Figure 4: Preliminary comparison of syndrome surveillance for gastroenteritis and clinical diagnosis for rotavirus and norovirus infections in Israel Community physician visits for diarrheal gastroenteritis and for vomiting were compared with laboratory confirmed severe acute rotaviral gastroenteritis in children < 5 yrs requiring hospitalization and norovirus outbreaks among adults in Israel between January 2004 and June 2008. A. Bi-weekly number of labo- ratory confirmed, severe cases of rotavirus infections in children < 5 yrs who were admitted to a hospital in central Israel between July 2004 and June 2008 (adapted from the Annual Reports of the Central Virology Laboratory, Public Health Services, Israel Ministry of Health). B. The bi-weekly number of labora- tory confirmed outbreaks of norovirus among adults in hospitals, assisted living and old age care facilities in Israel between January 2005 and June 2008 (adapted from the Annual Reports of the Central Virology Laboratory, Public Health Services, Israel Ministry of Health). The numbers of individuals infected during each out break varied from a few individuals to more than two thirds of the patients and staff at each institution. The duration of the outbreak rarely lasted more than two to three weeks. C. Weekly rate of visits in cases per 10,000 members of the Maccabi Health Care Services in Israel to physicians in community clinics of patients who presented between January 2004 and June 2008 with symptoms of gastroenteritis from any cause (based on anonymous ICD-9-based data provided by the Maccabi Health Care Services, and the Is- rael Center For Disease Control, Israel Ministry of Health). D. Monthly rate of visits in cases per 10,000 members of the Maccabi Health Care Services in Israel to physicians in community clinics of patients who presented between January 2004 and June 2008 with symptoms of acute diarrheal gastroenteritis from any cause (based on anonymous ICD-9-based data provided by the Mac- cabi Health Care Services, and the Israel Center For Disease Control, Israel Ministry of Health). E. Weekly rate of visits in cases per 10,000 members of the Maccabi Health Care Services in Israel to physicians in community clinics of patients who presented between January 2004 and June 2008 with vomiting and nausea from any cause (based on anonymous ICD-9-based data provided by the Maccabi Health Care Services, and the Israel Center For Disease Con- trol, Israel Ministry of Health).