Table 39.4.

Distinguishing Characteristics of Endemic and Epidemic Gastrointestinal Virus Infections

	Childhood Diarrhea (endemic)	Outbreaks (epidemic)
Viruses	Group A rotaviruses, adenoviruses, astroviruses, noroviruses, and sapoviruses	Human noroviruses, group B and C rotaviruses
Age	<5 year	All ages
Mode of transmission	Fecal–oral (hand-to-mouth, environmental contamination)	Common source (contaminated food, shellfish, water). Environmental contamination, person-to-person
Prevention and control	Improved living conditions (sewerage, running water, handwashing facilities, education) Vaccine against rotavirus available	Public health regulations for food and water quality; case and contact tracing, quarantine; environmental disinfection