Food Intolerance or Food Allergy? How to Spot the Symptoms and Get Help

Updated on Mar 23, 2023 | Allergy, Gastroenterology, Your Health

Bloating, diarrhea, vomiting—these are just some of the unpleasant symptoms that food allergies and intolerances can trigger.

It’s normal to experience stomach issues from time to time. But if you find yourself experiencing them on a regular basis, you may have developed a food intolerance or a food allergy.

You can still enjoy a healthy, balanced diet. But if you think you have a food intolerance or allergy, you should not try to diagnose it yourself and should talk with a medical provider. Food allergies and intolerances can be difficult to identify, and trying to resolve them on your own may lead you to eliminate foods from your diet unnecessarily.

Laura Manning, MPH, RDN, CDN

In this Q&A, Laura Manning, MPH, RDN, CDN, a registered dietitian at the Inflammatory Bowel Disease Center in The Mount Sinai Hospital, explains the differences between food intolerances and allergies, how to identify the symptoms, and how to seek help.

What are food allergies?

When someone has an immune response and produces an allergy antibody against a certain food, they have a food allergy. The most common food allergies are milk, eggs, fish, shellfish, tree nuts, peanuts, wheat, and soybeans, which are behind a majority of food allergies in the United States, according to the Food and Drug Administration. Allergic reactions typically occur within minutes, or up to two hours after ingestion.

What are the symptoms of food allergies?

An allergic reaction occurs every time you eat a food you are allergic to. Common symptoms include coughing, wheezing, itching, lip tingling, rashes, mouth swelling, hives, throwing up, and breathing difficulties. In severe cases, food allergies can cause people to go into shock and can be life threatening. You can experience changes in blood pressure and narrowing of your airways, which can cause difficulty breathing or vomiting.

What are food intolerances?

A food intolerance may happen when you lack enzymes responsible for digesting a certain food or food group. A common example is lactose intolerance, in which a person lacks a key enzyme for digesting lactose, a sugar found in milk. Other common examples of foods that may be poorly tolerated are beans, garlic, mushrooms, onions, and watermelon. These are foods that are high in FODMAPS, or fermentable carbohydrates, including lactose, fructose, fructans, galacto-oligosaccharides, and polyols.  These can rapidly ferment during digestion causing gas, bloating, diarrhea, and constipation when consumed in high amounts. Food intolerances typically develop in the gastrointestinal tract or the digestive system, and can sometimes be triggered by stomach infections. Certain gastrointestinal conditions, such as irritable bowel syndrome (IBS), can make someone more susceptible to FODMAP intolerances. Because FODMAPs are in a wide array of foods, it is important to seek help from a medical provider and trained dietitian to identify the foods causing the problem without completely eliminating them from a healthy diet.

What are the symptoms of food intolerances?

When you eat foods your body cannot digest, you will experience discomfort, including gas and bloating, and may also experience diarrhea, constipation, reflux, and gas.

What is the difference between food intolerances and food allergies?

Unlike food allergies, food intolerances do not involve the immune system, do not cause allergic reactions, and are not life threatening. People with food intolerances can usually have small amounts of these foods without a reaction, whereas those with allergies cannot. Those with food intolerances may even be able to acclimate themselves to these foods by eating small amounts over time, whereas those with food allergies cannot have even the smallest amount without a reaction. However, some food allergies may change or go away on their own with time, especially after adolescence. If you have a known food allergy, an allergist can help you safely retrial the foods you are allergic to.

How are food allergies diagnosed and treated?

A skin prick test, typically on the upper back or forearm, or blood test can identify food allergies. Because food allergies cannot be eliminated, you will need to avoid eating foods that trigger your allergies, including foods that have been manufactured in factories where those foods are also processed (a warning should be displayed on food labels). Working closely with a board certified allergist will help determine what your reactions are to certain foods and best treatments. You can schedule an appointment at the Elliot and Roslyn Jaffe Food Allergy Institute at the Icahn School of Medicine at Mount Sinai. You can also find qualified food allergists nationwide through The American College of Allergy, Asthma & Immunology.

How are food intolerances diagnosed and treated? Can I use a food sensitivity test?

Unlike food allergies, there are no official tests for food intolerances, which makes them more difficult to diagnose. While food sensitivity tests are available and popular, they are not FDA-approved, are unreliable, and frequently lead people to eliminate foods unnecessarily, which can lead to health issues. If you have an intolerance triggered by a FODMAP, going on a supervised food elimination diet, or low FODMAP diet, can help you identify the foods behind the intolerance. This diet involves eliminating high FODMAP foods and then slowly reintroducing them to identify the triggers. To avoid malnutrition, you should only go on this diet with guidance from a gastroenterologist and a trained registered dietitian. These experts will guide you through the process of identifying foods you are intolerant to and help you modify your diet in the healthiest way possible.

Contact the Elliot and Roslyn Jaffe Food Allergy Institute at Icahn Mount Sinai
Find a gastroenterologist at Mount Sinai
Find a registered nutritionist through Clinical Nutrition Department at The Mount Sinai Hospital

Three Years After the Start of the Pandemic, Reasons for Hope and Continued Vigilance

Updated on Mar 17, 2023 | COVID Response, COVID-19, Featured, Your Health

It has been three years since COVID-19 was declared a pandemic on March 11, 2020, by the World Health Organization. With New York City as an early epicenter, residents were hit hard. But from that experience, health care providers and researchers across the city found the opportunity to learn more about the virus and how to prepare for future pandemics.

Today, the city’s level of community transmission of COVID-19 is considered low, and the percentage of people who have completed their primary series of COVID-19 vaccinations is relatively high, according to the Centers for Disease Control and Prevention (CDC). Similarly, hospitalization and mortality rates from COVID-19 remained low in recent months, compared to the period between 2020 and 2022.

Bernard Camins, MD

These factors mean that New Yorkers can probably afford to relax their vigilance compared to previous years, notes Bernard Camins, MD, Professor of Medicine (Infectious Diseases) at the Icahn School of Medicine at Mount Sinai and Medical Director for Infection Prevention at the Mount Sinai Health System.

“We have come a long way. However, we still need to monitor how COVID-19 is affecting those who are at high risk of complications.”

Bernard Camins, MD

Who should remain vigilant?

Vulnerable groups include those who are immunocompromised, and those aged 50 and older, even if they’ve been vaccinated for COVID-19. People with certain underlying medical conditions, such as cancer; chronic kidney, lung, or liver disease; dementia; diabetes; heart conditions, or obesity are also considered at heightened risk.

For younger or healthy individuals, having COVID-19 these days might involve cold-like or mild symptoms, says Judith Aberg, MD, Chief of Infectious Diseases for the Mount Sinai Health System and Dr. George Baehr Professor of Clinical Medicine at the Icahn Mount Sinai. But vulnerable populations are at risk for developing severe disease, she adds. This includes hospitalization, needing intensive care, requiring a ventilator to breathe, or even death.

For at-risk groups, masking is recommended, as is avoiding large indoor gatherings. People planning to be organ donors should also remain vigilant for signs and symptoms of COVID-19, as an active infection could complicate one’s ability to donate, Dr. Aberg says.

“Also, people seem to have forgotten about hand hygiene; that is still important,” she notes.

What protection measures are available today?

With the federal Test to Treat initiative in place nationwide since 2022, symptomatic individuals who test positive for COVID-19 at testing sites can receive antiviral treatment, such as Paxlovid, on the spot.

“Taking Paxlovid provides that extra protection from developing complications, and the sooner it is taken, the better,” says Dr. Camins. Patients are recommended to receive antiviral treatment within five days of developing symptoms.

“One mistake people make with antivirals is that they wait to see if they feel better or worse before seeking treatment.”

Judith Aberg, MD

“If you’re a senior citizen, or have any of the underlying health conditions, when you test positive and have any symptoms, go seek treatment immediately. Do not wait,” says Dr. Aberg.

All individuals, and especially vulnerable populations, should stay up to date with COVID-19 vaccines, including the bivalent boosters, which are authorized for those ages 5 and older. “However, among people who were recommended to receive the bivalent booster, very few of them did,” Dr. Camins points out. “It seems many people have moved on regarding the pandemic before we really should.”

Judith Aberg, MD

According to the CDC, 17 percent of the U.S. population ages 5 and up have received the updated booster. In New York, that number is 18 percent.

Data have shown that the updated boosters either prevented infection or reduced the possibility of developing severe disease in people who received them. Another possible benefit of keeping up to date with vaccination is that it might prevent new variants from being as deadly as previous strains, Dr. Aberg says.

Will we need annual boosters?

Just as the bivalent boosters were updated to protect against current circulating variants and strains of SARS-CoV-2, the virus that causes COVID-19, researchers and officials are monitoring how the pathogen continues to evolve. Most of the scientific and medical community believe that the virus is headed in the direction of becoming endemic, or regularly occurring, Dr. Aberg says. “However, the jury is still out on whether annual updated boosters will be necessary,” she adds.

Neither the Food and Drug Administration nor the CDC has made any determinations on recommending annual COVID-19 shots, unlike what they have done with the flu. The data on COVID-19 collected over the recent winter could provide clarity on whether another shot might be needed this fall, says Dr. Aberg.

There are other seasonal coronaviruses and rhinoviruses that cause respiratory infections that do not require annual boosters. “It’s hard to predict whether the virus will take another turn to cause more morbidity or mortality. We’ll have to wait to see what the data shows us,” Dr. Aberg says.

What other things about COVID-19 should we be aware of?

The public health emergency declaration, which has been in place since 2020, will come to an end on Thursday, May 11, 2023. This might have implications regarding cost sharing or coverage regarding various COVID-19-related services, such as testing, treatment, or vaccinations. This might mean some services will no longer be free or will start requiring copays, depending on the insurance.

While the New York State Department of Health has not released any guidance on cost impacts, providers need to inform their patients and communities to follow up with their insurance companies and be aware of possible coverage changes, Dr. Aberg says.

“People need to be informed about potential costs before seeking COVID-19 care,” Dr. Aberg notes. “But on the other hand, we don’t want people to avoid seeking help because of cost.” If a patient experiences troubling symptoms, such as shortness of breath or fever, they should see a primary care doctor or go to the emergency room, she adds.

The medical and science community is also closer to understanding post-acute sequelae of COVID-19, or the condition colloquially known as “long COVID.”

Anyone who is infected with COVID-19 has a risk of going on to develop long COVID, in which individuals experience symptoms that persist beyond three months after the acute phase. An estimated 1 in 13 adults in the United States have long COVID, according to the CDC.

“We’re starting to zero in on specific biomarkers for people with long COVID,” says David Putrino, PhD, Director of Rehabilitation Innovation for the Mount Sinai Health System. These include platelet hyperactivation, microclots, immune dysfunction, and microbiome dysfunction.

“We are getting the science to a place where we may finally be able to identify this condition objectively.”

David Putrino, PhD

David Putrino, PhD

This has allowed providers to be better educated about the sorts of things that could cause long COVID symptoms to flare up, Dr. Putrino says. The availability of objective biomarkers also means the ability to start testing therapeutics to treat long COVID.

“A year ago, I would have thrown my hands in the air and said there were no good drug trials for long COVID,” Dr. Putrino says. “Now, I feel a little confident that we can start promising patients that these trials are on the horizon.”

“We’re getting close to getting therapeutics to prescribe. I’m hoping that will be a reality over the next two years or so,” Dr. Putrino says.

Read more about how COVID-19 research has progressed throughout the pandemic

Prostate Cancer Research Gala Celebrates Innovations in Research and Patient Care at Mount Sinai

Updated on Mar 16, 2023 | Community, Featured, Your Health

Frorm left: Dennis Charney, MD, Ash Tewari, MBBS, MCh, and Robert F. Smith

The Milton and Carroll Petrie Department of Urology at the Icahn School of Medicine at Mount Sinai hosted its annual Prostate Cancer Research Gala on Tuesday, March 7, at the Rainbow Room at Rockefeller Center.

Ash Tewari, MBBS, MCh, Chair of the Department of Urology at the Mount Sinai Health System and the Kyung Hyun Kim, MD Professor of Urology at Icahn Mount Sinai, started the gala with the goal of raising money for the Center of Excellence for Prostate Cancer within the Department of Urology. Its mission is to eliminate prostate cancer through programs that integrate patient care, research and prevention, and education for students, trainees, professionals, and the public.

With nearly 200 people in attendance and more than $1 million raised, the event was a success by any measure.

The first honoree to be recognized was Burton Wallack, a three-time cancer survivor who received the Patient of Courage Award.

Burton Wallack, left, and Robert F. Smith

“Go to the end…and you can still win. And that’s the story of Burt Wallack,” said Dr. Tewari in a video shown at the event. Mr. Wallack, the founder and Chairman of Wallack Management Company, also serves on the Chairman’s Urology Board, partnering with his doctor to advance research.

Dennis Charney, MD, Anne and Joel Ehrenkranz Dean of Icahn Mount Sinai and President for Academic Affairs for the Mount Sinai Health System, received the Champion of Excellence Award. As Dr. Tewari noted in a video: “I wanted to start a program in prostate cancer. Dr. Charney turned that into a prostate cancer Center of Excellence…He made it one of the most comprehensive programs and not just by telling us how to do it, but by providing every support.”

“I’m proud of where we have come, but I’m not satisfied,” said Dr. Charney, embodying his tireless pursuit of improved outcomes for patients before continuing: “Am I still being innovative? Am I still being inspiring to others? Am I still working with our teams to come up with great ideas? That’s what I think about all the time.”

The event also saw the bestowal of the inaugural Steven Southwick, MD Memorial Award, named in memory of a leading expert on trauma and resilience who passed away from prostate cancer in 2022. Dr. Southwick, Glenn H. Greenberg Professor Emeritus of Psychiatry, PTSD, and Resilience at the Yale School of Medicine, was also mentor and friend to Dr. Charney. “Steve was my buddy, my brother,” said Dr. Charney. “He was brilliant, but that doesn’t capture him. He was the finest person I’ve ever met,” Dr. Charney continued before detailing Dr. Southwick’s contributions to our understanding of post-traumatic stress disorder.

The Steven Southwick, MD Memorial Award recognizes the recipient’s dedication to prostate cancer research and was given to Sujit S. Nair, PhD, an Assistant Professor and Director of Genitourinary Immunotherapy Research in the Department of Urology at Icahn Mount Sinai. Dr. Tewari praised his innovation and hard work, while Dr. Nair noted, “The long-term goal, the fact that we can cure cancer, is the motivation—that’s what excites me.”

Sujit S. Nair, PhD, and Dennis Charney, MD

The final honoree was Robert F. Smith, the Founder, Chairman, and CEO of Vista Equity Partners, who was presented with the Visionary Award for his commitment to addressing the disparity that sees higher rates of prostate cancer—and death—among Black men. Through his collaboration and funding, the Mount Sinai Robert F. Smith Mobile Prostate Cancer Screening unit was launched, a state-of-the-art “doctor’s office on wheels” that takes specialized staff and equipment into the neighborhoods of the men who need it most.

“We’re honoring Robert for being a kind human being,” Dr. Tewari remarked, “a philanthropist, a person who really wants to make an impact, a person who is touched by human lives, a person who cannot take his eyes away from a problem, and if he can make a difference, he does it. He has made a tremendous difference in this cause for prostate cancer.”

Graciously accepting the award, Mr. Smith said, “I’m very hopeful that this is going to be one of those sparks that really leads to a platform of access to health care for the African American community—and save lives.”

With an ambitious goal to reduce deaths from prostate cancer by 25 percent in the Mount Sinai community, this is a spark that will have far-reaching implications. While the event was a celebration of many accomplishments at the Center of Excellence for Prostate Cancer, its true significance may lie in the ongoing inspiration to keep pushing forward at the boundaries of research and patient care.

The Milton and Carroll Petrie Department of Urology at the Mount Sinai Health System has more than 190 urologists on staff, more than any other health care system in New York City. Its robotic surgery program is among the most robust in the country. Genomic testing and advanced imaging are routine for patients with prostate cancer, providing personalized and precise treatment protocols.

Learn more about the Prostate Cancer Research Gala

Is It Time to See a Pain Specialist for My Knee or Shoulder Pain?

Updated on Mar 15, 2023 | Your Health

Your knee and shoulders contain complex joints that can make pain difficult to diagnose and treat. But with help from pain management specialists, you can find relief.

In this Q&A, Gary Esses, MD, Assistant Professor of Anesthesiology, Perioperative, and Pain Medicine at the Icahn School of Medicine at Mount Sinai and a leader of the Pain Management Service at Mount Sinai Brooklyn, answers common questions about managing knee and shoulder joint pain and explains when to seek help from a pain management specialist.

Gary Esses, MD

Why does my knee hurt?

Knee pain is typically caused by injuries, arthritis, and mechanical problems. Injuries often include an ACL injury (ligament tear), a fracture, a torn meniscus (tear in the cartilage between the shinbone and thighbone), bursitis, and patellar tendinitis (irritation or inflammation of knee tendons).

Types of knee arthritis include osteoarthritis (a breakdown of cartilage in the knee), rheumatoid arthritis (an autoimmune disease causing tissue deterioration), and gout (caused by uric acid crystals in the knee joint).

Mechanical problems can include loose bone or cartilage that might go into the knee joint space causing irritation, dislocation of the knee, and hip or foot pain that affects your gait, possibly impacting the knee joint.

What treatments are available for knee pain?

Depending on the cause of your knee pain, your doctor will likely recommend some treatment options to start, including:

  • Rest, ice, compression, elevation (RICE), as well as activity modification
  • Anti-inflammatory medication or injections
  • Gel (hyaluronic acid) injections to cushion your knee joint
  • Stem cell therapy
  • Radio frequency ablation, a type of heat therapy, to silence painful nerves in the knee
  • Physical therapy
  • Wearing a brace
  • Weight loss

What can I do at home to ease my knee pain?

In addition to medications, your pain management specialist may recommend low-impact, at-home exercises such as stretches, walking, cycling, and swimming, or using the RICE method. The specialist might suggest using a heating pad and, if there is swelling, applying cold compresses. Following a routine pain management plan will strengthen the muscles around your knee over time and reduce the pressure on the knee joint. Notify your doctor if you further injure your knee, or if you experience pain or a return of symptoms during exercises.

Why does my shoulder hurt?

The most common causes of shoulder pain include osteoarthritis, rheumatoid arthritis, bursitis, dislocation, injury (broken collarbone, rotator cuff tear, torn cartilage, sprain, tendon rupture), and tendinitis. It is important to note that shoulder pain can be caused by referred pain from the heart, lung, or respiratory system, which is why it is important to seek a proper diagnosis.

A family physician or orthopedic surgeon can help determine a course of treatment. Your physician will use X-rays and magnetic resonance imaging (MRI) to pinpoint the cause of the pain. Then, your doctor will advise you on treatment options. If you don’t need surgery, you will likely be referred to a pain specialist.

What kinds of treatments are available for shoulder pain?

Your pain specialist will work with you to decide on a personalized treatment plan based on your individual needs. The pain specialist will review X-rays or MRIs to assess which approach will best manage the pain. The pain specialist might recommend non-surgical options including muscle relaxants, prescription oral anti-inflammatory medications, and over-the-counter pain medications. The specialist’s recommendation for a shoulder injection will depend on the severity of your pain. They may also recommend physical therapy.

How can I treat my shoulder pain at home?

The pain specialist might recommend a number of ways to manage pain at home including:

  • cold compresses
  • heat therapy
  • compression
  • massages
  • over-the-counter pain medications

The specialist might also recommend limiting activity directly affecting your shoulder. Gradually increasing the level and intensity of exercise will reduce the likelihood of placing stress on the shoulder and prevent the likelihood of your pain returning.

When should I see a pain management specialist?

If you have seen a regular doctor and your pain isn’t healing, it may be time to see a pain management specialist. There are board certified medical specialists dedicated to diagnosing and treating pain-related disorders. Your pain management specialist will consider multidisciplinary approaches to treating your pain, and they will discuss possible therapies and help coordinate your care with other health care professionals. If needed, they will perform interventional therapies, such as administering an epidural injection in the spine.

To make an appointment with a Mount Sinai Brooklyn pain management specialist, call 718-758-7072.

Read more about Your Health.

Is Pregnancy Causing My Headaches?

Updated on Mar 10, 2023 | Pregnancy, Women's Health, Your Health

While pregnancy brings joy and excitement for many people, it can also cause quite a few headaches. Headaches are common during pregnancy, especially early on. However, there are ways to manage the pain. Most often, headaches are not serious and do not cause harm. But it is important for you and your physician to monitor your headaches, as headaches can be associated with pre-eclampsia, a condition that can become serious and lead to complications. In this Q&A, Mount Sinai obstetricians Bruno Caridi, MD, and Jian Jenny Tang, MD, explain the different types of headaches you may experience, how to ease and prevent headaches, and how to know if you should be concerned.

Bruno Caridi, MD

How common are headaches during pregnancy?
Headaches are a very common medical condition, especially among those who are pregnant. There are three different types of headaches: tension headaches, cluster headaches, and migraine headaches. Almost 26 percent of pregnant patients will experience tension headaches, a mild-to-moderate pain that is often described as having a tight band around the head. Pain may also be located toward the neck with tension headaches. Cluster headaches are characterized by intense pain, often concentrated around one eye or on one side of the head, and occurring frequently. Cluster headaches are very uncommon in women, occurring less than one percent of the time. A migraine headache is usually unilateral, which means it is concentrated on one side of the head. During pregnancy, about 10 percent of people will have experienced some type of migraine headache. With migraine headaches, an individual may be more sensitive to light, to certain types of noise, and to certain smells. Migraine headaches can also be accompanied by other symptoms, such as nausea. After 20 weeks of pregnancy, careful attention needs to be paid to headaches to ensure they are not a symptom of pre-eclampsia. Headaches associated with pre-eclampsia are usually global tension headaches, occurring all around the head.

What is pre-eclampsia?
While the causes of pre-eclampsia are not understood, the condition may be related to placenta and maternal vascular dysfunction. However, high blood pressure and protein in the urine are the most common signs. In rare cases, the condition causes seizures. If you are experiencing frequent headaches, it is important to have your vitals checked by your physician to see if your blood pressure is elevated. Also, be aware of any headache that is different from what you’ve previously experienced. Changes in vision, such as spots or blurriness, or right upper quadrant abdominal pain or epigastric pain are all signs of pre-eclampsia.

Jian Jenny Tang, MD

What are the best over-the-counter and non-pharmacological treatments for alleviating pregnancy-related headaches?
The first line of treatment recommended is Tylenol®. Patients may take three regular strength Tylenol (975 milligrams total), or two extra strength Tylenol (1000 milligrams total). Tylenol can be taken every six to eight hours, and must not exceed 3000 milligrams per day. This medication is an excellent initial line of over-the-counter treatment for headaches. We do not recommend migraine medicines that you may have been taking pre-pregnancy, such as sumatriptan. Besides Tylenol, caffeine is a great way to help alleviate headaches. Caffeine is fine to use in moderation, and should not exceed 200 milligrams per day. If the headache persists, then the patient should contact their physician. Other non-pharmacological treatments include drinking plenty of fluids to stay well hydrated, keeping your blood glucose levels up by snacking or eating light meals every few hours throughout the day, getting adequate rest, moving to a dark room to avoid light, or placing a damp washcloth over your forehead and relaxing. Other stress reduction or relaxation techniques, such as taking a shower to relax your muscles, listening to soothing music, and aromatherapy can help. Deep mindful breathing and light exercise, such as yoga, are other common non-pharmacological methods that help with headaches. Prevention is key.

How can I prevent pregnancy-related headaches?
Experiencing headaches during pregnancy does not mean you have pre-eclampsia. Other common causes can include dehydration, low blood glucose levels, lack of sleep, and anemia. As such, staying well hydrated and getting enough food and sleep are good ways to prevent headaches. Also, if you consume a lot of caffeinated beverages before pregnancy, abruptly scaling back on caffeine could trigger headaches related to withdrawal. If you plan to give up caffeine, easing yourself off of these beverages gradually can prevent headaches. Your pregnant body is going through a lot of changes, especially during the first trimester. Knowing how to adapt to these rapid changes will help put both your body and mind at ease, so you can focus on your baby.

Read more about Your Health.

What Should I Do If My Child Has Norovirus?

Updated on Feb 24, 2023 | Adolescent Health, Featured, Pediatrics, Your Health

If your child has a stomach bug, it could be norovirus—a highly contagious stomach virus that causes diarrhea and vomiting. Cases of this virus are on the rise in New York City and much of the northeastern United States, according to the Centers for Disease Control and Prevention.

While typically mild in older children and adults, lasting usually only a few days, norovirus can cause severe dehydration in babies and kids with certain underlying conditions. Knowing how to care for them is crucial.

In this Q&A, Tessa Scripps, MD, a pediatrician at the Mount Sinai Kravis Children’s Hospital, and Assistant Professor of Pediatrics at the Icahn School of Medicine and Mount Sinai, answers your questions about the disease, including what to do if your child is sick.

What is norovirus, and what are norovirus symptoms?

Norovirus is a common contagious virus that inflames the intestines, causing nausea, diarrhea, and throwing up. Sometimes it can also cause fever. The disease is spread when particles from an infected person’s feces or vomit spreads to others, typically in bathrooms, but also by eating or drinking contaminated foods and beverages; using contaminated utensils; touching contaminated surfaces; or having any direct contact with someone who is infected. Norovirus is highly transmissible, and infected people can actually shed billions of norovirus particles at a time, but it can take fewer than 100 norovirus particles to make another person sick. People are most contagious when they actively have symptoms and in the few days after their symptoms have resolved.

Tessa Scripps, MD

How can I protect my child from catching norovirus?

The most common way norovirus is spread is through close contact with an infected person, so it’s a good idea to keep kids some distance from people who are sick, or who have recently recovered from being sick. Norovirus can infect an entire family at the same time, since even simple contact with others can lead to infection. So, the most important thing is for kids to wash hands frequently with soap and warm water, and for adults to do the same, especially if any of you have been in contact with a person who has symptoms. Alcohol-based sanitizers do not work as effectively against preventing transmission.

My child has norovirus. How does their age or health condition affect their risk for severe illness?

Newborn babies and children who have underlying chronic illnesses such as kidney disease and diabetes are at higher risk for becoming dehydrated and severely ill because excessive fluid losses can affect their kidney and their liver function. It’s important they get medical attention right away if symptoms last longer than three days or if they’re unable to keep hydrated.

What symptoms might indicate my child needs medical help?

Watch for symptoms of dehydration, such as decreased or less frequent urination and small volume- or very dark or strong-smelling urine. If it has been more than eight hours from when your child has had a wet diaper or used the toilet to pee, reach out to your doctor for advice. A rapid heart rate or a significant change in your child’s activity can also be a sign of dehydration. If you notice that your child seems very lethargic and listless, you should seek medical advice right away.

What can I do to help my child recover from norovirus?

Once the virus has passed and the vomiting and diarrhea have subsided, make sure they are well hydrated and rested. For newborns and infants, you can give them small amounts of breast milk or formula. Toddlers, older children, and adults should drink small volumes of fluids—about one to two ounces every one to two hours—to ensure fluids get absorbed and to prevent recurrent vomiting. Drinking water and electrolyte fluids like Pedialyte®, Gatorade, or watered down apple juice can be very useful to maintain hydration, and can help prevent complications from norovirus. They can also have bland foods like rice, dry cereal, applesauce, bananas, and crackers.

Are there any medications I can give my child to ease their norovirus symptoms?

There are no over-the-counter anti-diarrheals or anti-nausea medicines that are recommended for children. In rare cases, pediatricians may prescribe Zofran, an anti-emetic, to help children stop vomiting so they can re-hydrate without the need for intravenous fluids.

How do I prevent norovirus from spreading to my other kids?

It is important that everyone in your house washes their hands regularly with warm water, and avoid sharing food and drinking cups with anyone who is sick. You should also wipe down any contaminated surfaces with a bleach-based disinfectant, especially toilets and sinks after an infected child has used them. And everyone should try to maintain some distance from infected household members while they’re actively sick.

Is there a test for norovirus I can give my child?

Testing is available. However, norovirus is similar to other types of stomach infections, such as rotavirus, and symptom management is the same, so testing isn’t useful. If there has been an outbreak at your child’s school and they are sick, there is a good chance they have norovirus.

Read more about Your Health.

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