Hepatitis Prevention How Diseases Spread Through the Fecal-Oral Route Proper handwashing is your best defense By Charles Daniel Charles Daniel, MPH, CHES is an infectious disease epidemiologist, specializing in hepatitis. Learn about our editorial process Charles Daniel Medically reviewed by Medically reviewed by Robert Burakoff, MD, MPH on January 13, 2020 linkedin Robert Burakoff, MD, MPH, is board-certified in gastroentrology. He is the vice chair for ambulatory services for the department of medicine at Weill Cornell Medical College in New York. Learn about our Medical Review Board Robert Burakoff, MD, MPH Updated on April 02, 2020 Print Viruses, bacteria, fungi, and parasites spread from person to person, sometimes causing diseases as they move in and out of people's bodies along various routes. When the disease spreads through the fecal-oral route, it means that contaminated feces from an infected person are somehow ingested by another person. For obvious reasons, this almost never happens deliberately. Usually, the situation occurs when an infected person might forget to properly wash their hands after using the toilet. Anything they touches afterward might be contaminated with microscopic germs that other people may encounter. d3sign / Getty Images Example A person infected with a disease transmitted through the fecal-oral route uses the bathroom and then opens the restroom door. Another person comes along, touches that contaminated doorknob, and then nervously bites on a fingernail before washing their hands properly. The microbe is spread through the fecal-oral route. Microbe Transmission Food workers must be extra diligent about hand hygiene because they are in a position to easily spread a fecal-oral disease through the food they prepare to anyone who eats it. In many cases of foodborne illness outbreaks, poor hand hygiene is the precipitating factor. Find out If You Are Washing Your Hands the Right Way While poor hand washing is a major cause of fecal-oral contamination, there are other equally important considerations. Here are other ways microbes use the fecal-oral route to cause disease: Drinking water contaminated with raw sewage. Eating shellfish (such as oysters and clams) that have been harvested from contaminated water. Eating raw fruits or vegetables washed in contaminated water. Sexual activity that allows direct mouth-to-anus contact or indirect contact (touching the mouth to something that touched the anus). Swimming pools that aren't properly disinfected. Viral Hepatitis There are many microbes that can be passed along through the fecal-oral route, including two of the hepatitis viruses, hepatitis A and hepatitis E. The other hepatotropic viruses spread by direct contact with infected blood, such as from sharing used needles, bodily fluid, or through childbirth. Prevention Good handwashing is a tremendously effective way to break the fecal-oral cycle. Other important tools for preventing the spread of disease through fecal-oral transmission include: Using instant hand sanitizers when soap and water are not available Practicing safe and careful food-handling practices Avoiding ingestion of water in pools or from other non-potable sources Using disposable towels Cleaning or disinfecting commonly touched, infected surfaces such as doorknobs, faucet handles, remote controls, etc. Was this page helpful? Thanks for your feedback! Sign up for our Health Tip of the Day newsletter, and receive daily tips that will help you live your healthiest life. Sign Up You're in! Thank you, {{form.email}}, for signing up. There was an error. Please try again. What are your concerns? Other Inaccurate Hard to Understand Submit Article Sources Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy. Centers for Disease Control and Prevention. (December 2016). Viral Hepatitis. Centers for Disease Control and Prevention. Food Worker Handwashing and Restaurant Factors. Centers for Disease Control and Prevention. Food & water precautions. Bonadonna L, La rosa G. A review and update on waterborne viral diseases associated with swimming pools. Int J Environ Res Public Health. 2019;16(2). doi:10.3390/ijerph16020166 John Hopkins Medicine. Viral hepatitis A and E. Additional Reading Bui D, Brown HE, Harris RB, Oren E. Serologic evidence for fecal-oral transmission of Helicobacter pylori. Am J Trop Med Hyg. 2016;94(1):82-8. doi:10.4269/ajtmh.15-0297 De graaf M, Beck R, Caccio SM, et al. Sustained fecal-oral human-to-human transmission following a zoonotic event. Curr Opin Virol. 2017;22:1-6. doi:10.1016/j.coviro.2016.11.001