Helicobacter Forums

After four courses of eradication, I get rid of my H.pylori finally. I really don't want to catch it again. But I live in China. In this country, people get used to share foods in one plate. I hate this habit, but I can't change it. When I at home, I don't share foods with my family. But sometimes I have to join party with other people for business. And I must face the question that share foods with other people in one plate. I want to know could this manner of eating be a risk factor to get H.pylori ? How danger is it ? Thank you!

Hi. The actual mode of transmission is still unclear. However, we like to believe it's through oral route. Sharing food with infected person definitely post a risk, but we dont know how easily it can be transmitted via food. the reason is because H. pylori survive poorly outside human body.

I understand that it's hard to avoid sharing food among chinese culture. However, you can try having an extra plate and grab all the food you need in before everyone dig in. you can tell people that you are sick and you dont want your germs to spread to them.

Thank you very much!

They did a study that showed even washed chopsticks still had H pylori on them.

I can't remember the precise details, but I think they looked at something like 20 pairs of chopsticks and found H pylori on 2 pairs, even after they'd been washed.

Crazy stuff!

Best,
Dave Hompes.

Got the numbers wrong - here's the study:

Dig Dis Sci. 1999 Jun;44(6):1173-6.
Use of chopsticks for eating and Helicobacter pylori infection.
Leung WK, Sung JJ, Ling TK, Siu KL, Cheng AF.
Source

Department of Medicine and Therapeutics, Prince of Wales Hospital, Chinese University of Hong Kong, Shatin.
Abstract

Epidemiological data suggests that ethnic groups using chopsticks for eating have a higher prevalence of H. pylori infection. This study investigated the carriage of H. pylori in chopsticks after eating. Used chopsticks and saliva were collected from asymptomatic individuals whose H. pylori status was determined by [13C]urea breath test and serology. Both the saliva specimens and chopsticks were cultured and processed by polymerase chain reaction (PCR) for the detection of H. pylori. Furthermore, chopsticks used by hospital staff in the cafeteria were pooled for the detection of H. pylori by bacteriologic culture and PCR. Sixty-nine volunteers were recruited in the first study and 45 (65%) were diagnosed to have H. pylori infection. While all cultures were negative, H. pylori was detected by PCR in the saliva from 15 (33%) infected subjects and in the chopsticks from one (2%). Among the 12 sets of pooled chopstick-washing studied, H. pylori was detected by PCR in two sets. This study showed that H. pylori was rarely detected in chopsticks after eating and hence, the risk of contracting this infection via the use of chopsticks is low.

Interesting paper. This is my thought. The study is based on PCR and it's a method with high false positive. Especially they only use one set of gene to determine if there is H. pylori.

The detection of H. pylori in the mouth seems possible. We conducted an identical experiment and too found H. pylori DNA in the mouth. However, since we have very low H. pylori culture rate from the saliva (very little people able to grow H. pylori from saliva), we are still not sure exactly how efficient it is to transmit H. pylori via saliva.

Nevertheless, they concluded that it's not easy to transmit H. pylori via chopstick with a detection of only 2%.

A detection rate of 2% in a population of 1billion people, as it would be in China, for example, of 315m, as it would be in the US, is still very high when converted into actual numbers rather than %.

When I had H pylori, I had my girlfriend tested. She also had H pylori. We then had her brother tested. He was also positive.

I've worked with dozens of families in which H pylori was in all members of the family.

Whilst it can't be concluded that close contact, sharing utensils, etc. is the route of transmission, it appears very likely.

Furthermore, identical H pylori strains are noted in families where H pylori infection rates are high, such as South America.

Warmest wishes,
Dave Hompes.

It's hard to find identical strains. It's such a fast mutating organism, even family members carrying slightly different H. pylori.

The findings suggest that we usually caught the bug when we are young, usually from mother. So siblings who play together, biting the same toy will probably get transmitted.

So, back to the original question, can food sharing transmit H. pylori? I think it's possible but not easily. Because H. pylori is a very timid organism. it lives in a very specific environment. not too salty, not too acidic, not too much competition, not too much oxygen, not too cold, not too warm either, lots of iron, has to be human stomach (not any other host), and so on. it grows so slowly (4x to 5x slower than E. coli), it cannot compete with other organism.

It also depends how you share the food I guess. In most Asian culture, the whole family share the same bowl of soup. Then again, H. pylori doesnt usually survive in the soup.

Is it a bad idea to take iron supplements when trying to kill the HP?

there is no study that showed iron tablets may reduce effectiveness of h. pylori eradication therapy. So, my believe is NO unless there is evidence of drug drug interaction between the iron tablets and the antibiotics that you are taking. You may take iron tablets together with your antibiotics