In brief
- With rotavirus, vomiting is one of the first and often the main symptom; diarrhea lasts 3–7 days on average [1].
- Norovirus: a short incubation period, most often 12–24 hours; almost half of children have no diarrhea or only minimal diarrhea [2].
- Enteric adenovirus (types 40 and 41) is linked to watery diarrhea; in one study it lasted longer than in other children with diarrhea [3].
- For all three, treatment is based on replacing lost fluids. A stool test helps identify the cause [1] [2].
When to see a doctor urgently
The main danger of stomach infections is dehydration. CDC lists its signs [4]:
- peeing less;
- dry mouth and throat;
- feeling dizzy when standing up;
- a child cries with few or no tears;
- unusual sleepiness or fussiness.
According to Russian Ministry of Health clinical guidelines, hospitalization is indicated in particular for children under 2 with moderate and severe intestinal infection, children with significant underlying health problems, and patients of any age with severe coexisting conditions or a prolonged course [1].
Comparison table
| Rotavirus | Norovirus | Adenovirus 40/41 | |
|---|---|---|---|
| Incubation period | from 12 hours to 3–5 days, most often 1–2 days [1] | from a few hours to 1–3 days, most often 12–24 hours [2] | — |
| Onset | vomiting is one of the first and often the main symptom [1] | sudden, fever often 38–39 °C (100.4–102.2 °F), lethargy, vomiting, headache [2] | watery diarrhea; compared with rotavirus, fever and dehydration are just as common, vomiting is more common [3] |
| Duration | diarrhea 3–7 days, fever rarely longer than 2–4 days [1] | vomiting 1–2 days, diarrhea from 1–2 to 3–4 days [2] | in one study (children under 2), diarrhea lasted 5.4 days on average vs 3.8 in other children with diarrhea [3] |
| Contagiousness | up to 10¹⁰–10¹¹ virus particles per gram of stool [1] | 10–100 virus particles can cause infection; the virus is shed for up to 7 weeks [2] | stays viable at room temperature for up to 2 weeks [5] |
| Vaccine | available; clinical guidelines recommend it [1] | not mentioned in clinical guidelines [2] | none for the general public [6] |
Rotavirus
Rotavirus infection starts suddenly in about 90% of children. Vomiting is one of the first and often the main symptom [1]. Stools are profuse, watery, frothy and yellow [1]. Fever can be high but rarely lasts longer than 2–4 days; diarrhea lasts 3–7 days on average [1].
Rotavirus infection typically leads to dehydration quickly [1]. Infants and young children get sick most often. You can get it more than once, even after vaccination, but the vaccine is the best way to protect your child from rotavirus [4].
Norovirus
Norovirus infection starts suddenly in 95% of children, and fever often rises to 38–39 °C (100.4–102.2 °F) [2]. The main symptoms are general malaise (intoxication), repeated vomiting, stomach pain and loose stools, but almost half of children have no diarrhea or only minimal diarrhea [2]. Vomiting lasts 1–2 days, diarrhea from 1–2 to 3–4 days [2].
Norovirus is highly contagious: 10–100 virus particles are enough to cause infection, and it can be shed in stool for up to 7 weeks [2]. CDC warns that hand sanitizer does not work well against norovirus; washing hands with soap is more reliable [7].
Enteric adenovirus
Intestinal infection is most often caused by species F adenoviruses, types 40 and 41 [8]. According to a review of studies from 2003–2023, they are found in about 10% of children with gastroenteritis [8].
In a study of children under 2 in Baltimore, enteric adenovirus was linked to watery diarrhea that lasted 5.4 days on average vs 3.8 days in other children with diarrhea. Compared with rotavirus, fever and dehydration were just as common, and vomiting was more common [3]. Learn more in the article on adenovirus gastroenteritis.
Tests
A stool test helps identify the cause: for rotavirus and norovirus, clinical guidelines suggest a rapid test and PCR [1] [2]. How adenovirus is detected is covered in the article on adenovirus testing.
Treatment is the same for all three
For all three, treatment is based on replacing lost fluids: clinical guidelines prescribe reduced-osmolarity oral rehydration solutions until signs of dehydration resolve [1] [2]. If oral rehydration does not help, fluids are given intravenously [1]. There are no drugs that work against adenovirus [9]; for severe rotavirus and norovirus infection, the guidelines allow antiviral drugs [1] [2]. Treatment is prescribed by a doctor.
How to keep your family from getting sick
Rotavirus spreads easily in families and child care settings [4], and norovirus is shed in vomit and stool even before symptoms appear [7]. Wash your hands with soap. For cleaning, CDC advises a chlorine bleach solution (1,000–5,000 ppm) left on the surface for at least 5 minutes [7]. Products that work against norovirus also work against adenoviruses [9].
Frequently asked questions
How can you tell rotavirus from adenovirus?
A stool test helps identify the cause [1]. In one study, diarrhea with gastrointestinal adenovirus lasted longer than in other children with diarrhea [3].
How long does norovirus last?
Vomiting lasts 1–2 days, diarrhea from 1–2 to 3–4 days [2].
How long does rotavirus diarrhea last?
On average 3–7 days; fever rarely lasts longer than 2–4 days [1].
Does hand sanitizer work against norovirus?
Not well: the CDC advises washing hands with soap and water; sanitizer is not a substitute [7].
Adenovirus gastroenteritis
Details on symptoms, timing and treatment of adenovirus gastroenteritis.
Sources
- Russian Ministry of Health. Clinical guidelines “Rotavirus gastroenteritis in children”, ID 755_1, published in the guidelines database on March 3, 2023 (in Russian). Accessed October 12, 2026.
- Russian Ministry of Health. Clinical guidelines “Norovirus gastroenteritis in children”, ID 825_1, published in the guidelines database on November 26, 2024 (in Russian). Accessed October 12, 2026.
- Pediatrics. Kotloff K. L. et al. Enteric adenovirus infection and childhood diarrhea: an epidemiologic study in three clinical settings. Pediatrics. 1989;84(2):219–225. Accessed October 12, 2026.
- CDC (US Centers for Disease Control and Prevention). About Rotavirus. Updated April 22, 2024. Accessed October 12, 2026.
- Russian Ministry of Health, Union of Pediatricians of Russia. Clinical guidelines “Acute respiratory viral infection (ARVI)”, children, ID 25_3, published in the guidelines database on September 2, 2026 (in Russian). Accessed October 8, 2026.
- CDC (US Centers for Disease Control and Prevention). About Adenovirus. Updated December 16, 2025. Accessed October 7, 2026.
- CDC (US Centers for Disease Control and Prevention). How to Prevent Norovirus. Updated January 13, 2025. Accessed October 12, 2026.
- BMC Infectious Diseases. Khales P. et al. Human adenoviruses in children with gastroenteritis: a systematic review and meta-analysis. BMC Infect Dis. 2024. Accessed October 9, 2026.
- CDC (US Centers for Disease Control and Prevention). Clinical Overview of Adenovirus. Accessed October 7, 2026.
This article was prepared by our editorial team from official sources and does not replace a doctor’s advice. Found an error? Write to us.