Alcohol gel its on a counter at Showtime Childcare and Preschool in Cedar Rapids on Wednesday, November 4, 2009. With close contact with sick children inevitable, employees say there is a lot of hand-washing going on. (Cliff Jette/The Gazette) They both make you ill, but health experts say the stomach flu and the flu are two separate things. Both, unfortunately, both are circulating now in Iowa. Influenza activity increased from “regional” to “widespread” in the period ending Dec. 8. Widespread means outbreaks of influenza or flu-like illnesses have been reported in at least half the regions of the state. At least 23 patients have been hospitalized and 14 schools have reported greater than 10 percent absenteeism due to flu-like illnesses. The State Hygienic Laboratory has identified three strains of flu – influenza A (H3N2), 2009 H1N1, and influenza B – circulating in Iowa. State epidemiologist, Dr. Patricia Quinlisk, said that norovirus – often referred to as “stomach flu” – is also ongoing across the state. Norovirus is a stomach illness that is typically short-lived, while influenza has respiratory symptoms, such as cough and runny nose, along with a fever and sometimes other symptoms, including body aches, nausea, vomiting or diarrhea. “Stomach flu is the wrong term for this,” Quinlisk said. “It’s not even in the same family of viruses.” Cases of norovirus are not tracked by the state, which “would be like trying to track the common cold,” she said, but reports from schools show that numbers generally increase in the winter. The virus can be food- or water-borne or spread person-to-person. Flu cases have also skyrocketed at schools this week, Quinlisk said. She noted that because the two illnesses are caused by unrelated viruses, the flu vaccine won’t protect people from norovirus. Quinlisk advised Iowans to get a flu shot if they haven’t already. That includes children. It can take up to two weeks for full protection to develop after vaccination and the holidays are a high-risk time for getting the flu because of travel and socializing. The U.S. Centers for Disease Control & Prevention is predicting an earlier and more severe flu season, which so far, is holding true in Iowa, though Quinlisk hesitates to say for sure. “I can’t really predict until we get a little more into the season,” she said.