Which parts of the US have it the worst?

Parts of the US are feeling the pangs of stomach flu.

The Midwest is experiencing the greatest impact this norovirus season with a testing positivity rate of 19.48% as of Feb. 4 — already surpassing last year’s high of 16.12%, recorded late in the season, on April 2, 2022.

Norovirus is trending higher than projected in other regions as well, according to NoroSTAT, the Centers for Disease Control and Prevention’s virus reporting program.

Unrelated to influenza, the “stomach flu” usually refers to an infection of norovirus. The highly contagious gastrointestinal illness can prompt days of nausea, vomiting, diarrhea and fever — and, in extreme cases, could lead to severe dehydration, reduced nutrient absorption and even death.

And, unlike the bona fide flu, norovirus isn’t respiratory — usually, it’s spread by making contact with fecal or vomit particles from an infected person, according to the CDC.

Norovirus moves year-round, but it’s in winter, roughly from November to April, that the germ really thrives — and seemingly more than usual this year.

Between Aug. 1, 2022 and Jan. 8, 2023, the CDC reported 225 norovirus outbreaks, a 30% increase from last year’s log of 172 during the same period. That’s bad news for hospitals and clinics already pressed for resources three years into a pandemic.

The CDC told media outlets the current trends are “within the expected range.” Nevertheless, certain regions are seeing an early-season spike in cases of norovirus — and thus would do well to be on high alert.

The latest look at the West shows a positive test rate of 13.42%, putting the region just a few cases away from beating last year’s high of 13.49%, logged the last week of April, the end of norovirus season.

Meanwhile, the Southern and Northeastern regions are on par with 2022 — though residents there should remain vigilant with more than two months left in the season.

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The CDC’s NoroSTAT program tracks public health department data from 14 participating states — Alabama, Massachusetts, Michigan, Minnesota, Nebraska, New Mexico, North Carolina, Ohio, Oregon, South Carolina, Tennessee, Virginia, Wisconsin and Wyoming — which are all reporting upticks in stomach flu cases.

The agency estimates some 19 million to 20 million Americans catch the bug every year — resulting in approximately 465,000 emergency department visits, mostly for children; 109,000 hospital admissions; and 900 deaths, particularly among patients 65 and older.

There is no vaccine for norovirus, but transmission can be prevented with diligent handwashing and hygiene. Those who are sickened should focus on replenishing fluids lost during bouts of diarrhea and vomiting by drinking water or electrolyte beverages and consuming bland foods when possible. Some with gastroenteritis may also find relief with anti-nausea and fever-reducing medications.

Though symptoms may subside within a few days of infection, those recovering from the stomach flu should continue to use caution while interacting with others, as the virus may shed for several more days, according to the CDC.