California officials have issued a warning that winter vomiting disease is on the rise. The state has already confirmed 32 outbreaks since October 1, which is far more compared to the nine cases reported last year.

Health officials have recommended people in California to wash their hands properly and frequently to avoid the infection.

The illness is caused by the quite contagious pathogen called norovirus, and it spreads at a fast pace in closed and crowded environments, including day-care centers, schools, hospitals, nursing homes, cruise ships and restaurants.

Generally it causes nausea, diarrhea, abdominal pain, and vomiting. These conditions are quite serious for older adults and young children.

Karen Smith, California Department of Public Health director and state public health officer, said, “One of the most important things you can do to avoid norovirus and other illnesses this holiday season is to wash your hands frequently with soap and running water for at least 20 seconds”. Smith added that thus mainly important after changing diapers, using the bathroom, and before cooking or eating food.

Health officials said that the virus can spread after coming in direct contact with an infected person, by infected foods or liquids consumption, or by touching one’s mouth after touching a contaminated surface.

The infectious diseases specialist at Vanderbilt University School of Medicine, Dr. William Schaffner, said when viral particles enter the body, they get attached to the mucosal that line the intestines and affects their ability of vital fluids absorption.

Health officials said most of the cases have occurred at nursing homes and other long-term care facilities in the recent California outbreaks, with the remainder affecting event centers and schools.