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Transmission

  1. Bloodborne hepatitis

    Hepatitis B, C and D are bloodborne hepatitis, which can be transmitted through contact with blood or other body fluids, such as amniotic fluid, semen and vaginal secretions.

    Routes of transmission:
    • Perinatal transmission

      An infected mother can transmit hepatitis virus to an infant perinatally, especially for hepatitis B virus (HBV). The chance of perinatal HBV transmission is more than 90%. In areas of high endemicity of hepatitis B like Hong Kong and China, this is a major route of transmission.

    • Blood contact
      • accidental contact with an infected person's blood or body fluids through skin cuts, abrasion, or mucosal membranes of the eyes and mouths
      • sharing injection instruments for drug injection
      • using contaminated instruments for ear-piercing, tattooing or acupuncture
      • sharing personal items such as razors, shavers or nail trimmer which may have been contaminated with blood
    • Sexual contact
      Unprotected sexual contact with an infected person
  2. Foodborne hepatitis

    Hepatitis A and E are typically foodborne hepatitis, which can be transmitted by faecal-oral route, via contaminated food or water.

    The hepatitis A virus can survive in water for more than a year and in food for a few days, therefore it can be transmitted by:
    • eating contaminated food (especially shellfish like oysters, clams, cockles and mussels) without proper cooking
    • drinking contaminated water
    • close personal contact with infectious person, including sexual contact and not limited to anal-oral contact
    Apart from eating contaminated food (e.g. shellfish) or drinking contaminated water, foodborne transmission of hepatitis E virus (HEV) through consumption of raw or undercooked meat has been documented and HEV has also been detected in pig livers. The ingestion of raw or undercooked shellfish may be the source of sporadic cases in endemic areas. Virus excretion in stools from infected persons has been demonstrated up to 3-4 weeks after onset of jaundice.

    For human infection with rat HEV, the exact mode of transmission is unknown at the moment. Possible routes of transmission include:
    • ingestion of food or water contaminated by rodents or their excreta;
    • exposure to environments or objects contaminated by rodents or their excreta; and
    • direct contact with rodents or their excreta.
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