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Incubation periods of viral gastroenteritis: a systematic review

Rachel M Lee1, Justin Lessler2*, Rose A Lee1, Kara E Rudolph2, Nicholas G Reich3, Trish M Perl4 and Derek AT Cummings2

Author Affiliations

1 Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, USA

2 Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, USA

3 Division of Biostatistics and Epidemiology, School of Public Health and Health Sciences, University of Massachusettes Amherst, Amherst, USA

4 Department of Medicine, Division of Infectious Diseases, Johns Hopkins University School of Medicine, Baltimore, USA

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BMC Infectious Diseases 2013, 13:446  doi:10.1186/1471-2334-13-446

Published: 25 September 2013



Accurate knowledge of incubation period is important to investigate and to control infectious diseases and their transmission, however statements of incubation period in the literature are often uncited, inconsistent, and/or not evidence based.


In a systematic review of the literature on five enteric viruses of public health importance, we found 256 articles with incubation period estimates, including 33 with data for pooled analysis.


We fit a log-normal distribution to pooled data and found the median incubation period to be 4.5 days (95% CI 3.9-5.2 days) for astrovirus, 1.2 days (95% CI 1.1-1.2 days) for norovirus genogroups I and II, 1.7 days (95% CI 1.5-1.8 days) for sapovirus, and 2.0 days (95% CI 1.4-2.4 days) for rotavirus.


Our estimates combine published data and provide sufficient quantitative detail to allow for these estimates to be used in a wide range of clinical and modeling applications. This can translate into improved prevention and control efforts in settings with transmission or the risk of transmission.

Incubation period; Norovirus; Rotavirus; Caliciviruses; Astrovirus; Systematic review