Want to know how to avoid Norovirus while in the backcountry? Then you have come to the right place, as I consider myself a self-proclaimed expert due to a medical condition that I have, which, if mixed with Norovirus, could easily kill me. I’ve spent almost a decade researching (and consulting with my GI) on how to avoid Norovirus while backpacking, so I can continue to knock trails off my bucket list.
I am sharing my knowledge and research on how to avoid Norovirus while backpacking with all of you, because the best way to prevent spreading it is to never contract it in the first place.
What is Norovirus?
Norovirus is a highly contagious germ (virus) that causes severe cramping, vomiting, and diarrhea. Symptoms tend to present themselves 12-48 hours after exposure and last one to three days, most of the time requiring treatment for dehydration.
You can continue to shed Norovirus in your feces for up to two weeks, and if you have an underlying health condition, it can last several weeks to several months.
The virus is spread through the vomit and feces of infected humans and animals and is contracted by eating contaminated food or drinking contaminated water. Even just having close contact with an infected person can put you at risk of becoming infected.
Once an area has been infected, it is hard to rid that area of norovirus because it can withstand hot and cold temperatures, and most disinfectants cannot kill it.
Norovirus Symptoms
The most common symptoms:
- diarrhea
- throwing up
- nausea
- stomach pain
Other symptoms:
- fever
- headache
- body aches
Tips to Avoid Norovirus
Wash Your Hands! – This should go without saying, but washing your hands after using the bathroom and before eating is the easiest way to prevent the spread of the norovirus. Make sure to wash them for at least 20 seconds (sing the ABC song)! Dr. Bronner’s Soap doesn’t weigh that much, and a little goes a long way, so there’s no reason why you shouldn’t carry some with you when you are out backpacking.
Use Clean, Purified Water in Contaminated Areas (or boil your water)—Speaking of washing your hands, remember you can also get Norovirus by drinking contaminated water. In areas where Norovirus is present, either try to avoid that area or ensure your water has been purified with a product like Aquamira Drops (filtering alone will not be effective, as most filters do not filter out viruses) before drinking or using it for hand washing. It’s pointless to wash your hands if the water is contaminated. MOST FILTERS HIKERS CARRY DO NOT KILL THE VIRUS! For more information, check out the CDC on water treatment in the backcountry1,
Use Bleach Wipes – Chlorine Bleach kills the virus. Chlorine Bleach kills the norovirus dead. Keep some chlorine bleach wipes on hand so you can use them at shelters or areas where you know norovirus is running rampant. Remember that it is bleach, so make sure not to touch clothes or gear (otherwise, you risk ruining them). According to the CDC, use a solution with at least a 2% concentration. A good one is Clorox Healthcare Bleach Germicidal Wipes. You can even buy small packets to keep with you through outbreak areas. Don’t forget to pack them out!
Don’t Share Food -Don’t let someone else reach into your bag, and don’t reach into someone else’s bag. Or, as my husband and I tend to do, eat out of the same Mountain House meal packet! Only accept food that is individually wrapped.
Don’t Share Drinks—This should go without saying, but one of the best ways to avoid norovirus is not to let anyone drink out of your cup, water bottle, or flask and not take a swig out of anyone else’s. You have no idea what their hygiene is like, so it’s best not to risk it.
Don’t Share Eating Utensils—Even if the person looks healthy, remember that symptoms can take up to 48 hours to appear. Your best bet is not to share utensils at all.
Don’t Share Gear – This applies to nearly all gear, but most importantly, water filters, dirty water bags, food bags, hand sanitizer, soap bottles, or any other item that the hiker may have handled with “dirty” hands. I can’t stress how highly contagious this virus is! If you run out of soap and need to borrow some, have that hiker squeeze some into your hands. Don’t touch the bottle it is contained in. Did your water filter freeze and become unusable? Boil your water instead of borrowing one! Then, get a replacement ASAP.
Avoid Trail Magic in Outbreak Areas—I know! It’s not something you want to hear! If you are in an area where Norovirus has been prevalent, skip the trail magic and thank me later!
Wipe down privy seats with bleach wipes before using – The AT is notorious for having norovirus outbreaks. If you have to stop, either skip the privy or at least wipe the seat down with a bleach wipe, and wash your hands thoroughly afterward.
Wipe down bear cables (or box handles) with bleach wipes before using – If using a bear cable or box, make sure to wipe the handle or cable down with an EPA-approved wipe (if available), then wash your hands immediately after. If no wipe is available, wash your hands with soap and water thoroughly after touching.
GEL HAND SANITIZERS DO NOT KILL NOROVIRUS! Most Hand Sanitizers have been shown to be ineffective at killing norovirus. – The CDC states, “Alcohol-based hand sanitizers can be used in addition to hand washing. But, they should not be used as a substitute for washing with soap and water”. Furthermore, the use of alcohol gel-based hand sanitizer has not only been proven to be ineffective but also increases the risk of contracting the virus2. There are a couple of hand sanitizers, such as Germstar ONE, Clorox Hand Sanitizer, and My-Shield, that have been proven to be effective3 in killing the norovirus according to their own testing; so it might be worthwhile to use them instead of the gel-based ones, which are ineffective. One that is EPA registered to kill Norovirus is CleanSmart Skin & Hand Cleanser. Of course, this should never take the place of washing hands, but should be used in addition to, between hand washings.
Stay out of shelters—Most of the time, People are packed in like sardines, which is one quick way to share germs. Therefore, if you can avoid shelters, it’s best to do so, especially in suspected outbreak areas.
Avoid Fresh Fruits and Vegetables—Norovirus can easily live on them. I know some hikers like to grab an apple or such, but unless you plan on washing it properly before eating, it’s best to skip it.
What To Do If You Get Norovirus While Backpacking
Get off the trail ASAP – Get off the trail as soon as possible and isolate yourself in a hotel room. Do not go to a hostel. Go to a hotel room where you have your own private space, including a room and a bathroom.
Notify the Hotel Clerk—Make sure to notify the hotel clerk upon checkout so they can properly sanitize the room and bathroom. You’d hope that’d be standard practice, but you never know these days.
Let Your Shuttle Driver Know BEFORE—Be courteous and inform your shuttle driver (if you need one) in advance so they can make arrangements to ensure you are the only person they are picking up. This allows them to take precautions themselves and disinfect their vehicle.
Isolate Yourself—Don’t walk around town or into the grocery store. Go to your room and plan to stay there for several days AFTER you are symptom-free! Need something from the store? Pay to have it delivered to the front desk, explain the situation to the front desk, and have them drop it off at your door.
Stay Hydrated—Drink as many small sips of room-temperature water as you can tolerate. Staying hydrated is essential because it is easy to become dehydrated with Norovirus.
Seek Medical Attention if Necessary—If you feel something isn’t right, don’t be afraid to go to the ER or an Urgent Care Clinic.
Don’t Prepare Meals or Handle Other People’s Property – You should wait a minimum of two days AFTER you feel 100% to start cooking food for others or handling other people’s property (meaning if you are hiking with a group or SO). Again, probably best to expect to spend 3-5 days in a hotel room.
Launder clothes & other gear items– Clothes and other gear items that are washable should be washed on the hottest/longest setting with detergent, then dried using the hottest setting available. Make sure to wash your hands immediately after placing items in the washer and also after placing items in the dryer.
What Else You Should Know About Norovirus
Norovirus can live on people, surfaces, and food for weeks! That means shelter floors, picnic tables, bear box handles, bear cables, privy doors, etc… It can live on both hard and soft surfaces.
Norovirus can live in still water for years! Yes, you heard that right, it can live in still water for months and possibly even years.
You can continue to spread it for 2+ weeks after you feel better. Once you feel better, it doesn’t mean you aren’t spreading it. You can continue to spread it through your feces for 2 weeks (longer for some people who can’t clear it).
You can get it more than once. Due to the multiple strains of Norovirus, you can contract it multiple times. It’s like the virus that keeps on giving. For instance, say a couple of strains are going around the trail. You get one strain and recover, and several days later, your hiking partner gets a different strain. Guess who is about to be sick again if they don’t take some serious precautions?! You!
There are no specific treatments. While anti-nausea medications can help, nothing can help shorten the duration of the virus. Your best bet is to stay hydrated as much as possible. If dehydration becomes an issue, a trip to the ER may be in order!
12-48 hour Incubation Period – Norovirus has a 12-to-48-hour incubation period, which means you can spread it before you even know you have it.
It can be airborne – If you are in close quarters (such as shelters or hostel bunkhouses) and someone infected with norovirus is coughing, sneezing, or vomiting, it can be spread through the air4.
Tips for Hostel and Airbnb Owners
If you own a hostel or Airbnb, it is imperative that you clean correctly with cleaners approved by the EPA to kill norovirus (see list below) and take steps to avoid spreading it to other hikers who stay with you. Here are some tips to help you join the fight to stop noro:
Clean after EVERY guest – This should go without saying; you should clean after every guest. I realize hostels have a steady flow, but all bedding should be immediately removed and washed according to the instructions below. Honestly, you should be wiping down high-touch items several times a day. The easiest way to do this would be to have only EPA-approved cleaners available for use that are effective against norovirus, so guests can wipe up as they go.
Wear disposable gloves when cleaning – to stop the spread to yourself, wear disposable medical gloves when cleaning and handling bedding, towels, etc…
Handle washable items carefully – When taking bedding, loaner clothes etc… to the washing machine, handle gently and avoid shaking the items.
Clean regularly with an EPA-approved cleaning product – Make sure you are cleaning all areas of the hostel or Airbnb with an EPA-approved cleaner to kill noro. See my list below of the most common cleaners that kill noro. You will want to make sure you are cleaning counters, door knobs, light switches, and other high touch areas in addition bathroom and common use areas. Noro can live on fabric, so make sure you are cleaning furniture and mattresses as well! This is where washable/waterproof mattress covers would come in super useful.
Wash bedding, loaner clothes, towels, etc… in hot water on the longest cycle & dry on the hottest setting – When washing bedding, towels, blankets, dish towels, loaner clothes, or any other washable items, make sure you are using the hottest temperature possible on the longest cycle. When drying, dry on the hottest setting.
Wash dishes in a dishwasher on the sanitize setting – If the sanitize setting is not available, wash on the hottest setting with the longest run time with a heated dry. Noro can survive in temps up to 145 degrees.
Get rid of the dish sponges at the kitchen sink – Those are breeding grounds for noro and other viruses and bacteria. I’ve seen some pretty nasty ones at hostels, too. Yuck! Instead, paper towels (the good kind) work great for handwashing dishes if a dishwasher is unavailable, and they can be thrown away after each use.
Have a dishwasher available for use – I know, this requires an extra expense, but at least you can be assured that the plates, cups, and other dishes are getting adequately cleaned and sanitized. Let’s face it, not all hikers clean the dishes properly (I have seen food on “clean” dishes in hostels before).
If someone got sick, clean up as much of the mess as possible before sanitizing. If someone has gotten sick, you will want to clean up all the visible mess as much as possible before sanitizing. You want the area to look “clean” before you disinfect. Here is a good poster on how to clean up vomit from someone suspected of having Noro.
Clean upholstery & carpet appropriately – If someone has become ill on upholstery or carpet, clean as much of the visible mess as possible and then use a steamer that reaches temperatures over 145 degrees, as Norovirus can survive in temperatures lower than that.
Tips for Shuttle Drivers
Clean After Every Drop – Once you have dropped off a hiker, take the time to wipe down handles (inside and out) with a wipe that has been proven to kill norovirus (see list below) and spray seats with an approved spray (listed below).
Isolate sick hikers – If you pick up an ill hiker or have reason to believe a hiker is sick, only transport that hiker (unless they are hiking with a group).
If someone gets sick inside the shuttle, ensure that it is cleaned before being disinfected. Refer to the tips for Hostels above for the correct way to clean and disinfect for Norovirus on both carpet and hard surfaces.
Cleaning Products That Kill Norovirus
Make sure to follow the directions on any cleaning product you use. Most require that the area be kept wet, anywhere from 1 min to 10 min, for it to kill the virus. The following cleaning products are registered with the EPA and are proven to kill Norovirus. They are the most common ones you can find in stores or on Amazon. Most of the items you cannot find in Walmart, but you can find them at office supply stores like Staples and Office Depot.
Trigger Spray Type Cleaners:
Wipes:
Spray:
Pour Bottle:
To see a complete list of all products registered with the EPA and proven to kill norovirus, click here. Additionally, you can make a chlorine bleach solution with a concentration of 1,000 to 5,000 ppm (5 to 25 tablespoons of household bleach [5% to 8%] per gallon of water) and leave it on the affected area for at least 5 minutes before cleaning with a paper towel. Throw the paper towel away; do not reuse it to clean another surface.
My Thoughts on How To Avoid Norovirus
The basic takeaway to avoid norovirus in the backcountry is to use common sense, wash your hands after using the bathroom and before you eat, and don’t share food. If you are sick, get off the trail and isolate yourself. Just because you are backpacking doesn’t mean you should stop practicing good hygiene! Wash your hands and wash them often! Be mindful of items you touch and keep current with where outbreaks occur.
Disclaimer: The information provided is for educational purposes only. I am not a healthcare professional. Always seek advice from a medical professional before using any product that claims to kill viruses or bacteria. The information provided does not constitute medical advice and should not be taken as such. Use the information in this article at your own risk.
Sources
- https://www.cdc.gov/healthywater/drinking/travel/backcountry_water_treatment.html ↩︎
- https://well.blogs.nytimes.com/2013/01/14/really-the-claim-hand-sanitizer-stops-norovirus-spread/ ↩︎
- https://www.stopthestomachflu.com/welcome-to-stop-the-stomach-flu/which-hand-sanitizers-kill-stomach-flu-viruses-especially-norovirus-and-c-diff-spores ↩︎
- https://health.clevelandclinic.org/how-long-do-norovirus-germs-live-on-household-and-office-surfaces ↩︎
Nice overview. An infected individual can shed billions of the virus and it only takes a few to make someone else sick. There are various strains as well. An individual may have some immunity the second time exposed to the same strain but not to the others. Genetics can make a difference as well when it comes to suseptibility. I’ve been backpacking, hiking and camping for 50+ years now. I’m also a retired Epidemiologist from the Public Health Service. In addition to the clorox wipes, you can make up a solution with clorox and water. Instructions are generally available for food service establishments to use in cleaning tables and utensils.
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