How come I've got it? (A review of Helicobacter pylori transmission)

Numerous epidemiological studies have shown the two main risk factors for H elicobacter pylori acquisition: childhood and low socio-economic level both in developing and developed countries. Nevertheless, in the absence of ubi quitous extra-human reservoir(s), the route(s) for person-to-person transmi ssion remains undetermined. Very recent data favour the ore-oral route: bes ides gastric mucosa, mouth might be a sanctuary site and the ore-oral trans mission hypothesis seems applicable worldwide. Nevertheless, the gastro-ora l route (vomiting, gastro-oesophageal reflux) is still possible and deserve s further research. In developing countries, faeco-oral transmission (perha ps through the water supply) might be a significant mechanism of human cont amination both for primary infection in children and perhaps, reinfection i n adults. (C) 2000 Lippincott Williams & Wilkins.