On the Role of Food in the Transmission of Infection: A Narrative Review.

is one of the most common human pathogens, infecting up to 50% of the global population. The bacterium colonizes the mucus layer overlying gastric epithelial cells and causes chronic infection, which can lead to peptic ulcers, lymphoma, and gastric cancer. Epidemiological studies showed that regions with poor sanitation have higher prevalence rates of , suggesting possible environmental or food-related transmission routes in addition to the well-established person-to-person pathways. This assumption is supported by the detection of and/or its DNA in a variety of food. Experimental studies further demonstrate that can survive in food with certain properties, such as milk, meat, and vegetables, suggesting that such products may serve as potential reservoirs. However, reliable detection of in food remains challenging due to its fastidious nature, the ability to enter a viable but non-culturable state, and methodological limitations. While the presence of bacterial DNA and survival across food matrices make foodborne transmission biologically plausible, direct and conclusive proof that ingestion of contaminated food leads to infection is still lacking. Hence, person-to-person transmission currently remains the most firmly established route of transmission. Taken together, the current findings provide substantial indirect evidence that food, particularly under conditions of poor hygiene, may provide a reservoir or vehicle for transmission. However, further research is needed to definitively clarify the role of food in the transmission of infection and identify appropriate measures to promote public health.