What is fecal-oral transmission?

Fecal-oral transmission means that the germs that cause illness are
found in the stool (feces) of an infected person, and are spread to another person. This occurs when a
person touches the stool of an infected person or an object contaminated with the stool of an infected
person and ingests the germs. An object or surface can appear clean and still have germs that can
cause illness. A disease that is spread by the fecal-oral route can be transmitted from person to
person, or in food or water. This can happen when a person fails to wash their hands properly after
using the bathroom, and then handles food that is eaten by others, or when feces contaminate a water
supply.

Human waste management is one of the most important public health program. It is considered by
WHO as one of the basic steps to be taken to safeguard our environment. As has been mentioned in
Chapter one lack of proper waste disposal is one of the most pressing public health problems in
Ethiopia where availability of safe excreta disposal is very limited. The inadequate and insanitary
disposal of infected human waste leads to the contamination of soil, ground and surface water, affords
an opportunity for domestic and other type of flies to lay their eggs to breed and carry infection.
Besides it causes nuisance, attracts animals and rodents and other vermin, which will spread the feces
within the environment.
Fecal oral Hepatitis A person to person contact,
(non bacterial) Amoebic dysentery domestic contamination
rotavirus
giardiasis
Fecal oral Cholera person to person contact,
( bacterial) Salmonellosis domestic contamination
shigellosis water contamination
many forms of diarrhea crop contamination

The process of transmission may be simple or involve multiple steps. Some examples of routes of
fecaloral transmission include:
water that has come in contact with feces (for example due to groundwater pollution from pit latrines)
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 livestock or house pets.
food that has been prepared in the presence of fecal matter;
disease vectors, like houseflies, spreading contamination from inadequate fecal disposal such as open
defecation;
poor or absent hand washing after using the toilet or handling feces (such as changing diapers)
poor or absent cleaning of anything that has been in contact with feces;
sexual practices that may involve oral contact with feces, such as anilingus, coprophilia or "ass to
mouth".
eating feces, in children, or in a mental disorder called coprophagia
eating soil (geophagia)
Faecal-oral transmission of organisms causing disease occurs mostly through faecal contamination of
food, water, and hands which is not at all apparent. Very small amounts of faeces can carry enough
organisms to establish infection. Seemingly sparkling clear water may be dangerously polluted.
Contaminated food may smell, look and taste normal and yet harbour infective organisms. Clean-
looking hands may carry and transmit enough micro-organisms to spread disease. The diagram below
summarizes the faecal-oral transmission route.
Fecal-Oral Transmission
Fecal-oral transmission can occur when bacteria or viruses in the stool of one person are swallowed by
another. This can occur whenever there is
Inadequate sanitation resulting in contamination of water supplies with human feces
Inadequate procedures in daycare settings, where fecal organisms are commonly found on surfaces
and on hands of providers
Contamination of swimming pools and water parks with human feces
Failure of food handlers to follow proper procedures: hand washing and wearing of gloves
Note:
Fecal-oral transmission can also occur during anal sexual contact. This mode of transmission would be
considered direct contact rather than common vehicle transmission.
The fecal-oral route can transmit diseases caused by bacteria, viruses, or protozoa.

4. Lack of sanitation is one of the biggest problems in the developing nations like India. Officially it has
been given some priority, but for common people it seems something remote, something that doesn't
have anything to do with them. But it affects each and everybody. If any strata of our society remains
poorly sanitized, it may physically or socially contaminate the whole society.
hygiene promotion is defined as the processes to promote changes in behavior to reduce the spread
of sanitation-related diseases
: What is sanitation promotion?
A: Sanitation promotion describes a number of different activities that make up an effective approach
to
improving sanitation. These include:
Creating demand for better sanitation in communities through programmes which raise awareness
about
why sanitation is important.
Providing consumers with information about a range of sanitation options.
Building and upgrading existing toilets.
Promoting health awareness and safe hygiene practice.
Providing users with information about their toilets to ensure that they are well maintained.
Monitoring and evaluation to assess the impact of programmes and suggest changes where
necessary.
Effective sanitation promotion involves teamwork and co-operation within a municipality. Key people
here include:
The Environmental Health Officer (EHO) - an outreach worker in communities who is responsible for
education about, and protection of, public health.
The Community Development Officer (CDO), who is responsible for community liaison and
community
development. Development facilitators play a critical role in strengthening and clarifying relationships
between
individual household members, local government and all other roleplayers involved in achieving better
sanitation.
The District Primary Health Care team, which is responsible for disease prevention and health
promotion.
Technicians and engineers, who plan and oversee the development of sanitation infrastructure.
Municipalities need to establish local sanitation teams to help co-ordinate sanitation activities,
maximise
resources and improve communication.
There are six key tasks that face any Municipality setting out to promote improved sanitation:
Identifing what problems poor sanitation is causing, and developing a coherent strategy to address
them.
Ensuring effective collaboration between the EHOs and the technicians who have traditionally
managed
sanitation. This could be within the local municipality, or with the provincial or regional environmental
health
service.
 Ensure that the environmental health service has the resources to work in communities. Often EHOs
do
not have access to transport and this severely limits their ability to be effective.
Identifing and organising training opportunities for staff. This includes training in sanitation
promotion and
in new skills such as community education and research. Visiting successful sanitation projects in other
areas is an excellent way of learning.
Ensuring that community education happens - either by providing training for EHOs and other
community
level workers, or by tendering work to non-governmental organisations (NGOs) and other agencies.
Ensuring that sanitation promotion is informed by a thorough understanding of local practices and
local belief
systems. Municipalities should assess local needs and priorities, provide baseline information, and
evaluate
work already undertaken. EHOs, NGOs and other agencies have a valuable role to play in working with
local residents to identify problems and appropriate remedies.
Q: What is health and hygiene promotion?
A: Without safe hygiene practices, health benefits from better water and sanitation services will be
limited.
Hygiene promotion has a positive impact on health even without improvements in water and sanitation
services!
Hygiene promotion is mostly about changing peoples hygiene behaviour, a difficult and often slow
process.
It begins with working with local residents to understand their beliefs, practices, and problems, and
raising
awareness of the impacts of poor sanitation. Residents work with support teams to devise appropriate
remedies.
Hygiene behaviours can be divided into five main areas:
Safe disposal of human faeces.
Protection and use of water sources.
Home and environmental hygiene.
Water and personal hygiene.
Food hygiene.
Education about how to maintain and care for toilets is often part of hygiene education.
Key elements of a good hygiene promotion programme include:
Close interaction between local residents and support teams to identify a specific local problem or
behaviour
as the priority target.
Household participation in identifying problems and needs and in finding solutions for those problems
and
needs.
Development of an effective communication or education campaign.
Local level advocacy work.
Evaluating the impact of the programme.
The best way to start a hygiene promotion programme is to understand local hygiene-related health
problems
and then identify one simple hygiene behaviour improvement goal as the target. Dont overload
communities
with too many messages!
Q: How can sanitation improvement be integrated into broader health
improvement programmes?
A: Good sanitation is an essential part of primary and preventative health care, and hygiene promotion
is just
one aspect of health promotion. All health programmes use the same approach of research, education
and
advocacy.
One method of strengthening both a hygiene and sanitation promotion programme is to link it with
other health
promotion projects. In this way, staff gain skills and expertise more quickly and available resources can
be
shared.
Complementary health promotion programmes are:
Promotion of breast-feeding.
Food hygiene education.
Prevention of TB.
Home-based care services, especially around caring for people with AIDS.
National governments can seriously and visibly act on their commitment to sanitation and hygiene by
commissioning a thorough review of policy and institutional arrangements; making explicit budget
allocations for sanitation and hygiene programmes to district and local governments; ensuring that
sanitation is included in poverty reduction strategies and environmental action plans; funding hygiene
promotion and sanitation, training and capacity building; and establishing micro-credit policies and
facilities for communities wishing to engage in sanitation initiatives. District/local governments can
contribute to making sanitation and hygiene a reality in local settings by allocating resources to public
and school sanitation; hiring sanitation and hygiene specialists; reviewing local planning and technical
regulations for opportunities to improve sanitation; and sponsoring hygiene promotion and sanitation
marketing. Communities and civil society can raise the profile of sanitation by lobbying local
government for sanitation and hygiene promotion programmes; by offering expertise and support
especially for social mobilisation and hygiene promotion; by finding out what local people really want
and making sure that government knows about it; and by being bold and showing the government
what it means to live without access to sanitation. Households can be vocal and active encouraging
local authorities to champion sanitation, adopt good sanitation and hygiene practices and serve as role
models for others; seeking ways of acting collectively with neighbours to improve and maintain
sanitation facilities; and offering to help with hygiene promotion and sanitation marketing in other
locations. Entrepreneurs can lobby governments for the right to provide sanitation services (where this
is not yet the case); find out what sort of sanitation services people want and start developing
products; offer financial terms to help people make the needed investments; and let the government
know what is happening at the local level.
Access to safe drinking water supply and sanitation services is fundamental to improving public health
and meeting national poverty reduction objectives. As is now widely recognised, lack of access to
these essential basic services contributes substantially to the high burden of disease that needlessly
foreshortens and impairs the lives of far too many of Nepals citizens. Many people, both in rural and
urban areas, are affected by water borne and water related diseases due to use of unsafe water and
poor hygiene practices and inadequate sanitation facilities. People have to face several problems and
loose opportunity to income sources. Particularly rural women are deprived of finding the income
sources including due to hardship of availability of water as they spend several hours a day to fetch
water from far away sources.
Many people believe that simply providing a fresh, clean water supply will substantially reduce water-
borne illnesses. What most people do not know is that safe hygiene practices and access to sanitation
are crucial for combating the main health threats to children under five, in particular diarrhoea.
 What do we mean by "sanitation"? The first challenge for countries
seeking to solve the problem of access to sanitation is to define what
sanitation" really means. The second challenge is to decide what
aspects are the most important. In other words, what aspect of the
problem is going to be dealt with as a priority. This problem is not a
simple one and many professionals confuse the two steps. With
respect to defining sanitation most professionals would agree that
"sanitation" as a whole is a big idea which covers inter alia: safe
collection, storage, treatment and disposal/re-use/recycling of human
excreta (faeces and urine); management/re-use/recycling of solid
wastes (trash or rubbish); drainage and disposal/re-use/recycling of
household wastewater (often referred to as sullage or grey water);
drainage of storm water ; treatment and disposal/re-use/recycling of
sewage effluents; collection and management of industrial waste
products; and management of hazardous wastes (including hospital
wastes, and chemical/ radioactive and other dangerous substances).
For countries with very low access to basic sanitation, increasing the
effectiveness of management of
Why is sanitation
important?
A:
QUICK ANSWER

Sanitation is important because a variety of harmful or deadly bacteria would otherwise infect people and
potentially start a disease. The increase in lifespan and the improved quality of life over the past few
centuries is partially due to improvements in sanitation procedures.

Access to improved water and sanitation facilities does not, on its own, necessarily lead to improved health. There is now very clear evidence showing
the importance of hygienic behaviour, in particular hand-washing with soap at critical times: after defecating and before eating or preparing food. Hand-
washing with soap can significantly reduce the incidence of diarrhoea, which is the second leading cause of death amongst children under five years
old. In fact, recent studies suggest that regular hand-washing with soap at critical times can reduce the number of diarrhoea bouts by almost 50 per
cent.

Good hand-washing practices have also been shown to reduce the incidence of other diseases, notably pneumonia, trachoma, scabies, skin and eye
infections and diarrhoea-related diseases like cholera and dysentery. The promotion of hand-washing with soap is also a key strategy for controlling the
spread of Avian Influenza (bird flu).

The key to increasing the practice of hand-washing with soap is to promote behavioural change through motivation, information and education. There
are a variety of ways to do this including high-profile national media campaigns, peer-to-peer education techniques, hygiene lessons for children in
schools and the encouragement of children to demonstrate good hygiene to their families and communities. See the hygiene promotion page [link:
Hygiene promotion page] for more information.

It is also true that without water there is no hygiene. Research shows that the less readily available water is, the less likely that good hygiene will be
practised in households.