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David O Matson, MD, PhD
Miguel G O'Ryan, MD
Neil R Blacklow, MD
Section Editor
Martin S Hirsch, MD
Deputy Editor
Elinor L Baron, MD, DTMH


Norovirus is the most common viral cause of epidemic gastroenteritis worldwide. The first outbreak was described in Norwalk, Ohio, in 1968 [1]. Illness due to norovirus was initially described as "winter vomiting disease" due to its seasonal predilection and preponderance of patients with vomiting as a primary symptom.

The epidemiology, virology, clinical manifestations, diagnosis, pathogenesis, and prevention of norovirus will be reviewed here. Issues related to management of acute viral gastroenteritis in adults are discussed separately. (See "Acute viral gastroenteritis in adults", section on 'Treatment'.)


Norovirus is the most common viral cause of epidemic gastroenteritis worldwide; it is also a common cause of endemic diarrhea in community settings [2-11].

In the United States, norovirus has become the most common cause of gastroenteritis in adults and children since introduction of rotavirus vaccination [7,12-14]. Each year, norovirus causes 19 to 21 million illnesses, including 570 to 800 deaths, 56,000 to 71,000 hospitalizations, 400,000 emergency department visits, and 1.7 to 1.9 million outpatient visits [15].

Norovirus antibody seroprevalence rises progressively during childhood; more than 90 percent of young adults are seropositive [3,16,17]. However, immunity is not long lasting, and reinfection can occur [18]. Exposure over time to a diversity of norovirus strains may result in repeat infections.

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Literature review current through: Dec 2017. | This topic last updated: Jul 25, 2017.
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