Outbreaks of norovirus – also known as the winter vomiting bug – are increasing in England with nurseries and childcare settings among those most badly affected.

The UK Health Security Agency says the increase in reported outbreaks was initially in educational settings, with 48% more incidents reported than would be expected, but that transmission was now being seen in care homes too.

Norovirus is highly infectious and causing vomiting and diarrhoea that usually passes in a couple of days. It is spread easily through contact with infected people or contaminated surfaces.

Alongside a growth in cases among very young children in the past four weeks reports of outbreaks in care homes are also on the rise.

There were 24 recorded outbreaks, says the UKHSA, in the week beginning February 7 but this had risen to 40 by the following week.

And while outbreaks in care homes currently below pre-pandemic levels health officials say it is likely that cases will increase in the coming weeks while also warning that outbreaks in care homes often precede an increase in norovirus in hospital settings.

Cases of norovirus have risen as people mix more, says the UKHSA.

It is also warning that it is possible communities will see unusual or out-of-season increases and outbreaks over the coming months as almost all Covid restrictions fall away and people integrate in a way that hasn't been seen for two years.

Professor Saheer Gharbia, of the Gastrointestinal Pathogens and Food Safety Directorate, UKHSA, said: "Norovirus, commonly known as the winter vomiting bug, has been at lower levels than normal throughout the pandemic but as people have begun to mix more, the numbers of outbreaks have started to increase again.

"Symptoms include sudden onset of nausea, projectile vomiting and diarrhoea but can also include a high temperature, abdominal pain and aching limbs.

"Stay at home if you are experiencing norovirus symptoms and do not return to work or send children to school or nursery until 48 hours after symptoms have cleared.

"Please avoid visiting elderly relatives if you are unwell – particularly if they are in a care home or hospital.

"As with Covid-19 and other infectious illnesses, hand washing is really important to help stop the spread of this bug, but remember, unlike for Covid-19 alcohol gels do not kill off norovirus so soap and water is best."

Those with the infection are also advised to avoid cooking or helping to prepare meals for others until 48 hours after symptoms have stopped and wash any contaminated clothing at 60 degrees.

Household surfaces used frequently such as taps, door handles, telephones, toilets and kitchen surfaces also need regularly disinfecting with a beach-based household cleaner.