The incidence of Helicobacter pylori acquisition in children of a Canadian First Nations community and the potential for parent-to-child transmission.
OBJECTIVE
We have previously reported that Wasagamack, a Canadian First Nations community has a seroprevalence rate of Helicobacter pylori of 95% and a prevalence rate among children aged 0-12 years as measured by stool antigen testing of 56%. We aimed to determine the rate of infection acquisition and possible modes of transmission of childhood Helicobacter pylori infection in this Canadian First Nations community.


METHODS
Children who were previously negative for H. pylori by stool antigen testing in August 1999 were eligible for enrollment in August 2000; 50 (77%) eligible children underwent stool collection. H. pylori stool antigen status was tested using the Premier Platinum HpSA test. Drinking water samples, maternal saliva, breast milk, local berries and flies were tested by three complementary H. pylori-specific PCR assays. Soothers or bottle nipples, collected from 16 children whose H. pylori stool antigen status was determined, were bathed in sterile water and this water was tested by PCR.


RESULTS
Stool was positive for H. pylori in 16% (8/ 50) of children retested. Five had no other siblings infected and three had infected siblings. The mothers of all children infected were positive for H. pylori. The median age of newly infected children was 6 years (range 1-13 years). By PCR, 78% (18/23) mothers' saliva samples, 69% (11/16) soother water samples and 9% (1/11) water samples from infected homes tested positive. All of 24 sequenced PCR-produced DNA fragments from samples showed 99% homology with that from ATCC type strain H. pylori.


CONCLUSIONS
The rate of childhood H. pylori acquisition was 16% over 1 year, and was not dependent on number of siblings infected. The finding of homologous H. pylori DNA in saliva and in soother water suggests the possibility of human to human transmission, particularly via an oral-oral route. Thus, there is the potential for further investigations in this population and other endemic communities that are directed at prevention of infection transmission via this modality.
Sinha
Samir K
SK
Section of Gastroenterology, Department of Internal Medicine, University of Manitoba, Winnipeg, Manitoba, Canada.
Martin
Bruce
B
Gold
Benjamin D
BD
Song
Qunsheng
Q
Sargent
Michael
M
Bernstein
Charles N
CN
D000293:Adolescent; D000818:Animals; D000942:Antigens, Bacterial / Q000032:analysis; D002648:Child; D002675:Child, Preschool; D004269:DNA, Bacterial / Q000032:analysis / Q000302:isolation & purification; D004175:Diptera / Q000382:microbiology; D018562:Disease Transmission, Infectious; D005243:Feces / Q000382:microbiology; D005618:Fresh Water / Q000382:microbiology; D005638:Fruit / Q000382:microbiology; D016481:Helicobacter Infections / Q000453:epidemiology* / Q000382:microbiology / Q000635:transmission*; D016480:Helicobacter pylori / Q000276:immunology / Q000302:isolation & purification*; D006801:Humans; D015994:Incidence; D007223:Infant; D008895:Milk, Human / Q000382:microbiology; D016133:Polymerase Chain Reaction; D012463:Saliva / Q000382:microbiology
D000942:Antigens, Bacterial; D004269:DNA, Bacterial