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Running to the bathroom with vomiting, diarrhea, or both is never fun. Yet “stomach bugs” are a common part of life, and norovirus is often behind these outbreaks.
Norovirus is a highly contagious virus that triggers symptoms like vomiting and diarrhea, and cases are climbing this winter. While it often makes headlines during cruise ship outbreaks, most infections occur on land, anyone can catch it.
“Originally called ‘winter vomiting disease,’ norovirus is one of the leading causes of vomiting and diarrhea in both children and adults,” explains Dr. Ava Anklesaria, a gastroenterologist at Columbia who treats multiple cases each year. “The virus is very stable in the environment, and only a tiny amount is needed to infect someone, which makes it easy to spread. Simple measures like washing your hands with soap and water for 20 seconds and avoiding contact with sick individuals can prevent infection.”
In the U.S., the CDC estimates that norovirus causes about 21 million illnesses, 465,000 emergency visits—mostly among children—and around 900 deaths annually.
Norovirus causes viral gastroenteritis, sometimes called “stomach flu” or a “stomach bug,” though it isn’t related to influenza. As per Mayo Clinic, it consists of several strains of RNA viruses that inflame the stomach and intestines, causing nausea, vomiting, and diarrhea.
Symptoms usually appear one to two days after exposure and often include:
Most people recover within one to three days, though they can still spread the virus for up to two weeks after feeling better.
Anyone can get infected. Norovirus is the leading cause of acute gastroenteritis in the U.S., affecting all ages. Young children, older adults, pregnant people, and individuals with existing health conditions are more vulnerable.
Norovirus spreads very easily. It survives well in the environment, and only a minuscule amount is enough to infect someone. In fact, just a few particles on the head of a pin can infect over 1,000 people.
Exposure can happen through:
As per the National Institute Of Health, once inside the body, norovirus targets the stomach and intestines. It inflames the lining of the gut, which disrupts normal digestion and absorption. This inflammation leads to increased fluid secretion and faster movement through the intestines, causing watery diarrhea. Vomiting occurs as the stomach reacts to the irritation.
The gut lining may also temporarily lose some of its ability to absorb nutrients and fluids, which can lead to dehydration, electrolyte imbalances, and fatigue. While symptoms usually resolve in a few days, the virus can continue to be shed in stool for up to two weeks, meaning the gut can remain a source of infection even after recovery.
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Hundreds of thousands of children are set to receive an additional vaccine under the NHS routine childhood immunisation programme. Health officials have confirmed it will be given alongside the existing MMR jab, which protects children in England against measles, mumps and rubella.
The decision follows advice from the Joint Committee on Vaccination and Immunisation and will see the current MMR jab replaced with a combined MMRV vaccine. This single injection protects against measles, mumps, rubella and chickenpox. Studies estimate that chickenpox in childhood leads to around £24 million a year in lost earnings and productivity across the UK. Alongside reducing this impact, the rollout is expected to save the NHS about £15 million each year in treatment costs linked to the illness.
Dr Claire Fuller, National Medical Director for NHS England, said: “This marks a very positive step for children and families, offering protection against chickenpox for the first time and strengthening the range of routine vaccinations we already give to help shield children from serious diseases.
“From now on, the combined vaccine covering measles, mumps, rubella and chickenpox will be offered at children’s routine vaccination appointments. This will help keep children healthier, prevent illness caused by these highly infectious viruses, and support the NHS shift from treating sickness to preventing it, while keeping more children safe and in school.”
Recent figures show that around half of children will have chickenpox by the age of four, with nine in ten catching it before they turn ten. Children who develop chickenpox are usually advised to stay away from school until all spots have crusted over, which typically happens about five days after the rash appears.
With the new vaccine in place, fewer children are expected to miss time at nursery or school. This should also reduce the amount of work parents need to take off to look after them.
Protection against chickenpox is being offered through a new combined vaccine known as MMRV, which replaces the existing MMR jab. The MMRV vaccine protects against measles, mumps, rubella and varicella, the virus that causes chickenpox.
Specialists say adding the varicella vaccine to the NHS childhood immunisation schedule will significantly cut the number of people who get chickenpox, resulting in far fewer severe cases.
While the vaccine does not guarantee lifelong immunity, it greatly lowers the chances of catching chickenpox or developing a serious form of the illness. Serious side effects, including severe allergic reactions, are extremely uncommon.
The vaccine is a live vaccine, meaning it contains a weakened form of the chickenpox virus. Because of this, it is not recommended for people with weakened immune systems due to conditions such as HIV or treatments like chemotherapy.
The change brings the UK in line with countries that already include routine chickenpox vaccination, such as Germany, Canada, Australia and the United States.
In the past, there were concerns that vaccinating children against chickenpox could lead to an increase in shingles later in life, but a large long-term study from the US has since shown this is not the case.
The Joint Committee on Vaccination and Immunisation, which advises the government, recommended the introduction of the MMRV vaccine for all children in November 2023.
The government confirmed plans to roll out the MMRV vaccine in August 2025, after new figures showed that none of England’s main childhood vaccinations reached the 95 percent uptake target in 2024 to 2025.
According to the UK Health Security Agency, 91.9 percent of five-year-olds had received one dose of the MMR vaccine. This figure was unchanged from 2023 to 2024 and remains the lowest level recorded since 2010 to 2011.
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Atenolol is widely prescribed for conditions such as high blood pressure and irregular heart rhythms. While it is suitable for many adults, some people need to be especially careful before starting the beta-blocker.
NHS guidance highlights that certain medical conditions and life stages mean a doctor should be consulted first. This includes people with low blood pressure, Raynaud’s phenomenon, or asthma, among others.
The NHS advises speaking to a doctor before taking atenolol if you fall into any of the following groups:
According to official NHS advice, atenolol works by slowing the heart rate, which helps the heart pump blood around the body more easily. In addition to treating blood pressure and heart rhythm problems, it is sometimes prescribed to help prevent migraines and ease symptoms of anxiety.
The NHS notes: “Atenolol is only available on prescription. It comes as tablets or a liquid that you swallow. It can also be given by injection, but this is usually only done in hospital.”
People who take other medicines should also check with a doctor before starting atenolol, as some drugs can affect how well it works or increase the risk of side effects. This applies not only to prescription medicines but also to herbal remedies, vitamins, and supplements.
You should speak to a doctor if you take:
The NHS also states: “There’s not enough information to say that herbal remedies and supplements are safe to take with atenolol. They’re not tested in the same way as pharmacy and prescription medicines, and they’re generally not tested for how they affect other medicines.”
The dose of atenolol you need depends on the condition being treated. For high blood pressure, the usual adult dose is between 25mg and 50mg once a day, but you should always follow your doctor’s instructions. Your medication packaging will also provide guidance on how to take it.
How long you stay on atenolol varies as well. For long-term conditions such as high blood pressure, it is often taken for many years and, in some cases, for life.
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Furosemide is commonly prescribed in the UK to help manage conditions such as heart failure and high blood pressure. The diuretic medication is used by people of all ages, including children and infants. In 2024 alone, it was dispensed around 11 million times, making it one of the 20 most frequently prescribed medicines in the country.
Although it is widely used, doctors stress that furosemide must be taken carefully and in line with medical advice, as misuse can lead to serious health problems.
To ensure safe use, the NHS has issued guidance urging certain people to speak to a doctor before taking furosemide. This is particularly important for anyone showing signs of dehydration, which can include feeling unusually thirsty, having a dry mouth, or noticing dark-coloured urine. Because furosemide increases urine output, it can raise the risk of fluid loss if not managed properly.
The NHS advises the following people to consult a doctor before using furosemide:
Beyond these groups, the NHS also says furosemide users should seek medical advice if:
Official NHS guidance explains that diuretics are often referred to as “water tablets” because they increase how often you urinate. This helps the body remove excess fluid.
“Furosemide is only available on prescription,” the NHS states. “It comes as tablets and a liquid that you swallow. It can also be given by injection, but this is usually only done in hospital.”
The NHS also warns that certain medicines can reduce how well furosemide works or increase the risk of side effects. This includes some commonly used over-the-counter treatments, such as paracetamol, co-codamol, and remedies for heartburn or indigestion.
Anyone prescribed furosemide is advised to speak to a doctor before taking:
Other medicines can also interfere with how furosemide works, including:
The NHS advises patients to tell their doctor if they are taking potassium supplements, as these can alter potassium levels in the blood and affect how furosemide works.
The health service also cautions against combining furosemide with herbal remedies or supplements. According to NHS guidance, there is not enough evidence to confirm they are safe to take alongside the drug.
Unlike prescription and pharmacy medicines, herbal products are not tested to the same standards and are generally not assessed for how they interact with other medications.
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