Fecal oral route.

Contaminated food.

Contaminated water.

Hand contamination.

Parental transmission possible

The hepatitis A virus is transmitted in feces.

Outbreaks of hepatitis A occur mainly from contaminated water and food.

In some developing countries, hepatitis A is widespread because of poor sanitation.

However, in the United States most infections result from eating raw shellfish or from oral contact with food or other matter contaminated with feces from an infected person.