The Kid's Doctor: What is stomach flu?
Monday, March 31, 2014
Norovirus is the most common cause of "stomach flu" (actually 


By Sue Hubbard, M.D.

  I've seen a lot of patients in recent weeks with complaints of "stomach flu." Just to be clear, "stomach flu" really is not flu at all, and has nothing to do with influenza. The stomach stuff is actually called gastroenteritis, and is typically caused by a virus.

   If you've been watching the news, you've no doubt heard the cruise ship (another one!) recently forced to return to port after many passengers and crew were sickened by gastroenteritis. Most patients experience vomiting, diarrhea and stomach cramps. It's pretty miserable. The most common cause of the "bug" is a virus called norovirus.
  Rotavirus was previously the culprit in most cases of viral gastroenteritis, but since the rotavirus vaccine was introduced for infants, rotavirus has now been surpassed by norovirus. Viruses are really smart, sneaky and strong (or "virulent" in medical terms). 
  Norovirus makes you feel awful (who likes to vomit?) and is very easy to pick up. Where it takes exposure to many viral particles to get sick from some viral illnesses, a recent study in The New England Journal of Medicine found that as few as 10-100 norovirus particles may cause disease.
   It's a very efficient virus and may even be acquired by breathing in the viral particles. (as a gross example, a child spews vomit while you're in the room, and you breathe in the virus). 
  Norovirus illness peaks in children 6-18 months old. By the age of 5, 1 in 6 children will have seen a doctor for vomiting/diarrhea caused by norovirus. 
  The key to combating norovirus is hydration. The virus typically sticks around several days, with vomiting usually lasting a shorter period than the diarrhea. Treat vomiting with frequent sips of clear liquids and increase the volume of liquid over time. Once your child is tolerating liquids and the vomiting has stopped, you can let the child eat. 
  If your child is over the age of 1 year and diarrhea is a big problem, restrict dairy for a couple of days, as well. Probiotics may also help. 
  Knowing that norovirus can be transmitted by hand to mouth, as well, good hygiene is vital, especially after using the bathroom, so make sure those little hands are washed.
 Dr. Sue Hubbard is a nationally known pediatrician and co-host of "The Kid's Doctor" radio show. Submit questions at
This article was printed in the March 23, 2014 - April 5, 2014 edition

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