In the Hepatitis B epidemiology, the predominant mode of transmission in an area with HBsAg carrier rate of 10-15% in the general population (hyperendemic area like South-East Asia) is:
- A Sexual transmission
- B Blood transfusion and intravenous drug use
- C Perinatal (vertical) transmission and horizontal transmission in early childhood ✓
- D Fomite transmission through shared utensils
Explanation
In hyperendemic areas (carrier rate >8%), the dominant transmission pattern is perinatal (mother-to-infant at birth) and horizontal transmission between young children (through minor cuts, shared personal items, and close household contact). This is why seroconversion occurs early in life and the carrier state is established in childhood, when immune tolerance is high. In low-endemicity countries (Western Europe, USA), sexual transmission and IV drug use predominate. The mode of transmission determines the epidemiological pattern and the importance of birth-dose hepatitis B vaccination.
Reference: Park's Textbook of Preventive and Social Medicine, 27th ed.
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