Fecal–oral route

The foundations for the "F-diagram" being used today were laid down in a publication by the World Health Organization (WHO) in 1958.^[6] This publication explained transmission routes and barriers to the transmission of diseases from the focal point of human feces.^{[citation needed]}

Modifications have been made over the course of history to derive modern-looking F-diagrams. These diagrams are used in many sanitation publications.^[7] They are set up in a way that fecal–oral transmission pathways are shown to take place via water, hands, arthropods and soil. To make it easier to remember, words starting with the letter "F" are used for each of these pathways, namely fluids, fingers, flies, food, fields, fomites (objects and household surfaces).^{[citation needed]}

Rather than only concentrating on human feces, feces from other animals should also be included in the F-diagram.^[7]

The

The process of transmission may be simple or involve multiple steps. Some examples of routes of fecal–oral transmission include:^[citation needed]

• water that has come in contact with feces (for example due to
  pit latrines) and is then not treated
  properly before drinking;
• by shaking someone's hand that has been contaminated by stool, changing a child's diapers, working in the garden, or dealing with
  domestic animals
  ;
• food that has been prepared in the presence of fecal matter;
• eating soil (geophagia);
• disease vectors, like houseflies, spreading contamination from inadequate fecal disposal such as open defecation;
• poor or absent hand washing after using the toilet or changing diapers;
• poor or absent cleaning of anything that has been in contact with feces;
• sexual practices that may involve oral contact with feces, such as anilingus, coprophilia, or A2M.
• eating feces, in children, or in a mental disorder called coprophagia

Prevention

One approach to changing people's behaviors and stopping open defecation is the community-led total sanitation approach. In this process "live demonstrations" of flies moving from food to fresh human feces and back are used. This can "trigger" villagers into action.^[8]

Diseases

The list below shows the main diseases that can be passed via the fecal–oral route. They are grouped by the type of pathogen involved in

• Vibrio cholerae (cholera)
• pseudomembranous enterocolitis
  )
• Shigella (shigellosis / bacillary dysentery)^[9]
• Salmonella typhii (typhoid fever)^[10]
• Vibrio parahaemolyticus^[11]
• Escherichia coli^[12]
• Campylobacter^[13]

Viruses

• Hepatitis A^[14]
• Hepatitis E^[15]
• Enteroviruses
• Norovirus acute gastroenteritis
• poliomyelitis
  )
• Although most human Coronaviruses are not transmitted fecally (Feline coronavirus, in contrast, is), there have also been reports of SARS-CoV-2 being found in stool samples.^[16][17]
• Rotavirus gastroenteritis
• Adenovirus
  gastroenteritis

Protozoans

• Entameba histolytica^[12] (amoebiasis
  / amoebic dysentery)
• Giardia (giardiasis^[18])
• Cryptosporidium (cryptosporidiosis)
• Toxoplasma gondii^[13] (toxoplasmosis)

Helminths

• Tapeworms^[12]
• Soil-transmitted helminths

Related diseases

microorganisms that most commonly are transmitted in contaminated fresh water. This is one particular type of fecal-oral transmission.^{[citation needed}

]

Neglected tropical diseases also include many diseases transmitted via the fecal-oral route.^{[citation needed}

]

See also

• Basic reproduction number
• Toilet
• Vector control

References

1. ^ "Principles of Epidemiology: Chain of Infection". U.S. Centers for Disease Control and Infection. 2019-02-18. Archived from the original on 2020-07-23. Retrieved 2020-07-21. This article incorporates text from this source, which is in the public domain.
2. ^ LaMorte, Wayne W. (2016-01-06). "Common Vehicle Spread". Boston University School of Public Health. Archived from the original on 2020-05-14. Retrieved 2020-07-21.
3. ISBN 978-1-119-17931-3
4. PMID 23040490
   .
5. S2CID 11166016
   .
6. ^ Wagner, E. G., and Lanoix, L. N. (1958). Excreta disposal for rural and small communities (PDF). WHO, Geneva, Switzerland. p. 12. Archived from the original on 2020-04-12. Retrieved 2016-08-26.{{cite book}}: CS1 maint: location missing publisher (link) CS1 maint: multiple names: authors list (link)
7. ^
   PMID 28926696
   .
8. ^ Kal, K and Chambers, R (2008) Handbook on Community-led Total Sanitation Archived 2015-04-10 at the Wayback Machine, Plan UK Accessed 2015-02-26
9. ISBN 978-0-9631172-1-2. (via NCBI Bookshelf)
   .
10. ISBN 978-0-9631172-1-2. (via NCBI Bookshelf)
    .
11. ISBN 978-0-9631172-1-2. (via NCBI Bookshelf)
    .
12. ^ ^{a b c} Intestinal Parasites and Infection Archived 2010-10-28 at the Wayback Machine fungusfocus.com – Retrieved on 2010-01-21
13. ^ ^{a b} "Stool-To-Mouth or Fecal–Oral Route of Transmission of Infection | Healthhype.com". www.healthhype.com. Archived from the original on 2020-02-05. Retrieved 2016-04-18.
14. ISBN 978-0-9631172-1-2. (via NCBI Bookshelf)
    .
15. PMID 15259057
    .
16. PMID 32004427
    .
17. ^ Pinghui, Zhuang (2020-02-02). "Coronavirus: scientists identify possible new mode of transmission in human faeces". South China Morning Post. Archived from the original on 2021-03-08. Retrieved 2020-02-04.
18. ISBN 978-0-9631172-1-2. (via NCBI Bookshelf)
    .

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