Fecal–oral route

The fecal–oral route (or alternatively the oral–fecal route or orofecal route) is a route of transmission of a disease, when pathogens in fecal particles passing from one host are introduced into the oral cavity of another host. One main cause of fecal–oral disease transmission in developing countries is lack of adequate sanitation and, often connected to that problem, water pollution with fecal material.

The foundations for the "F-diagram" being used today were laid down in a publication by Wagner, E. G and Lanoix, J. N. in the WHO monograph series no 39 explaining transmission routes and barriers to the transmission of diseases from the focal point of feces. Modifications have been made over the course of history to give modern day F-diagrams which has been widely used in many other sanitation publications. It was set up in a way that fecal–oral transmission pathways are shown to take place via water, hands, arthropods and soil. The sanitation barrier however when placed prevents the transmission of infection through the hands, water and food.

The F-diagram is also used to show how proper sanitation (in particular toilets, hygiene, handwashing) can act as an effective barrier to stop transmission of diseases via fecal–oral pathways.

One approach to changing people's behaviors and stopping open defecation, the community-led total sanitation approach, uses "live demonstrations" of flies moving from food to fresh human feces and back to "trigger" villagers into action.

The process of transmission may be simple or involve multiple steps. Some examples of routes of fecal–oral transmission include:

Some of the diseases that can be passed via the fecal–oral route are (grouped by the type of pathogen involved in disease transmission):

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