The Distribute project began in 2006 as a distributed, syndromic surveillance effort networking state and local health departments to share aggregate ED based influenza-like illness (ILI) syndrome data (4) . The AGE pilot was conducted to assess the feasibility of generalizing the Distribute model from ILI trends to monitoring other syndromes. Distribute participating jurisdictions were asked to submit diarrheal and vomiting AGE syndrome ED data, following a commonly used syndrome definition. Of the 10 Distribute participating jurisdictions that submitted AGE data, 6 provided historical baseline data going back to January 2006 or earlier. Of these, 3 were state, 3 large city or county jurisdictions, located in Northeastern, Mid-Atlantic, Midwestern and Western U.S. surveillance regions. Syndrome time-series ratios [(weekly AGE syndrome count)/ (total ED visit count)] were assessed by jurisdiction and age group. To aid comparison of seasonal trends across jurisdictions, time-series were normalized around their baseline as a measure of relative increase [(weekly AGE ratio)/(weekly lowerquartile)]. Rotavirus vaccine 2006 pre-and postlicensure periods were compared.