Routes of transmission:
(1) water contaminated with fecal material
(2) food contaminated with fecal material
(3) hands of food handlers contaminated with fecal material
(4) parenteral exposure, including injection drug use and blood transfusion
(5) person-to-person contact, including nosocomial outbreaks
(6) oral-anal contact (homosexual or heterosexual)
(7) raw or undercooked shellfish
Risk factors for becoming infected with HAV:
(1) lack of active or passive immunity
(2) poor hygiene
(3) being present in an area with an epidemic outbreak
(4) child < 7 years of age or contact with children, especially at day care centers
(5) living or working at a home for the mentally disabled
(6) living or traveling to an area with high rate of HAV
