Transmission of Helicobacter pylori

The exact modes and routes of transmission of Helicobacter pylori (H. pylori) infection remain unproven. Studies showed that H. pylori bacteria can spread directly from one person to the other, or indirectly from an infected person to the environment. Presently, interpersonal pathways are more probable than environmental exposure routes. Person to person transmission can be mainly fecal-oral or oral-oral. In the last 30 years many authors have investigated the main potential sources of H. pylori infections, vectors and risk factors for both fecal-oral and oral-oral routes of transmission, eating of contaminated food, drinking of contaminated water, and exposure to animals. They have tried to isolate H. pylori from feces, saliva, dental plaque. These aspects are the basis for the effective prevention of both H. pylori acquisition and gastroduodenal pathology associated with it. These issues will be discussed in this narrative review.