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The clinical manifestations vary and depend on whether it is the first infection or reinfection. After 3 months of age, the first infection is generally the most severe. Infection begins with acute onset of vomiting followed 24 to 48 hours later by watery diarrhea; up to one-third of patients have high fevers. Symptoms usually last for 3 to 7 days but improve over time. In moderate to severe cases or with prolonged diarrhea, dehydration, electrolyte abnormalities, and acidosis may occur. In certain immunocompromised children, including children with congenital cellular immunodeficiencies or severe combined immunodeficiency and children with hematopoietic stem cell...

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