Which of the following diseases is not spread through the feco-oral route?

Appeared in: Raj. CHO -2020

Explanation

Measles, caused by the Rubeola virus, is an airborne disease.
It spreads through respiratory droplets released when an infected person coughs or sneezes.
The virus enters a new host through the respiratory tract, not the gastrointestinal tract, distinguishing it from fecal-oral diseases.

Option B: Typhoid fever is caused by the bacterium Salmonella Typhi, which is transmitted through the fecal-oral route, typically by ingesting contaminated food or water.
Option C: Cholera is caused by the bacterium Vibrio cholerae. It is a classic example of a disease spread via the fecal-oral route, primarily through water contaminated with feces from an infected person.
Option D: Hepatitis A is a viral liver infection caused by the Hepatitis A virus (HAV). It spreads through the fecal-oral route when an uninfected person ingests food or water that is contaminated with the feces of an infected person.

Visual 1: Infographic: A diagram illustrating the difference between airborne transmission (coughing, sneezing, droplets) and fecal-oral transmission (contaminated hands, food, water).

Clinical Relevance

Nursing practice connection: This is primarily an exam-oriented knowledge point with limited direct bedside application, so retain Modes of Disease Transmission as background academic context rather than a clinical decision trigger.
Understanding a disease's mode of transmission is fundamental for nurses to implement the correct infection control precautions and break the chain of infection.
For measles, a nurse must implement Airborne Precautions (N95 mask, negative pressure room). For fecal-oral diseases like cholera or Hepatitis A, Standard and Contact Precautions (hand hygiene, gloves, gown) are key.
What if? If a patient presents with fever and a rash, the nurse must consider measles and initiate airborne precautions immediately, even before a definitive diagnosis, to prevent nosocomial spread. If the patient had fever and diarrhea, contact precautions would be the initial step.

How to Approach the Question

First, identify the negative keyword 'not'. This tells you to look for the option that is the exception.
The core concept is the 'feco-oral route' of transmission. Understand this means the pathogen is shed in feces and transmitted by ingestion.
Systematically review each option and recall its primary mode of transmission.
Measles: Airborne/droplet.
Typhoid: Fecal-oral.
Cholera: Fecal-oral.

Concept Tested & Keywords

Concept Tested: Modes of Disease Transmission
Stem keywords: disease, spread, feco-oral route
Lead-in keywords: not
Negative lead-in flag: Question asks for the exception (NOT spread by feco-oral route)

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Practise the full Raj. CHO -2020

Attempt every question from this paper in a timed mock, then review the full solution for each one.