Stopping Infections Spreading at Home: Hands, Cleaning and Fresh Air

When someone in your home has a sickness bug, flu or COVID-19, the actions that stop it spreading to the rest of the household are simple and they work: wash hands with soap and water, keep the ill person at home, clean the surfaces germs survive on, wash soiled laundry separately at 60°C, and let fresh air into rooms. The numbers to remember are 48 hours and 60°C. With norovirus, the winter vomiting bug, you stay off school, nursery or work and avoid visiting hospitals and care homes until 48 hours after the last episode of sickness or diarrhoea¹, and you wash clothes and bedding with poo or vomit on them on a 60°C wash, separately from other laundry¹.

The reason these steps matter is that the germs do not leave with the person. Flu germs from coughs and sneezes can live on hands and surfaces for 24 hours². Norovirus is tougher still: it can survive outside the body for several days³. So a household that only rests and waits can pass an infection round for weeks, when a few habits carried out for a couple of days would break the chain.

This page sets out what to do, in the order you need it: hands first, then staying home, then cleaning, laundry, food, coughs and fresh air, protecting people at higher risk, and finally when to call NHS 111 or 999. It covers the whole UK, and says where Scotland's advice differs where that matters.

Wash hands with soap and water, not gel

Handwashing is the single most effective way to stop the spread of infection⁵. When a stomach bug is in the house, it is also the step people most often get wrong, because the convenient option, alcohol hand gel, does not do the job. Alcohol hand gels do not kill norovirus¹. The government's norovirus guidance is blunt on the point: do not rely on alcohol gels instead of washing your hands, as these do not kill the virus⁶. Hand sanitiser does not effectively remove all types of disease-causing organisms, so soap and water should be used to wash hands wherever possible⁷.

Wash your hands with soap and water after going to the toilet or changing nappies, and before preparing, serving or eating food¹. In a household with an ill person, add the moments that matter most:

• after any contact with the sick person, and before handling food⁸
• after using the toilet, and after handling dirty linen or clothing⁴
• before eating, and before feeding anyone else⁴

Do not share towels or wash cloths with the sick person⁴. A shared hand towel in the bathroom can carry the virus from the person who is ill to everyone who dries their hands on it, so give the ill person their own towel and change it regularly.

There is one exception where gel is the right answer. If you have no running water, for example during a flood or a supply interruption, you can use alcohol gels or wet wipes to clean hands before handling food, on the advice of Food Standards Scotland⁹. It is a fallback for an emergency, not a substitute when a tap and soap are available.

Stay at home while you are infectious

The most reliable way to stop an infection leaving your home is for the ill person not to leave it. If you are unwell, try to stay home or avoid contact with other people; some diseases have specific exclusion periods⁷. Within the home, the ill person should avoid contact with others as much as possible¹.

Norovirus: 48 hours after symptoms stop

Norovirus is the most common stomach bug in the UK and is highly infectious¹⁰. Symptoms usually appear 1 to 2 days after you become infected and typically last for up to 2 or 3 days³; one NHS source gives the duration as 12 to 72 hours⁴. People usually recover in about 2 days¹. There is currently no vaccine to help prevent norovirus, and antibiotics do not work against it¹, so hygiene and isolation are the whole of the treatment for a household.

The rule that matters most: do not go to school, nursery or work, or visit others in hospital or care homes, until 48 hours after the last episode of sickness or diarrhoea¹. Food Standards Scotland puts the same rule as staying off school or work, especially if you are a food handler, until the symptoms have stopped for 2 days¹⁰. Norovirus is most infectious from the start of symptoms until 48 hours after all symptoms have stopped, and possibly for a short time before and after this³. That is why the exclusion period runs from the end of the illness, not the start: you can feel completely well and still be shedding the virus.

The same 48-hour rule applies to other diarrhoeal infections. With cryptosporidiosis, you are infectious while you have symptoms and should not return to work or school until you have been free from diarrhoea and/or vomiting for 48 hours¹¹.

Flu and COVID-19: stay home while you have a temperature

Flu is a virus that spreads easily from person to person¹². If you have flu symptoms, stay at home if you can, to help avoid spreading germs to others¹². Try to stay at home and avoid contact with other people if you have a high temperature, feel hot, cold or shivery, or do not feel well enough to do your normal activities². You can spread flu even if you do not have symptoms, and you are more likely to spread it to others in the first 5 days after getting infected¹².

For COVID-19 and other respiratory infections, the official advice is the same in principle: if you have symptoms and a high temperature, or do not feel well enough to go to work or carry out normal activities, try to stay at home and avoid contact with other people until you no longer have a high temperature or no longer feel unwell¹³. If you have a positive COVID-19 test result, try to stay at home and avoid contact with other people for 5 days after the day you took your test¹³. Children and young people aged 18 and under with a positive test should try to stay at home and avoid contact with other people for 3 days after the day they took the test, if they can¹³. Our page on how long to stay at home after a positive COVID test covers this in detail.

Clean the toilets, taps and handles the virus survives on

Cleaning is where norovirus households most often fall short, because the virus survives so long outside the body. It can survive outside the body for several days³, and it spreads through close contact with an infected person, through food or drink prepared or handled by someone who has norovirus, and by touching contaminated items or surfaces and then touching your mouth¹. Clean surfaces that people touch a lot, such as door handles, and regularly clean and disinfect all areas in contact with food, dirt or body fluids, such as toilets⁷.

When someone in the house has a stomach bug, it makes sense to clean the surfaces people touch most often as part of keeping the home tidy¹:

Flush away any infected faeces or vomit in the toilet and disinfect the surrounding area, and flush the toilet with the lid down to stop the virus spreading⁴. The lid-down habit is worth keeping even after the illness has passed: flushing aerosolises whatever is in the bowl, and with norovirus in the house that spray carries virus onto nearby surfaces.

Disinfect door and toilet handles, taps and the toilet seat after the ill person uses them⁸, not just once a day. The most effective way to help stop an outbreak is to disinfect the contaminated areas and ensure good hygiene¹⁴. Norovirus can close hospitals, care homes and schools¹⁴, and the same force that closes a ward can take a family round the same bug for a fortnight.

Wash soiled clothes and bedding at 60°C

Anything with poo or vomit on it needs its own wash. Wash clothes and bedding that has poo or vomit on it on a 60°C wash, and separately from other laundry¹. Do not shake soiled items before washing: the point of the hot, separate wash is to keep the virus out of the rest of the laundry and out of the air.

Handle dirty linen and clothing with care, and wash your hands with soap and water afterwards⁴. Do not share towels or wash cloths with the sick person⁴. If the ill person has been using a towel or face cloth, treat it as soiled: change it daily while symptoms last and for the 48 hours afterwards, and wash it hot and separately.

Keep going for the full infectious window. You need to be very clean around your home for at least 48 hours after symptoms stop, because you remain infectious to other people during that time¹¹. A single missed wash of a sick child's bedding on day three of recovery can restart the whole household's illness.

Prepare food safely when someone is ill

Food is one of the main routes by which infections travel, so the kitchen needs its own rules when someone is ill. The most important one: ensure that anyone with diarrhoea, vomiting or nausea does not prepare food⁵. This applies to the whole household, not just the ill person, and it matters most for food handlers at work as well as at home¹⁰.

Wash your hands after contact with the sick person and before handling food⁸. Norovirus can be caught from food or drinks prepared or handled by someone who has the virus¹, and infection can also happen by eating food grown in or treated with contaminated water, such as shellfish or fresh produce¹⁰. So while the bug is in the house:

• The ill person does not cook, and does not handle food for anyone else⁵
• Wash hands with soap and warm water before preparing food¹⁰
• Wash fruit and vegetables before eating them¹⁰
• Keep worktops and chopping boards clean to avoid cross-contamination¹⁰
• Do not prepare food too far in advance; keep it either piping hot or refrigerated until it is served⁵
• Cook food thoroughly, following the manufacturer's guidelines, and make sure food is hot throughout before consumption⁸

Cross-contamination is the everyday kitchen risk that continues whether or not anyone is ill. Avoid it by keeping raw meat and unwashed vegetables separate from ready-to-eat foods during storage and preparation, using different chopping boards, plates and utensils for raw and cooked food or washing them thoroughly between uses, washing your hands, worktops and utensils thoroughly after touching raw meat, poultry, fish and eggs, keeping raw meat in a sealed container at the bottom of the fridge, never washing raw meat, and using separate shopping bags for raw and ready-to-eat foods¹⁵. Chilling food at the correct temperature prevents the growth of harmful bacteria¹⁵.

Cover coughs and sneezes, and let fresh air in

Respiratory infections such as flu and COVID-19 spread differently from stomach bugs: through the air and via hands and surfaces. Flu is spread by germs from coughs and sneezes, which can live on hands and surfaces for 24 hours². COVID-19 can present with a wide range of symptoms, from mild to severe¹⁶, and you can still catch or spread COVID-19 if you do not have symptoms, are fully vaccinated, or have had the virus before¹⁷.

The habits that interrupt that spread are the ones public health bodies repeat every winter:

• Wash your hands often with warm water and soap²
• Cover your mouth and nose with a tissue when you cough or sneeze, or cough into the bend of your elbow, not into your hand²
• Bin used tissues as quickly as possible²
• Cover your mouth and nose when you cough or sneeze, and encourage children to do this¹⁷
• Regularly clean surfaces that are touched¹⁶
• Wear a face covering in crowded places or close contact¹⁶
• Stay at home if you are unwell¹⁶

Dispose of dirty tissues promptly and carefully, bagging and binning them¹⁸. A tissue left on a coffee table is a 24-hour reservoir of flu virus².

Ventilation matters too. Let fresh air in when you have visitors¹⁶, and if you have visitors, it can help stop the spread of germs to ventilate the room for a few minutes before and after they arrive¹⁹. Opening a window for a few minutes is enough; the aim is to replace the room's air, not to make the house cold. This matters most in the room where the ill person is resting, and in any room where people gather.

One caution from the NHS for a household with COVID-19: do not use a fan to cool your room, as it may spread the virus²⁰. If the ill person is breathless, they should lie on their side or sit upright rather than on their back, and try to stay calm, as anxiety can make breathlessness feel worse²⁰.

Protecting people at higher risk in your home

Most people recover from these infections at home, but they are not equal in their effects. Flu can be more serious for pregnant women, very young children and older people²¹, and those more likely to become seriously ill from flu include children under 6 months old, people aged over 65, pregnant women and those with certain underlying health conditions¹². For COVID-19, people more likely to become seriously ill include older adults, those with some long term conditions, and those who are pregnant, especially after 28 weeks¹⁶. Norovirus can cause serious illness for some groups, for example children under 5 years, older adults and those with weakened immunity¹.

If someone in your household falls into one of these groups, keep the ill person away from them where you can. Stay away from people at increased risk of becoming more unwell from respiratory infections, if possible, and do not visit hospitals or care homes while ill²². In practice this means the ill person uses a separate room and, if possible, a separate bathroom, eats separately, and does not handle food or shared items.

Vaccination is the protection you can arrange in advance. The flu vaccine helps to reduce the chance of catching and passing on flu, and reduces the risk of becoming seriously ill and needing care in a hospital¹². It is important to get the flu vaccine if you are advised to²³. Our pages on who can get a free flu vaccine and who can get a COVID-19 vaccine now set out the current lists, and our page on people at higher risk in an outbreak goes further on protecting vulnerable relatives.

Two practical points complete the picture. Make sure you and your family are up to date with routine vaccinations²⁴. And if you are caring for someone ill at home, keep the household safe in other ways too: close doors behind you, since this should prevent a fire spreading²⁵, and avoid keeping lots of items in the home, which could make a fire spread quicker and block your escape route²⁵. An ill household is a household at home for days, so the ordinary home-safety habits matter more, not less.

When to call NHS 111 or 999

Most of these illnesses pass at home. Norovirus infections are usually self-limiting²⁶, and flu often gets better on its own, though it can make some people seriously ill¹². The main treatment for a sickness bug is to drink plenty of fluids to avoid dehydration²⁶.

For urgent health advice, help with symptoms, or access to out-of-hours GP services, call NHS 111 on 111, or use the NHS 111 online service²⁷. NHS 111 is the right first call when you are worried but it is not an emergency: for example, if you are worried about a baby under 12 months, a child stops feeding, there are signs of dehydration, the ill person cannot keep fluid down, there is bloody diarrhoea, diarrhoea lasts more than 7 days, or vomiting lasts more than 2 days³. Our page on when to call 111 and when to call 999 explains the choice in full.

Phone 999 or go to A&E for severe symptoms, including vomiting blood, green vomit, possible poisoning, a stiff neck with pain when looking at bright lights, or a sudden severe headache or stomach ache³.

If you are looking after someone ill at home for more than a day or two, our checklist for caring for someone ill at home and our page on how to treat dehydration at home cover the supplies and steps you need. For the wider picture of outbreaks and how they affect households, see health emergencies: a household guide.