Journal of Gastroenterology and Hepatology (1999) 14, 519–522 METHODS A house-to-house survey was done in one subsector of Chandigarh. Individuals with a history of dyspepsia and an equal number of asymptomatic individuals aged 15 years or more were asked to attend the outpatient ser- vices of our department. Information was noted regard- ing age, sex, education, occupation, income, marital status, duration of marriage, number of children, pres- ence of upper gastrointestinal symptoms and the use of any medications during the previous 2 months, specif- ically antibiotics, bismuth-containing compounds, proton pump inhibitors (PPI) or non-steroidal anti- inflammatory drugs (NSAID). Each subject was also questioned about smoking and alcohol use and whether they kept pets at home. Those who attended the out- patient service were asked to undergo upper gastroin- INTRODUCTION Helicobacter pylori is a major cause of gastric and peptic ulcer and it has also been implicated in the development of gastric malignancy. 1–3 The epidemiology of H. pylori infection has been extensively studied 4–10 but the precise mode of transmission still remains unclear. Evidence is accumulating in favour of person-to-person transmis- sion of H. pylori. 11–16 Recently, a few studies have high- lighted the spouse-to-spouse transmission; however, their results are conflicting. 17–22 Collins, in an editorial, stated that follow-up studies in families in which only one spouse is infected would provide the strongest evidence for intrafamilial spread of the infection. 23 Therefore, we studied the prevalence as well as intraspousal transmission of H. pylori in couples in the community. HELICOBACTER PYLORI Helicobacter pylori: Evidence for spouse-to-spouse transmission V SINGH,* B TRIKHA, † K VAIPHEI, ‡ CK NAIN, † K THENNARASU § AND K SINGH ‡ *Departments of Hepatology, † Gastroenterology, ‡ Pathology and § Biostatistics, Postgraduate Institute of Medical Education and Research, Chandigarh, India Abstract Background: Spouse-to-spouse transmission of Helicobacter pylori infection still remains controversial. Methods:We studied the prevalence of H. pylori infection among spouses of H. pylori-positive or -neg- ative individuals and looked for intraspousal transmission.Twenty-five couples were studied. Initially, one individual per couple was selected as the index subject. Spouses of these H. pylori-positive or -neg- ative index individuals underwent screening for H. pylori by serology, the rapid urease test and histol- ogy. Those couples in whom only one spouse was positive were followed up and H. pylori status was re-evaluated using the above tests after approximately 1 year in the H. pylori-negative spouse. Results: Of 25 randomly selected index subjects, 18 were H. pylori positive and seven were negative. There was no significant difference in age, sex, socioeconomic status, presence of dyspeptic symptoms, duration of marriage and number of children in these index subjects. Spouses of H. pylori-infected index subjects had a significantly higher prevalence of H. pylori infection than the spouses of H. pylori-nega- tive index subjects (83.3 vs 28.5%; P < 0.01). Age, sex, socioeconomic status, dyspeptic symptoms, dura- tion of marriage and number of children were not different in H. pylori-positive or -negative spouses of H. pylori-positive index subjects. There were five such couples in whom only one spouse was H. pylori positive initially. At follow up, three of these H. pylori-negative spouses became positive. These findings suggest person-to-person transmission or common source exposure within couples. © 1999 Blackwell Science Asia Pty Ltd Key words: epidemiology, Helicobacter pylori, spouses, transmission. Correspondence: Virendra Singh, Postgraduate Institute of Medical Education and Research, House no. 1457, Sector 42-B, Chandigarh, Punjab 160012, India. Accepted for publication 17 December 1998.