not work as reliably against norovirus, so it should not replace washing.

Teach children to scrub the backs of the hands, between fingers and under nails. A short song or timer can make it easier.

Preventing Norovirus in the Family

There is no vaccine for norovirus in the United States. Prevention depends on habits.

• Wash hands often and well.
• Keep a sick child away from siblings when possible, and use a separate bathroom if you have one.
• Do not prepare food for others while sick and for at least two days after symptoms stop.
• Wash fruits and vegetables, and cook shellfish thoroughly, because oysters and other shellfish are a common source.
• Clean kitchen counters and cutting boards well. Our guide on fridge organization and food safety has useful storage tips.
• Pack lunches safely. See our tips for school lunch food safety.
• Avoid sharing cups, utensils and towels during an illness.

Norovirus Versus Other Stomach Bugs

Several illnesses can look alike, and a doctor can help sort them out.

• Rotavirus: once a common cause of severe diarrhea in infants, now less common because of the rotavirus vaccine.
• Food poisoning from bacteria: may include fever, bloody diarrhea and more severe cramps. It can come from undercooked meat, eggs or unpasteurized products.
• Influenza: causes fever, cough and body aches, and sometimes vomiting in children. Our guide on flu season and kids explains the differences.
• Other viral infections: adenovirus and others can cause similar symptoms.

If symptoms are unusual, severe or last long, ask the doctor to check.

A Parent's Sick-Day Setup

A little preparation makes a stomach bug easier to handle.

• Keep supplies on hand: oral rehydration solution, disposable gloves, paper towels, trash bags, bleach and a thermometer.
• Set up a sick station: a bucket, towels and a water cup next to the bed or couch.
• Use waterproof mattress covers or old towels for nighttime accidents.
• Plan for hand hygiene: a pump bottle of soap near the bathroom helps.
• Rest: sick children usually want to sleep, and rest helps recovery.
• Look after yourself: wash your hands often, because caregivers get sick easily.

Norovirus at School and Child Care

Outbreaks are common wherever young children share space. Shared toys, bathrooms, snack tables and close play give the virus plenty of chances to spread. A single sick child can lead to several absent classmates within a few days, and teachers often send a notice home when they see a cluster of cases.

Parents can help in a few practical ways. Tell the school or child care center if your child has a confirmed stomach illness so staff can step up cleaning. Send a change of clothes and a sealed plastic bag in the backpack for younger children. Remind your child to wash hands after the bathroom and before eating, and avoid sending a child back too early, even when the child says they feel fine. Returning before the vomiting and diarrhea have fully stopped is one of the most common ways the virus keeps circulating through a classroom.

Parents who work outside the home can plan ahead as well. Talk with a trusted relative, neighbor or sitter about backup care, and find out in advance whether your employer allows sick days for a child’s illness. Having a plan before the first bug of the season makes a stressful week much easier.

What to Do If Another Family Member Gets Sick

If a second or third person starts vomiting, the same rules apply. Keep fluids coming for everyone, separate sick family members from healthy ones where possible, and clean the bathroom after each use if it is shared. Adults can become dehydrated too, and older adults and pregnant women should check with a doctor if they cannot keep fluids down.

Avoid preparing food for the rest of the family until at least two days after your own symptoms stop. If possible, ask a healthy family member to handle meals, and use disposable plates and utensils for a day or two if you are the only caregiver. Wash dishes in hot water or run them through the dishwasher.

Frequently Asked Questions

How long does norovirus last in kids?

Most children recover in one to three days. Fatigue and a poor appetite can last a little longer, and the virus can remain in the stool for two weeks or more.

What should my child drink with a stomach bug?

Small, frequent sips of an oral rehydration solution are best. Breastfed and formula-fed infants should continue nursing or taking formula in smaller amounts.

Does hand sanitizer kill norovirus?

Alcohol-based hand sanitizer is not as reliable against norovirus as soap and water. The CDC recommends washing hands with soap and running water for at least 20 seconds.

When can my child return to school after vomiting?

Many schools ask that children be free of vomiting and diarrhea for 24 to 48 hours. Follow your school’s policy and your doctor’s advice.

Do antibiotics help norovirus?

No. Norovirus is a virus, and antibiotics treat bacteria. Treatment focuses on fluids and rest.