A clinical syndrome characterized by acute infectious gastroenteritis with watery diarrhea, vomiting, malaise, and abdominal cramps with a relatively short incubation period (12–36 h) and duration (24–48 h). A viral etiology is suspected when bacterial and parasitic agents are not found. In the United States, no etiologic agent can be found in 70% of the outbreaks of gastroenteritis. Most of these may be due to viral agents, such as the Norwalk, Snow Mountain, and Hawaii agents, astroviruses, caliciviruses, adenoviruses, nongroup A rotaviruses, and paroviruses. Epidemics are common worldwide and have occurred following the consumption of fecally contaminated raw shellfish, food, or water, although the virus may be spread by airborne droplets as well. Epidemics are most frequent in residential homes, camps, institutions, and cruise ships. Many individual cases of mild diarrhea may in fact occur in epidemics for which the source of the infection cannot be found. Epidemic viral gastroente...