Microscopy image of Tuberculosis bacteria

© Charlotte Passemar

Transmission basics
Bacteria can be transmitted to and from humans
via direct or indirect mechanisms.

Direct transmission can occur through person-to-person

contact, when an infected person touches or exchanges
bodily fluids with someone else. For example, the bacterial
pathogens Chlamydia trachomatis and Neisseria
gonorrhoeae are spread by sexual contact. Indirect
transmission can occur through other animals (vector-borne
transmission); for example, the bacterium that causes
plague, Yersinia pestis, is transmitted by fleas. Indirect
transmission can also occur through inanimate objects or
substances (vehicle-borne transmission).

Examples of vehicle-borne transmission

Transmission route Disease (causal bacteria)

Tuberculosis (Mycobacterium
tuberculosis), Pneumonia (Streptococcus
Respiratory droplets
pneumoniae, Haemophilus influenzae and
others)
Transmission route Disease (causal bacteria)

Food poisoning (Salmonella

Food enterica, Campylobacter jejunii and
others), Shigellosis (Shigella species)

Cholera (Vibrio cholerae), Legionnaires’

Contaminated water
disease (Legionella pneumophila)

The transmissibility of a bacterium in an outbreak determines

its basic reproduction number or R0 (R zero). This is the
average number of secondary infections that result from each
infection. This metric is useful because it influences how an
infectious disease will spread through a population - for an
epidemic to occur in a susceptible population, the R0 must by
>1. Transmissibility depends not only on the mode of
transmission, but also on the infectious dose of the
bacterium, which is the number of organisms required to
establish an infection. For M. tuberculosis, the infectious dose
is thought to be very low at fewer than 10 bacteria, whereas
thousands of V. cholerae bacteria are required to cause
cholera.

An outbreak or epidemic is a sudden increase in the

occurrence of an infectious disease in a specific time or place.
This could involve a single ward in a hospital, or could involve
hundreds of people across a country. The classification of an
outbreak is very context dependent, so for very rare
pathogens they can involve as little as two cases.
A pandemic is an outbreak occurring across multiple
continents.