A. Faeco-oral route:
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It may be food-borne, water borne or through direct personal contact.
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Water or food contaminated by faeces is the most common source for the spread of infection.
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Poor sanitation, eating raw or uncooked shell fish, dirty and contaminated hands and utensils and overcrowding also favour the spread of infection.
B. Parenteral route:
In very rare cases, HAV is transmitted through blood and blood products or by skin penetration through contaminated needles, or through accidental cuts and scratches.
