Centers for Disease Control and Prevention People should always read the label for proper usage instructions. This article was medically reviewed by Roy Nattiv, MD. For one thing, its simple. Learn about food safety practices that can help prevent these outbreaks. Confusion surrounding whether or not hand sanitizer could kill norovirus may be attributed to companies making marketing claims that it essentially could. If they have to go back to work there has to be complete and utter vigilance about washing your hands, Aiello says. According to experts at the U.S. Centers for Disease Control and Prevention (CDC), you can get norovirus from: The department is "looking at how to monitor this more closely," a spokesperson said. CDC is not responsible for Section 508 compliance (accessibility) on other federal or private website. A little while later, she started feeling lousy. In January 2020, the FDA sent a similiar warning letter to GOJO Industries, makers of Purell hand sanitizer, for marketing its products with claims that imply they could be used to kill viruses and prevent disease. Which Clorox Products kill Norovirus? Accessed Oct. 29, 2021. Hand sanitizer does not work well against norovirus. wikiHow is where trusted research and expert knowledge come together. During outbreaks, use soap and water for hand hygiene after providing care or having contact with patients suspected or confirmed with norovirus gastroenteritis. This content does not have an Arabic version. Norovirus cases are on the rise in the US, Centers for Disease Control and Prevention data shows and hand sanitizer won't protect you from getting sick. This site complies with the HONcode standard for trustworthy health information: verify here. Accessed Oct. 29, 2021. "To wash and dry infected person's clothes separately. This article was originally published on Feb. 9, 2017, Placenta Previa Dos & Donts, & What To Expect When You Give Birth, Vaginal Bleeding After C-Section: What To Expect & How Long It Lasts, Can You Take Ozempic While Pregnant Or TTC? Board-Certified Family Nurse Practitioner. If anybody in your household gets it, its just so infectious that everyone around you is likely to get it, Barron said. Surfaces Focus on regularly cleaning items that are touched by hands. O'Ryan MG. Norovirus. Dr. John Treanor of the University of Rochester Medical Center in New York is working on a vaccine against norovirus. By subscribing to this BDG newsletter, you agree to our. As the New York Times points out in a recent, very informative article about the virus, it only takes 20 particles of norovirus to make someone sick, and just one tablespoon of puke contains 15 million viruses. The body temperature will rise, making the virus more vulnerable to the immune system. That's because the symptoms can easily lead to dehydration. Approved. 2023 BDG Media, Inc. All rights reserved. Sigh. Norovirus infection causes gastroenteritis (inflammation of the stomach and . They can survive temperatures as high as 145F. How to prevent spread of nasty norovirus: Start by washing hands. By continuing to use this site you are giving us your consent. For non-porous surfaces like countertops, sinks, or tile floors: Dissolve one third of a cup of bleach in a gallon of water. https://www.cdc.gov/handwashing/when-how-handwashing.html. There are no medicines that treat norovirus, and the CDC recommends drinking liquids to prevent dehydration for the time being. Theres no treatment. Here are some tips to help prevent the spread of norovirus in your home: https://www.cdc.gov/norovirus/about/symptoms.html, https://www.cdc.gov/norovirus/about/transmission.html, https://www.cdc.gov/norovirus/preventing-infection.html. Consuming contaminated food or water. And food poisoning typically stems from bacteria that have developed in food, like mayonnaise dishes that need to remain cold and have sat out in the sun too long. Scrub your hands with soap each time you use the bathroom or clean up someones vomit. In December, a team at Ohio State University found the virus stuck to plates that had been washed in restaurant-like conditions -- and they found sticky dairy products like cheese helped the virus stay there. Everyone goes and samples the food. Did you know you can get expert answers for this article? Unfortunately, people who are infected with norovirus sometimes dont know they have it until they get sick. Norovirus is the most common cause of acute gastroenteritis -- stomach upset -- in the United States. This shedding can last weeks to months if you have another medical condition. Using soap and water is the best way to kill germs on your hands. Accessed Nov. 1, 2021. You have to let it run its course, Barron said. https://www.cdc.gov/norovirus/about/prevention.html. Noroviruses are difficult to kill because they can withstand hot and cold temperatures and many disinfectants. The water helps create soap lather that removes germs from your skin when you wash your hands. Feldman M, et al., eds. Wash hands frequently with soap and warm or hot water. These cookies perform functions like remembering presentation options or choices and, in some cases, delivery of web content that based on self-identified area of interests. Before eating, preparing, or handling food. Your stomach may become inflamed, causing pain. In the meantime, they can touch food or surfaces in schools like desks and notebooks. If you suspect any kind of food of being contaminated, you should dispose of it immediately. The Centers for Disease Control and Prevention (CDC) cannot attest to the accuracy of a non-federal website. Its the the most common cause of foodborne-disease outbreaks, CDC says. It is pretty difficult to get rid of, says Allison Aiello, who studies how viruses spread at the University of Michigan. Federal health officials say a new strain, called the Sydney strain, is now causing most of the misery across the United States and the world. New recipe ideas for the tried and true potato. But, once she returned home and was stuck in the bathroom for about 24 hours, she realized that she was suffering from norovirus instead. Centers for Disease Control and Prevention Most older children and adults dont need to see a doctor for norovirus. Virtual visit Actively promote adherence to hand hygiene among healthcare personnel, patients, and visitors in patient care areas affected by outbreaks of norovirus gastroenteritis. Out of these, the cookies that are categorized as necessary are stored on your browser as they are essential for the working of basic functionalities of the website. Norovirus is a common and very contagious infection that causes vomiting and diarrhea. Consume plenty of fluids. The virus stays alive on the surface, then when other people touch the same spot, the infection spreads. Other symptoms can include fever, headache, and body aches. Seek medical attention if you develop diarrhea that doesn't go away within several days. The highly contagious virus has closed schools this month, was a primary factor in fines paid by Chipotle, and cut cruise ship trips short. It usually lasts no more than three days. It is mandatory to procure user consent prior to running these cookies on your website. I think I will also put all my clean. Put on rubber or disposable gloves and wipe the entire area with paper towels, then disinfect the area using a bleach-based household cleaner as directed on the product label. It is pretty stable. Barron said norovirus is common when people are gathering in close quarters and are eating together. This also applies to sick workers in restaurants, schools, daycares, long-term care facilities, and other places where they may expose people to norovirus. When and how to wash your hands. Symptoms from food poisoning, in contrast, usually last just a couple of hours. According to NBC, bleach will kill norovirus effectively, and it should be used to clean surfaces after you've had a bout of the virus. Norovirus is encapsulated, which means it is surrounded by a little capsid, or shell, that not even alcohol can get through - making alcohol and alcohol-based cleaners, about useless. [N]orovirus grows in the small intestine, so changing the stomach environment is really not going to do you much good, she told the Times. But according to Dr. Mary Wikswo, from the CDC, it was likely all in my imagination. A person usually develops symptoms 12 to 48 hours after being exposed to norovirus. of Health and Human Services She is also a storyteller. Food on cruise ships can serve as a source of infection. As many as 800 people die, mostly elderly patients who become dehydrated. For porous surfaces, like wooden floors: Dissolve one and two thirds of a cup of bleach in a gallon of water. This article was originally published on Dec. 19, 2018, I'm The Old Mom With A Young Kid & Yes, Sometimes It's Weird. For more information, see EPAs Registered Antimicrobial Products Effective Against Norovirus (Norwalk-like virus). Ways to Prevent Foodborne Norovirus Outbreaks. Share. The CDC stresses that hand sanitizer should not be used as a substitute for hand-washing; rather it can be used in addition to soap and water. 13 January 2021. forks, spoons, etc in the dishwasher again ,since I may have still been sick when unloading the dishes. And, unlike the flu, theres no vaccine. Simple cleaning alone doesnt always kill it, and it takes just a few particles of virus to sicken a person. Access your favorite topics in a personalized feed while you're on the go. Norovirus, which is not related to the flu, is a highly infectious disease that causes gastrointestinal issues like vomiting and diarrhea, according to the National Foundation for Infectious Diseases. Norovirus is spread fecally -- in the poop -- and that means it can get into laundry. (KMTV) Across the country, cases of a stomach bug have returned to pre-pandemic levels as social distancing has become a distant memory. Barron said hand sanitizers, which contain alcohol, can be useful to protect people from other illnesses like COVID-19, colds and the flu. Remember that this virus can be passed to you when you touch surfaces contaminated with the virus and then put those fingers in your mouth. Infectious disease Washing your hands and any part of your body that comes into contact with norovirus is on the yes list here. Soap and water are more effective than hand sanitizers in removing certain germs from your hands. Last Update: Jan 03, 2023 This is a question our experts keep getting from time to time. "Individuals with norovirus infection should not prepare food for others for at least two days after resolution of symptoms," according to Trinh, while children should be kept out of child care centers until their stools are "no more than two" more frequent in comparison to what they would normally be. It's sometimes called "stomach flu" but has nothing to do with any influenza virus. Norovirus is a virus that causes diarrhea and vomiting, according to the CDC's website. Go to source Don't use alcohol-based hand sanitizers because they won't kill the germs. There is only one protein they use to make virions, Treanor says. You cant really do anything about that.. Trustworthy Source So, in order to keep yourself and your family healthy, remember to wash your hands with soap and warm water often, especially when handling food or after using the bathroom, and if you do feel sick, stay home from work or school and avoid food preparation altogether. Alcohol-based hand . Cases of norovirus jumped from 206 in 2021 to 306 in 2022, the Douglas County Health Department told 3 News Now. It only takes one or two particles of this virus to make you sick, Barron said. https://www.cdc.gov/norovirus/about/transmission.html. There really isnt very much you can do, says Treanor. Infectious enteritis and proctocolitis. [2] It could be the door handle. For example when someone eats food that has been handled by an infected person, when a person touches infected surfaces and then puts their hands in their mouth, or if objects contaminated with norovirus are placed on surfaces, which in turn contaminates the surface. Use disposable cloths to clean and disinfect the entire area with chlorine bleach. Hand sanitisers with less than 60% alcohol . To stop the spread of norovirus, the CDC recommends washing hands regularly with soap and warm water for at least 20 seconds, especially after using the toilet or changing diapers, and also before eating or handling food, or giving or consuming medicine. It mutates like real influenza does. Handle soiled items carefully without agitating (shaking) them. Anyone can get norovirus infection more than once. "Claims that a hand sanitizer can protect consumers against infection from pathogens are drug claims and therefore, these products are regulated by the FDA as drugs," the FDA said in 2018. CDC twenty four seven. Pediatrics care The most common symptoms of norovirus are diarrhea, vomiting, nausea and stomach pain along with fever, headache and body aches. Warm and cold water remove the same number of germs from your hands. See Handwashing: Clean Hands Save Lives.. This content does not have an English version. Wear disposable gloves if you can while cleaning the carpets. Wash your hands with soap and water for at least 20 seconds. Bleach and other disinfectants are not suitable for consumption or injection under any circumstances. According to the CDC, outbreaks typically tend to be more common between November and April and happen in places like daycare centers, schools, restaurants, hospitals, and cruise ships. The viruses infect the epithelial cells which line the digestive tract, causing cramps, diarrhea and vomiting, but its not understood exactly why. And, once you ingest the virus, youre going to get sick, Barron said. Touching your hand to your mouth after your hand has been in contact with a contaminated surface or object, Being in close contact with a person who has norovirus infection, Eating in a place where food has been handled by someone with norovirus infection or the food has been in contact with contaminated water or surfaces, Attending preschool or a child care center, Living in close quarters, such as in nursing homes, Staying in hotels, resorts, cruise ships or other destinations with many people in close quarters, Having contact with someone who has norovirus infection. It only takes one or two particles of this virus to make you sick, Barron said. Also call your health care provider if you experience severe vomiting, bloody stools, stomach pain or dehydration. https://www.cdc.gov/norovirus/index.html. Are norovirus outbreaks common on cruise ships? How norovirus spreads. Centers for Disease Control and Prevention, Main public health institute for the US, run by the Dept. Some studies show it can be aerosolized. We use cookies to make wikiHow great. The symptoms, though, don't last long, Wilson said. While Barron protects herself well from infectious diseases, she has gotten norovirus herself. Water itself does not usually kill germs; to kill germs, water would need to be hot enough to scald your . The current scientific evidence for handwashing says following five steps to washing hands the . However, dont rely on hand sanitizer. RELATED: Try This DIY Hand Sanitizer Spray Recipe To Keep Your Hands Germ-Free. Mayo Clinic. So, once you get norovirus, all you can do is let the virus run its course and try to protect people around you from getting sick. Perhaps worst of all, people start spreading norovirus before they actually feel sick, and they can spread it for as long as two weeks after they start getting better. Support wikiHow by Cruises have these huge buffets. CDC recommends using bleach, including chlorine bleach or hydrogen peroxide. ", In 2013, Innovative BioDefense said in a press release, citing a study, that "Zylast has proven it can effectively kill the norovirus immediately." You can review and change the way we collect information below. Leave the bleach disinfectant on the affected area for at least five minutes, then clean the entire area again with soap and hot water. Get the latest news and weather delivered straight to your inbox. Cookies used to track the effectiveness of CDC public health campaigns through clickthrough data. Vomiting Diarrhea Norovirus can be found in your vomit or feces (poop) even before you start feeling sick. With over 20 years of experience he specializes in a broad range of pediatric gastrointestinal and nutritional illnesses such as constipation, diarrhea, reflux, food allergies, poor weight gain, SIBO, IBD, and IBS. Norovirus, aka Norwalk, is in the news again. How you treat norovirus. RELATED: How to Make Simple DIY Disinfectant Wipes So You Can De-Germ Everything. The CDC notes that hand sanitizer does not work well against norovirus and should not be used as an alternative for hand washing. Besides how awful it is to see your child uncontrollably vomiting or having diarrhea (sometimes both at the same time, so help me God), the problem with norovirus is that its almost impossible to contain. Once, when she was traveling, she grabbed a sandwich at the airport to eat on the plane. Nov. 2, 2021. These cookies allow us to count visits and traffic sources so we can measure and improve the performance of our site. You can use hand sanitizers in addition to hand washing, but hand sanitizer is not a substitute for washing your hands with warm water and soap. He completed his pediatric residency at the Childrens Hospital at Montefiore, Albert Einstein College of Medicine in New York, and his fellowship at the University of California, San Francisco (UCSF). Preventing Norovirus Outbreaks, Food Service has a Key Role Norovirus is the leading cause of disease outbreaks from contaminated food in the United States. ", "Don't let others use contaminated items.". Some will have low-grade fevers or body aches. She attended Colorado College, thanks to a merit scholarship from the Boettcher Foundation, and worked as a park ranger in Rocky Mountain National Park during summer breaks from college. In this case, a strain called New Orleans has been replaced by the Sydney strain. 1998-2023 Mayo Foundation for Medical Education and Research (MFMER). So, be sure to keep hand sanitizer on hand. The highly contagious virus has closed schools this month, was a primary factor in fines paid by Chipotle, and cut cruise ship trips short. National Institute of Diabetes and Digestive and Kidney Diseases. [1] Once, when she was traveling, she grabbed a sandwich at the airport to eat on the plane. They do come abruptly, though. Especially vulnerable people, such as the elderly, infants, or the immunocompromised, may have symptoms longer. Preventive care https://www.niddk.nih.gov/health-information/digestive-diseases/viral-gastroenteritis/all-content. You will be subject to the destination website's privacy policy when you follow the link. Using hand sanitizer doesn't kill norovirus particles as effectively as washing your hands with soap and warm water. If a family member is contaminated, do not let them cook for anyone else. Roy Nattiv, MD. You should always contact your doctor or other qualified healthcare professional before starting, changing, or stopping any kind of health treatment. By clicking Sign up, you agree to receive marketing emails from Insider According to the CDC, there are 19 to 21 million cases of vomiting and diarrhea illnesses caused by norovirus each year. Alcohol-based hand sanitizer does not kill norovirus, Wilson said, but soap and water do. You can spread the virus from the time you first have symptoms of illness until several days after you recover. And, unlike the flu, theres no vaccine. And the virus mutates. Dr. Trong Tony Trinh, M.D., MPH, infectious disease physician at the Polyclinic in Seattle, Washington. Germstar ONE 2oz Hand Sanitizer Spray Bottles (6/case) . Norovirus infection can cause severe vomiting and diarrhea that start suddenly. How to prevent norovirus Cookies used to make website functionality more relevant to you. Top editors give you the stories you want delivered right to your inbox each weekday. "Washing the clothes, sheets, and bleaching the doorknobs is good advice. This is compared to 172 during the same period in the previous year, according to the CDC. The virus is also surrounded by a case called a capsid, which makes it hard to kill. Avoid other people. Get the most popular stories delivered to your inbox monthly. Theres no treatment. Its a very infectious virus that causes pretty severe diarrhea and vomiting for 24 to 36 hours. You also have the option to opt-out of these cookies. 24 Hour Defense Foaming Hand Sanitizer | Kills 99.99% Of Germs | Stays Effective Throughout Hand Washings For 24 Hours Of Lasting Protection | Rich . Having direct contact with an infected person. The CDC's best advice for handwashing to. Alcohol-based sanitizer doesn't kill norovirus all that well, so clean your hands with soap and water. Remove any traces of vomit or feces by wiping it away with paper towels or a disposable absorbent material. Primary care Accessed Oct. 29, 2021. Norovirus infection is highly contagious. This material may not be published, broadcast, rewritten, or redistributed. Wash your hands. A detergent like soap can most of the time, said Dr. Michelle Barron, senior medical director of infection prevention and control at UCHealth University of Colorado Hospital on the Anschutz Medical Campus. While at UCSF, he was a California Institute of Regenerative Medicine (CIRM) fellowship trainee and was awarded the North American Society for Pediatric Gastroenterology, Hepatology, and Nutrition (NASPGHAN) Fellow to Faculty Award in Pediatric IBD Research. The good news is that while norovirus is an incredibly disgusting nuisance, it is usually a short-lived virus when it hits you, with most of us feeling better in 24-48 hours. Norovirus can be found in your vomit or feces (poop) even before you start feeling sick. In 2018, the U.S. Food and Drug Administration (FDA) filed a complaint against Innovative BioDefense Inc., the makers of Zylast hand sanitizers, for making claims that its products were "effective against infection by pathogens such as norovirus, rotavirus, flu virus, Methicillin-Resistant Staphylococcus Aureus (MRSA), and Ebola. Dr. Roy Nattiv is a Board-Certified Pediatric Gastroenterologist in Los Angeles, California. Download our apps today for all of our latest coverage. [CDATA[ People who are sick should not prepare or handle food. Use detergents with bleach to clean and disinfect surfaces. In: Sleisenger and Fordtran's Gastrointestinal and Liver Disease: Pathophysiology, Diagnosis, Management. Diarrhea. Saving Lives, Protecting People, Handwashing: A Health Habit in the Kitchen, Norovirus: Types, Symptoms, Causes, Diagnosis And Treatment, EPAs Registered Antimicrobial Products Effective Against Norovirus (Norwalk-like virus), National Center for Immunization and Respiratory Diseases, Camp Healthy: Norovirus Prevention at Youth Camps, Preventing Norovirus Outbreaks, Food Service has a Key Role, CDC Vital Signs Preventing Norovirus Outbreaks, Food Service has a Key Role, CDC Vital Signs: Making Food Safer to Eat, CDCs Healthcare-associated Infections Website, U.S. Department of Health & Human Services. While they are completely different . With all that said, while proper hand hygiene is the best way to protect your family from contracting norovirus, if soap and water are not available at the moment, using a hand sanitizer with. The virus, sometimes known as Norwalk virus or winter vomiting disease, causes vomiting, diarrhea and that someone-just-hit-me-with-a-plank feeling. Norovirus infection occurs most frequently in closed and crowded environments. Before giving yourself or someone else medicine. UCHealth University of Colorado Hospital After someone vomits or has diarrhea, always thoroughly clean and disinfect the entire area immediately: To help make sure that food is safe from norovirus, routinely clean and sanitize kitchen utensils, counters, and surfaces before preparing food. Use it to try out great new products and services nationwide without paying full pricewine, food delivery, clothing and more. Accessed Nov. 1, 2021. The clothes should be dried separately from the uncontaminated clothes. Headaches. RELATED: What To Eat When You Have The Stomach Flu (And Feel Like Ralphing 24/7). Vomiting Alcohol-based hand sanitizers can actually kill certain types of germs - but not all germs - and in those cases, you need to use soap and water. To prevent norovirus infection: Wash your hands thoroughly with soap and water for at least 20 seconds, especially after using the toilet or changing a diaper and before you prepare food and eat or drink. Hands and foods can be infected. If you notice dark urine or lack of tears, seek medical help immediately. IE 11 is not supported. There are many types of noroviruses. Touching contaminated surfaces and then putting your unwashed hands in your mouth. Do not wash contaminated clothing with uncontaminated cleaning. Holy shit. Its a very infectious virus that causes pretty severe diarrhea and vomiting for 24 to 36 hours. After this stage is complete, wash the clothes using a regular washing cycle and detergent. According to the FDA, this claim was highly misleading. If you are a nurse or doctor, wash your hands before and after coming into contact with an infected patient, even if you wear gloves. By using our site, you agree to our. Tosh PK (expert opinion). And Ive had some success. You should scrub for at least 20 seconds, and then rinse your hands well under clean,. 1 thing is to stay home. A person is most contagious when the symptoms are clearly visible. According to experts at the U.S. Centers for Disease Control and Prevention (CDC), you can get norovirus from: Norovirus is an extremely crafty bug and each particle comes with its own protective shield of sorts to help it survive as long as possible. Copyright 2023 Scripps Media, Inc. All rights reserved. Follow these tips to prevent norovirus at youth camps. Consider wearing a facemask that covers your mouth and nose as well. Remember, too, that norovirus is airborne (sorry), so bleach all the surfaces within a 25 foot radius. Check out these best-sellers and special offers on books and newsletters from Mayo Clinic Press. Finish by cleaning soiled laundry, taking out the trash, and washing your hands. It is important to continue washing your hands often during this time. Most people recover completely without treatment. Handwashing is always best. However, they're still contagious and can spread the virus to others. ", Unlock expert answers by supporting wikiHow, https://www.cdc.gov/norovirus/about/index.html, https://www.cdc.gov/norovirus/about/prevention.html, https://www.webmd.com/food-recipes/food-poisoning/norovirus-symptoms-and-treatment, http://www.cdc.gov/norovirus/preventing-infection.html, http://www.nhs.uk/Conditions/Norovirus/Pages/Symptoms.aspx, http://www.cdc.gov/norovirus/about/treatment.html. Consuming contaminated food or water. According to the CDC, each person with norovirus can shed billions of particles of the disease. They commonly spread through food or water that is contaminated during preparation or through contaminated surfaces. A new strain is making people miserable around the world this year. Any use of this site constitutes your agreement to the Terms and Conditions and Privacy Policy linked below. It has similar symptoms to the stomach flu, but has a different cause. . Purell's website has since been updated. You should leave the bleach solution on these surfaces for at least 5-10 minutes to give it time to work. A person will usually get symptoms within 12 to 48 hours of being in contact with the virus, which will last between one and three days. Most older children and adults dont need to see a doctor for norovirus. To wash your hands, wet them thoroughly with water, lather them with soap, and scrub for at least 20 seconds.Then rinse and dry . Cook oysters and other shellfish thoroughly to an internal temperature of at least 145F . "Even though it's a self-limited infection it can lead to potentially dangerous symptoms if it's not identified early or not treated appropriately," Wilson said. virtual health You might wonder how you can protect yourself and your family members from norovirus. In June, the Food Chain Workers Alliance issued a report showing that only 21 percent of workers surveyed could take a paid sick day off work. Symptoms: But in reality, can hand sanitizer actually kill norovirus? Signs and symptoms of norovirus infection may start suddenly and include: Signs and symptoms usually begin 12 to 48 hours after your first exposure to a norovirus and last 1 to 3 days. Clearly, washing your hands is important., Dont miss the latest health news on NBCNews.com. According to Mayo Clinic experts, it's impossible to keep hands germ-free but there is good news. Children who are dehydrated might cry with few or no tears. And my success rate wasnt exactly stellar. Just as you suspected, norovirus is extremely freaking contagious, more so than most viruses. This article has been viewed 115,176 times. Resist many common disinfectants and hand sanitizers. Mayo Clinic; 2021. If you do not allow these cookies we will not know when you have visited our site, and will not be able to monitor its performance. Paramedics dressed in protective attire enter a German cruise ship quarantined in December after an outbreak suspected to be norovirus. Be careful not to splash or drip while cleaning. Rub your hands together to make a lather and scrub them well; be sure to scrub the backs of your hands, between your fingers, and under your nails. Norovirus is hard to kill and stays on food, kitchen surfaces, and utensils. Alcohol cant break the shield. Will pouring boiling water on the surfaces kill the norovirus germs? A new strain of norovirus -- often called stomach flu -- is going around and its going to be very hard to avoid it, experts say. 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