Dear Alice,

I have been hearing a lot about the norovirus. What is it and how can I protect myself from getting it in NYC? I feel like there are germs everywhere, especially on the subway!


Dear Reader,

Norovirus (also known as the stomach flu) is a highly contagious virus that leads to symptoms similar to those of food poisoning and is the most common cause of acute gastroenteritis in the United States. Although it is unrelated to the flu virus (influenza), it is transmitted in similar ways: through contact with infected individuals, consuming contaminated water or food, and touching contaminated surfaces (like subway poles). The symptoms of norovirus infection range in severity but usually only last for one to three days. Additionally, there are several tips you can follow to help protect yourself from norovirus infection.

Symptoms of norovirus infection include nausea, stomach pain, fever, headache, vomiting, diarrhea, and resulting dehydration. Unfortunately, antibiotics and other medicines can’t be prescribed to treat norovirus infection because antibiotics are not effective for addressing viral illness. Therefore, if you’re exhibiting symptoms, the best you can do is to drink as much water as possible to prevent dehydration, which can lead to further serious health problems (especially among children and the elderly). Dehydration, marked by infrequent urination, dry mouth, and dizziness upon standing, is one of the more potentially dangerous symptoms of infection. In addition to drinking lots of water, after vomiting or using the bathroom, disinfect all surrounding surfaces with a cleaning product that contains bleach. Norovirus can tolerate heat up to 140 degrees, so using hot water may help as well.

The best way to avoid symptoms of norovirus is to prevent the initial infection. The way to prevent infection will be the same regardless of where you live. Because transmission via contact with contaminated surfaces is fairly common, one of the best ways to protect oneself from infection is through frequent and thorough handwashing. In a 2011 Centers for Disease Control and Prevention study, it was found that norovirus transmission occurred six times more often when individuals used hand sanitizers instead of soap and water, so it’s wise stick to the traditional hand cleansing method. Additionally, be sure to avoid spending time with individuals experiencing symptoms to help prevent exposure to the virus. If you are around many people during the day, or if you happen to be touching common surfaces (e.g., subway car poles or handles), you may just want to wash your hands more frequently. 

Washing one’s hands after going to the bathroom is especially important in (re-)infection prevention both before and after symptoms manifest — the virus can live in stool before symptoms appear and for up to two weeks after you start to feel better. In addition to washing your hands after using the restroom, make sure to wash fruits and vegetables thoroughly before eating them. Finally, keep in mind that prevention is an ongoing process because previous infection of one strain of norovirus doesn’t necessarily render someone immune to other types of the virus. The virus is most common between the months of November and April, so be especially cautious throughout the winter and early spring.

If you are concerned, make an appointment with your health care provider. In the meantime, drink plenty of fluids and remain within a contained environment to prevent further transmission. Adherence to these tips should bring you back to good health in no time.


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