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Chapter 2 : Epidemiology of Infection
Category: Bacterial Pathogenesis
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This chapter provides the reader with the most recent data in regard to the epidemiology of Helicobacter pylori and reviews current areas of controversy. H. pylori infection is ubiquitous and infects both males and females. Natural acquisition of H. pylori infection occurs, for the most part, in childhood. Once established within the gastric mucosa, the bacterium persists for life. The possibility that H. pylori may be a zoonosis first arose following the publication of two seroepidemiological studies that showed that the prevalence of H. pylori infection in abattoir and meat workers was significantly increased as compared with that in subjects not involved in handling animals or animal products. Confirming the importance of adult-child transmission, seroconversion only occurred among children living with H. pylori-positive mothers over the period of the study. The presence of H. pylori in the gastric juice of up to 58% of patients infected with H. pylori raises the possibility that refluxed gastric juice may represent a vehicle of transmission for the organism. The ability to detect H. pylori-specific DNA from the oral cavity has varied significantly. Attempts to detect H. pylori DNA in feces by PCR have resulted in variable outcomes. Given the association between H. pylori and peptic ulcer disease, gastric cancer, and B-cell mucosa-associated lymphoid tissue (MALT) lymphoma, there is an urgent need for the development of intervention strategies to prevent the spread of the bacterium.