What is the mode of transmission of Helicobacter pylori (H. pylori) infection?

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Last updated: April 24, 2025View editorial policy

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From the Guidelines

Helicobacter pylori infection is primarily transmitted through oral-oral or fecal-oral routes, particularly within families where close contact facilitates the spread of the bacteria. The most common mode of transmission is person-to-person contact, especially in areas with poor sanitation and inadequate water treatment 1. This tendency to cluster within families is in part responsible for the clinical observation that the risk of peptic ulcer disease and gastric cancer is increased within families.

Key Transmission Routes

  • Person-to-person contact, particularly within families
  • Contaminated food and water, especially in areas with poor sanitation and inadequate water treatment
  • Contact with fecal matter or vomit from infected individuals
  • Gastro-oral transmission through improperly cleaned endoscopic equipment in medical settings Most people acquire the infection during childhood, with transmission typically occurring from parents to children or between siblings 1. The bacteria survive in the acidic environment of the stomach by producing urease, which neutralizes stomach acid and allows it to colonize the gastric mucosa.

Prevention Strategies

  • Good hygiene practices, including handwashing
  • Consuming clean water
  • Proper food handling Prevention of H. pylori infection is crucial in reducing the risk of peptic ulcer disease and gastric cancer, and good hygiene practices, including handwashing, consuming clean water, and proper food handling, are essential in preventing the transmission of the bacteria 1.

From the Research

Transmission of H. pylori Infection

  • The exact modes and routes of transmission of Helicobacter pylori (H. pylori) infection remain unproven 2
  • Studies suggest that H. pylori bacteria can spread directly from one person to another, or indirectly from an infected person to the environment 2
  • Person-to-person transmission can be mainly fecal-oral or oral-oral 2

Possible Routes of Transmission

  • Fecal-oral route: contaminated food, drinking water, or exposure to contaminated soil may increase the risk of infection 3
  • Oral-oral route: transmission through vomitus, saliva, or dental plaque is possible 3
  • Waterborne transmission: fecal contamination of water may be an important source of infection, especially in areas with untreated water 3
  • Iatrogenic transmission: transmission through endoscopy is a proven mode of transmission 3

Risk Factors for Transmission

  • Inadequate sanitation practices, low social class, and crowded or high-density living conditions may facilitate transmission of infection among family members 3
  • Consumption of contaminated food or water, and exposure to animals may also increase the risk of infection 3
  • Poor hygiene and crowded conditions may contribute to the higher prevalence of H. pylori infection in certain populations 3

References

Guideline

Guideline Directed Topic Overview

Dr.Oracle Medical Advisory Board & Editors, 2025

Research

Transmission of Helicobacter pylori.

Minerva gastroenterologica e dietologica, 2018

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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