Although fecal–oral transmission is usually discussed as a route of transmission, it is actually a specification of the entry and exit portals of the pathogen, and can operate across several of the other routes of transmission. Fecal–oral transmission is primarily considered as an indirect contact route through contaminated food or water. However, it can also operate through direct contact with feces or contaminated body parts, such as through anal sex. It can also operate through droplet or airborne transmission through the toilet plume from contaminated toilets.
F-Diagram
The foundations for the "F-diagram" being used today were laid down in a publication by WHO in 1958. This publication explained transmission routes and barriers to the transmission of diseases from the focal point of human feces. Modifications have been made over the course of history to derive modern-looking F-diagrams. These diagrams are used in many sanitation publications. 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. Rather than only concentrating on human feces, animal feces should also be included in the F-diagram. The sanitation and hygiene barriers when placed correctly prevent the transmission of an infection through hands, water and food. The F-diagram can be used to show how proper sanitation can act as an effective barrier to stop transmission of diseases via fecal–oral pathways.
Examples
Transmission
The process of transmission may be simple or involve multiple steps. Some examples of routes of fecal–oral transmission include:
water that has come in contact with feces 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;
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.
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 disease transmission.
are diseases caused by pathogenicmicroorganisms that most commonly are transmitted in contaminated fresh water. This is one particular type of fecal-oral transmission. Neglected tropical diseases also contains many diseases transmitted via the fecal-oral route.