A. Faeco-oral route:
It may be food-borne, water borne or through direct personal contact.
Water or food contaminated by faeces is the most common source for the spread of infection.
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.