Winter Vomiting Bug: What Your Pharmacist Can Give You, and When to Call 111

Every winter there is a week, usually in late November or December, when the phone calls change. "Is there a bug going around?" Yes. There always is. Norovirus, the winter vomiting bug, circulates every year, and while it is miserable, for most people it is short and safe to manage at home. This is what I tell people at the counter, including the two questions everyone asks and the one thing almost everyone gets wrong.

What is the winter vomiting bug, and how long does it last?

Norovirus is a stomach virus. The UK Health Security Agency describes the classic picture as a sudden onset of feeling sick, followed by projectile vomiting and diarrhoea, sometimes with a high temperature, stomach pain and aching limbs. Symptoms usually start 12 to 48 hours after you pick it up, which is why a whole household can go down within two days of one child bringing it home from school.

For most people it is over within 2 to 3 days. That is the answer to "how long does norovirus last", and it is also your safety net: if you are still vomiting on day three, or diarrhoea has gone on for a week, it is time to get advice rather than wait it out.

It is worth knowing that norovirus is not one virus but several strains, and catching it once does not protect you against the others. You can catch it more than once in the same winter. I have seen it happen in the same family.

Is there a stomach bug going around right now?

Between November and March in the UK, the answer is almost always yes. Norovirus has a winter peak, which is where the name comes from, and UKHSA publishes surveillance figures through the season. Laboratory reports are consistently highest in people over 65, partly because outbreaks in care homes and hospitals are recorded carefully. In practice, though, the first cases we hear about in Gillingham each year come from primary schools and nurseries, and the adults follow a few days later.

What can the pharmacy give you for norovirus?

Nothing cures it and antibiotics do nothing against a virus. What we can do is help you avoid dehydration, which is the only part of norovirus that is dangerous, and make the 48 hours more bearable. The NHS diarrhoea and vomiting advice matches what I recommend:

• Oral rehydration sachets. Dioralyte or a pharmacy own-brand equivalent. These replace the salts and sugar you lose, not just the water, and they are the single most useful thing on our shelves for a stomach bug. Mix with the stated volume of water, sip slowly, and do not make it stronger. Suitable for children and adults, with baby-appropriate advice from the pharmacist.
• Small, frequent sips. Water or diluted squash. If you feel sick, a mouthful every few minutes stays down better than a glass in one go. Avoid fruit juice and fizzy drinks, which make diarrhoea worse.
• Paracetamol for aches and temperature. Avoid aspirin in anyone under 16, and be careful with ibuprofen on an empty, upset stomach.
• Loperamide (Imodium) can stop diarrhoea for a few hours if you absolutely have to travel or work. It is not suitable for children under 12, and I usually steer people away from it in the first day or two, because diarrhoea is your body clearing the virus. It is a convenience, not a treatment.
• Anti-sickness tablets are not something we sell over the counter for a stomach bug. If vomiting is severe enough to need them, you need to be assessed, not medicated.

Keep eating if you can. Bland food such as toast, rice or plain pasta is fine once you feel able. Breastfed babies should keep feeding normally, and formula should never be watered down.

The 48-hour rule, and why hand gel will not save you

The one thing nearly everyone gets wrong is going back too early. The NHS norovirus guidance is clear: do not go to school, nursery or work until you have not been sick or had diarrhoea for 2 days. You are still shedding the virus after you feel better, and a Monday morning return is how the office goes down on Wednesday. Do not prepare food for other people during that window either.

The second surprise for most people is that alcohol hand gel does not kill norovirus. It is excellent against most winter bugs and useless against this one. Soap and warm water, for a proper 20 seconds, after every trip to the toilet and before you touch food, is what works. For surfaces, UKHSA recommends a bleach-based cleaner. A toilet, a bathroom tap and a door handle are the three places I would clean first.

When to call 111 or 999 for a stomach bug

Call 111 or ask for an urgent GP appointment if:

• you keep being sick and cannot keep any fluid down
• you have bloody diarrhoea or bleeding from the bottom
• diarrhoea has lasted more than 7 days, or vomiting more than 2 days
• a baby under 12 months has diarrhoea or vomiting
• you or your child show signs of dehydration: very dark or very little urine, dry mouth, feeling dizzy on standing, and in babies a sunken soft spot, fewer wet nappies, or crying without tears
• you are over 65, pregnant, or have a weakened immune system or a long-term condition such as diabetes or kidney disease

Call 999 or go to A&E if someone vomits blood or bright green liquid, has a severe headache with a stiff neck, severe stomach pain, difficulty breathing, or becomes confused or very drowsy. Medway Maritime Hospital's emergency department is not the place for an ordinary stomach bug, and taking norovirus into a hospital puts other patients at risk, so please ring 111 first unless it is a genuine emergency.

A family who nearly waited too long

A mum came in on a Sunday afternoon last January with a toddler who had been vomiting since Friday night. The older children had had it first and shaken it off in a couple of days, so she had assumed the little one would too. But he had stopped drinking, his nappies had been almost dry since the morning, and he was floppy and quiet in a way that made me uneasy the moment she lifted him onto the counter. Babies and toddlers dehydrate much faster than adults because they are so much smaller. We did not sell her anything. We rang 111 together from the consultation room, he was seen at the urgent treatment centre that evening and rehydrated, and he was back to throwing toys by Tuesday. The lesson she took away, and the one I want you to take, is that the rules for a baby under 2 are different from the rules for a nine-year-old.

What to do about your regular medicines when you are vomiting

This is the question people forget to ask. If you vomit within a couple of hours of taking a tablet, it may not have been absorbed. That matters most for the contraceptive pill, where our contraception service can advise on cover, and for medicines like blood pressure tablets, diabetes tablets and anticoagulants. If you take medicines for a long-term condition and cannot keep them down for more than a day, ring us or your GP rather than guessing. Do not double up when you feel better. If you run short because a bug stopped you collecting, our repeat prescription service can usually sort it the same day.

Norovirus advice at Medway Pharmacy, Gillingham

We are at 465 Canterbury Street, Gillingham, ME7 5LJ, open Monday to Sunday from 7:30am to 10pm, excluding bank holidays, which is useful when a bug starts at 9pm on a Saturday. If someone at home is unwell and you would rather not bring them in, you can ring 01634 575805 and a pharmacist will talk you through it, or send someone else in for the sachets. Please do not come in yourself while you are still vomiting. We would rather talk to you on the phone and keep everyone else on Canterbury Street well.