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To better define the optimum timing of specimen collection and identify alternate ways to diagnose Norwalk virus outbreaks, we looked at the timing of the antibody response and virus excretion in a human volunteer study. The Norwalk virus antibody titers and antigen in stool specimens were examined by biotin-avidin immunoassay. Our data suggest that in epidemic situations, convalescent-phase sera could be collected as soon as 13 days after the onset of illness and acute-phase sera could be collected as late as 5 days after onset. Our data also suggest that if sufficient serum samples are collected, convalescent-phase case and control serum samples can be used to identify Norwalk virus outbreaks. Antigen detection was much less sensitive than seroconversion for detecting infection.

Norwalk virus antigen and antibody response in an adult volunteer study