| Hepatitis A |
15-50 days, median 28 days |
Jaundice, dark urine, fatigue, anorexia, nausea |
Penetration spread, invasion of enteric mucosa, spread to liver resulting in inflammation (hepatitis) |
Detection of IgM anti-hepatitis A virus in serum from persons who have consumed epidemiologically implicated food |
Spread by fecal- oral route; ingestion of contaminated food or water Shellfish |
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| Norwalk family of viruses |
15-77 hours, usually 24-48 hours |
Vomiting, cramps, diarrhea, headache |
Mucosal invasion |
Serological testing; > fourfold rise in antibody titer to Norwalk virus or Norwalk-like virus in acute- and convalescent-phase sera OR Molecular diagnostic assays |
Spread by fecal- oral route; ingestion of contaminated food or water Shellfish |
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| Astrovirus, calcivirus, others |
15-77 hours, usually 24-48 hours |
Vomiting, cramps, diarrhea, headache |
Mucosal invasion |
Visualization of small round structured viruses that react with patient's convalescent-phase sera but not acute- phase sera OR Molecular diagnostic assays |
Spread by fecal- oral route; ingestion of contaminated food or water |
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