Winter vomiting disease is surging in the U.S. Here’s how to avoid it.

Health officials are reporting a surge in “winter vomiting disease” with norovirus cases spiking across the U.S. since mid-October.

According to the Centers for Disease Control and Prevention’s National Wastewater Surveillance System , which monitors infectious diseases through more than 1,000 wastewater sampling sites across the country, there have been significant norovirus outbreaks in Indiana, Louisiana and Michigan with Alabama, California, Florida and Texas flagged for pockets of heavier concentration.

The virus, sometimes called “the stomach flu” or “a stomach bug,” causes acute gastroenteritis, or inflammation of the stomach or intestines. It typically peaks from December to April, so this surge, which started in October, is considered ahead of schedule.

Of particular concern