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What Is the Fecal-Oral Route?


Updated June 16, 2014

What Is the Fecal-Oral Route?

Washing your hands is the single best way to prevent the spread of a fecal-oral disease.

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Viruses and bacteria spread from person to person, sometimes causing diseases as they move in and out of people's bodies along various routes. When disease spreads through the fecal-oral route, it means that contaminated feces from an infected person is somehow ingested by another person.

Obviously, this isn't done on purpose! What usually happens is that infected people might forget to properly wash their hands after using the toilet. Anything they touch afterward might be contaminated with microscopic (invisible) germs that other people could encounter. Let's suppose one of those people then opens the restroom door with his bare hands. The cycle is complete when another person comes along, touches that contaminated doorknob and then nervously bites on a fingernail. The microbe has spread to another person through the fecal-oral route.

Another example involves people infected with a fecal-oral disease who prepare food. It is very important for food handlers to have good hand washing skills because they can easily spread a fecal-oral disease through their prepared food to anyone who eats it.

While poor hand washing is a major cause of fecal-oral contamination in many places, there are other equally important ways. Here are other ways microbes use the fecal-oral route to cause disease:

  • Drinking water contaminated with raw sewage.
  • Eating shell fish (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.

Is Viral Hepatitis a Fecal-Oral Disease?

There are many microbs that can be passed along this way and specifically there are two hepatitis viruses that spread via the fecal-oral route: Hepatitis A and hepatitis E both. The other hepatotropic viruses spread from direct contact with infected blood, such as from sharing used needles.

Can I Prevent Fecal-Oral Spread?

Yes. Good hand washing is a tremendously effective way to break the fecal-oral cycle. Another important part is to make sure what you eat or put into your isn't contaminated.

Seven Reasons to Get the Hepatitis A Vaccine


Centers for Disease Control and Prevention. June 23, 2008. Viral Hepatitis.

Dienstag, JL. Acute Viral Hepatitis. In: AS Fauci, E Braunwald, DL Kasper, SL Hauser, DL Longo, JL Jameson, J Loscaizo (eds), Harrison’s Principles of Internal Medicine, 17e. New York, McGraw-Hill, 2008.

Sjogren, MH. Hepatitis A. In: M Feldman, LS Friedman, LJ Brandt (eds), Gastrointestinal and Liver Disease, 8e. Philadelphia, Elsevier, 2006. 1639.

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