Norovirus: What Experts Say About the 2022-2023 Season

Infection Control TodayInfection Control Today, April 2023, (Vol. 27, No. 3)
Volume 27
Issue 3

Are norovirus cases going to skyrocket, or will the pandemic slowdown of this infectious disease continue?

How often do we hear, “I have the stomach flu!”? While norovirus is not related to the influenza virus, it does cause millions of people to sicken yearly. It is the number 1 cause of foodborne illness and is extremely infectious. The number of cases of norovirus has been much lower in the last few years because of the COVID-19 pandemic precautions. Do the experts believe this year will be the same? Or with “pandemic fatigue,” will the number rise?

With the norovirus season in full swing, Infection Control Today® (ICT®) spoke with Chip Manuel, PhD, Food Safety Science Advisor, and Megan DiGiorgio, MSN, RN, CIC, FAPIC, infection prevention senior clinical manager, both with GOJO Industries, about this norovirus season for both food service providers and health care providers.

In this first installment, Manuel and DiGiorgio cover what norovirus is and whether they believe that norovirus will be worse this season or not, and how much that will be affected by the COVID-19 pandemic. They also discuss what precautions are taken and which oes are too often overlooked.

When asked about what he sees in the norovirus season we are in, Manuel answered, “We're seeing a major relaxation of a lot of these COVID-19 pandemic-related practices. So think isolation, social distance masking. Many people have pandemic fatigue, and they're just dropping many of their hygiene practices. They're dropping their guard. That can allow for a lot of other viruses to come in and cause a surge. The other thing that's important to remember is that during the pandemic, especially at the height of the pandemic, norovirus case has dropped off to historic lows.”

“But if we look at this slice of US data, there are around 900 deaths per year, around 100,000 hospitalizations, 465,000 ER visits, mostly in young children,” DiGiorgio told ICT® in this exclusive interview. “Then there are about 2.2 million outpatient clinic visits, mostly in young children. But this is a big burden to society and health care facilities. It's not something that should be ignored. With many diseases, we tend to worry about the very young and the very old. In the case of norovirus, we worry most about kids under the age of 5 and adults that are over the age of 85 because they're more likely to seek health care as a result of their infection.”

DiGiorgio continued, “When we talk about people over the age of 85, we think about long-term care facilities, and over half of the outbreaks that are reported in the US are in long-term care facilities; it's a unique setting; it tends to have an older population as we know, many comorbidities, immunodeficiency, as well as close shared quarters. This is their home; it's not like a hospital where they're staying for a few days. They often share bathroom facilities; they're eating together. It's tough to do isolation the same way in a long-term care facility as it is in a hospital. The situation in long-term care promotes transmission.”

CDC added 4 weeks of data on its NoroSTAT page, showing an increase in norovirus outbreaks. Manuel said that data reports confirmed cases (as defined as when an individual goes to hospital or doctor and is diagnosed with norovirus) from the 14 participating states. There is typically a lag while the data is curated. The higher cases reported are happening in the UK as well; their norovirus cases are up about one-third higher than normal this time of yeaThis is part 1 of 2. Part 2 can be found here.r, mostly in those 65 years and older. More information is here: Natioal norovirus and rotavirus report, week 3 report: data up to week 1 (8 January 2023) - GOV.UK (

This is part 1 of 2. Part 2 can be found here.

(Quotes have been lightly edited for clarity.)

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