All three types of diarrhoeal diseases discussed so far are transmitted directly or indirectly by faeco-oral routes.

Briefly distinguish between direct and indirect modes of faeco-oral transmission of infectious agents.

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Direct transmission occurs through contact between hands contaminated with faeces and the person's mouth; indirect modes of transmission are through ingestion of contaminated food or water, contact with infected soil, utensils, etc., and transmission by flies that have crawled on faeces (figure below).

Fly
Flies are a major source of indirect transmission of diarrhoeal diseases. (Photo: CDC Image Library, image 5452)

The main modes of transmission for cholera, shigellosis and viral diarrhoeal diseases are summarised in the table and figure below.

Main modes of transmission for bacterial and viral diarrhoeal diseases.

Diarrhoeal diseaseMain modes of transmission
Cholera Contaminated water or food (summarised in the figure below)
Shigellosis (bacillary dysentery) Person-to-person contact, e.g. while caring for a sick person, or via contaminated water or food
Viral diarrhoeal diseases Contaminated water or food, particularly when feeding infants with milk or other nutritious fluids in a contaminated bottle

Main modes of transmission for most diarrhoeal diseases

The main modes of transmission for most diarrhoeal diseases are by ingestion of contaminated food and water. (Source: adapted from AMREF, 2007, Communicable Diseases Distance Education Programme, Unit 11)
Last modified: Wednesday, 9 July 2014, 9:00 PM