Which of the following types of hepatitis are transmitted primarily by the fecal-oral route? Select all that apply.

Hepatitis viruses differ significantly in their transmission routes, which has direct implications for prevention and infection control. Hepatitis A and Hepatitis E are both transmitted primarily via the fecal-oral route, meaning they spread through ingestion of contaminated food or water, particularly in settings with poor sanitation. Hepatitis A is a common cause of travel-related hepatitis, while Hepatitis E is especially significant in developing countries and is associated with contaminated water supplies. Hepatitis B is transmitted through blood, sexual contact, and vertically from mother to infant — it does not use the fecal-oral route. Hepatitis C is also bloodborne, primarily spread through sharing of needles and other percutaneous exposures, and is not transmitted by the fecal-oral route. Hepatitis D is a defective virus that requires co-infection with Hepatitis B to replicate; it shares Hepatitis B's bloodborne transmission route and is not spread via the fecal-oral pathway. Understanding these distinctions is essential for appropriate isolation precautions: enteric precautions are used for fecal-oral transmission (Hepatitis A and E), while standard and bloodborne precautions are used for Hepatitis B, C, and D. The keyed answer correctly identifies Hepatitis A and Hepatitis E.