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Helicobacter pylori is associated with the pathogenesis of chronic gastritis, peptic ulcer disease and gastric cancer (MatysiakBudnik & Megraud, 2006). It is thought that the acquisition of H. pylori infection occurs mainly during childhood (Sherman, 2004). Although an intrafamilial route has been suggested (Kivi & Tindberg, 2006), the major routes of transmission of H. pylori are poorly understood. There have been cases reported in which the intrafamilial route does not appear to apply. In 2002, we investigated H. pylori prevalence in 224 children (age range 0–6 years) in three districts in Miyagi prefecture, Japan (Fujimura et al., 2004). The H. pylori prevalence rate in the children studied was 0 % in district C. H. pylori prevalence rates in districts A and B were approximately equal to those in other reports from Japan (Kato et al., 2003a). However, there were no reports of 0 % prevalence rates such as found in district C. Therefore, we examined H. pylori prevalence 3 years later to determine whether the prevalence rate in the children of district C had changed.

Water source as a Helicobacter pylori transmission route: a 3-year follow-up study of Japanese children living in a unique district