A conceptual model of water's role as a reservoir in Helicobacter pylori transmission: a review of the evidence

Abstract

Helicobacter pylori infection plays a role in the development of chronic gastritis, peptic ulcer and gastric cancer, yet the route of transmission into susceptible hosts remains unknown. Studies employing microbiological techniques have demonstrated that H. pylori has the ability to survive when introduced into water and that H. pylori is present in water and other environmental samples all over the world. Epidemiological studies have shown that water source and exposures related to water supply, including factors related to sewage disposal and exposure to animals, are risk factors for infection. This review describes the microbiological and epidemiological evidence for, and proposes a model of, waterborne H. pylori transmission outlining important features in the transmission cycle. In the model, humans and animals shed the bacteria in their faeces and the mechanisms for entry into water, and for survival, ingestion and infection are dependent upon a range of environmental influences. Verification of the proposed model pathways has important implications for public-health prevention strategies.

Community-driven research on environmental sources ofH. pyloriinfection in arctic Canada

“…Based on the reviewed literature, inverse associations were not expected. While the scientific community has been unable to demonstrate conclusively whether H. pylori organisms are able to retain infectivity in water, [30][31][32][33] epidemiologic investigations of exposure to sources of untreated water suggest the potential for waterborne transmission of H. pylori. [34][35][36][37][38][39][40][41][42][43][44][45] However, a large proportion of the estimates reported in the literature have 95% CIs that indicate the association may actually be closer to the null.…”

Helicobacter Pylori Infection in Peptic Ulcer Disease

“…1, 45 Various modes of transmission have been suggested, such as person-to-person, water-borne, food-borne and zoonotic transmission. 45,46,47,48,49,50,51,52,53,54 The transmission of H. Pylori seems to be direct from person-to-person via faecal-oral or oral-oral routes. 45,46 Certain epidemiological studies have suggested water-borne and food-borne transmissions.…”

Quantitative PCR Monitoring of Antibiotic Resistance Genes and Bacterial Pathogens in Three European Artificial Groundwater Recharge Systems

“…paratuberculosis. For all of these pathogens, surviving long-term in aquatic systems and causing waterborne diseases are well documented (6,8,23,29,30,33,43,45). Additionally, the ability of Y. enterocolitica (39), H. pylori (1,29,32), and M. avium (5,34,46) to persist for a long time in a dormant or viable but nonculturable state in aquatic environments has been reported.…”