TRANSMISSION OF HELICOBACTER-PYLORI

Authors
Citation
Atr. Axon, TRANSMISSION OF HELICOBACTER-PYLORI, The Yale journal of biology & medicine, 70(1), 1997, pp. 1-6
Citations number
22
Language
INGLESE
art.tipo
Article
ISSN journal
0044-0086
Volume
70
Issue
1
Year of publication
1997
Pages
1 - 6
Database
ISI
SICI code
0044-0086(1997)70:1<1:TOH>2.0.ZU;2-K
Abstract
Helicobacter gastroduodenitis is a serious chronic infectious disease that is responsible for widespread morbidity and mortality. An underst anding of the way in which it spreads is fundamentally important when considering measures for its control. Its prevalence is highest in the developing world and in individuals with a disadvantaged socio-econom ic childhood. The disease is believed to be contracted during the earl y years of life. A faeco-oral mode of transmission is considered by ma ny to be the most likely mode of spread, however, the organism is diff icult to culture both from faeces and from the environment and unlike other enteric organisms Helicobacter does not give rise to a diarrhoea l illness that would facilitate its transmission. An oro-oral route of spread has also been suggested, however, Helicobacter cannot be cultu red from saliva, and if it was spread orally there is no reason why ch ildhood should be the most frequent age for its acquisition. A third p ossibility is that the bacterium is transmitted gastro-orally. In favo r of this hypothesis, the infection is easily acquired following gastr ic intubation with inadequately disinfected equipment. Children have a greater tendency to vomit than adults, and tend to explore with their fingers and place foreign objects in their mouths. Initial Helicobact er infection causes a dyspeptic illness characterised by mucousy vomit ing, which may provide a vehicle for transmission. Furthermore, during the acute infection the organism induces achlorhydria in the host, po ssibly enabling the organism to survive longer in vomited mucus in the absence of acid. This theory fits best with the epidemiological data. Those most at risk are children living in an overcrowded environment who share beds with one another and live in houses that do not possess a fixed hot water supply (thus making cleaning up of vomit more diffi cult). It is also commoner in institutionalized children and is associ ated with school catchment areas.