The Disease

In general, norovirus infection is associated with sudden onset of nausea and vomiting that is severe, projectile, and frequent. However, a significant proportion of patients report diarrhea, abdominal cramps, headache, myalgia, and pyrexia.[11,15,16] In the elderly, however, disease can be severe and cause death. In a study of diarrheal disease in the United Kingdom there were 43 deaths in 38 outbreaks in hospitals or elderly care facilities,[19] and in the United States norovirus is estimated to account for 7% of fatalities due to foodborne disease.[20] Disease manifestation persists for a median of 5 days with diarrhea persisting for a median of 4 days. The median duration of illness decreased with age.[15] Chronic diarrhea can occur in the immunocompro-mised.[9- Sapovirus gastroenteritis is more often associated with diarrhea than vomiting; however, nausea and vomiting precede diarrhea in a proportion of cases. Disease persists for a median of 6 days.

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