Rotavirus cases in Virginia are running above normal levels in 2026, the Virginia Department of Health confirmed this week. The increase follows a pattern health officials have tracked for years: even-numbered years tend to see higher peaks of the highly contagious stomach virus than odd-numbered ones. Emergency room visits for rotavirus are still climbing, but state epidemiologists expect the surge to level off soon.

The trend is not a surprise, according to Kelsey Holloman, Foodborne Disease Epidemiology Program Manager at VDH. “Rotavirus has kind of like a biennial season, which means that the even years have higher peaks than the odd years,” Holloman said. “It’s still been increasing, but it should be leveling off.”

Rotavirus is best known for causing severe diarrhea and vomiting in infants and young children. It spreads easily through contaminated hands, surfaces, and food — and often tears through day care centers and households once it arrives. The virus typically circulates most heavily in the winter and spring, but cases can occur year-round.

The VDH is not reporting specific case counts in the current advisory, but the term “elevated” signals that the proportion of lab-confirmed infections and ER visits is higher than the seasonal baseline. Similar biennial spikes have been documented in other states and nationally. The virus follows this pattern in part because of the way immunity builds in the population after high-transmission years.

Symptoms to watch for include diarrhea, vomiting, fever, stomach cramps, loss of appetite, and dehydration. In young children, dehydration can develop quickly and may require medical attention. Signs include dry mouth, crying without tears, unusual sleepiness, and urinating less frequently than normal.

There is no specific treatment for rotavirus. Care focuses on managing symptoms and preventing dehydration with oral rehydration solutions and, in severe cases, intravenous fluids. Antibiotics do not work against the virus.

Prevention is straightforward but requires consistent effort. Holloman stressed three measures: staying home when sick, watching for symptoms, and getting children vaccinated against rotavirus. “The best way to prevent and protect your child from getting …” she began, with the implication that vaccination remains the single most effective tool.

The rotavirus vaccine has been part of the routine childhood immunization schedule in the United States since 2006. It is given orally in two or three doses depending on the brand, starting at two months of age. Before the vaccine was introduced, rotavirus caused an estimated 2.7 million infections, 500,000 doctor visits, and 200,000 emergency room visits each year in the U.S., according to CDC data. Vaccination has cut severe rotavirus disease by more than 80 percent.

Yet vaccine coverage is not universal, and waning immunity in older children and adults means some transmission still occurs. The biennial pattern that VDH is observing is a reminder that the virus has not disappeared — it still finds pockets of susceptible people.

For families with young children, the current elevated cases mean extra caution is warranted. Frequent handwashing with soap and water, disinfecting toys and surfaces, and keeping sick children at home can help slow the spread. The virus can survive on hands for hours and on hard surfaces for days, making hygiene critical in group settings.

Holloman noted that ER visits for rotavirus are still on the rise, which suggests the peak has not yet passed. But the VDH expects the curve to bend downward in the coming weeks, consistent with the pattern seen in previous even-numbered years.

The situation in Virginia is not isolated. Health departments in other states are also reporting elevated rotavirus activity in 2026, in line with the typical nationwide biennial pattern. The CDC’s national surveillance system tracks rotavirus through a network of laboratories, and the data so far shows a similar uptick.

What is different this year? Nothing fundamentally new about the virus itself, but the exact timing and magnitude of the biennial peaks can shift slightly depending on weather patterns, vaccine coverage rates, and community immunity levels. The post-pandemic period has also disrupted some seasonal disease patterns, though rotavirus appears to have returned to its pre-COVID rhythm.

For now, VDH’s message is straightforward: know the symptoms, keep sick children home, and make sure infants are vaccinated on schedule. The current elevated level of rotavirus is not cause for alarm, but it is a call for attention, especially for parents of newborns and toddlers who are most vulnerable to severe disease.

As the 2026 season winds down, the numbers should taper off. In the meantime, washing hands and wiping down surfaces are the simplest forms of defense. The vaccine is the strongest.