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Transmission may occur via consumption of contaminated water, or when people share personal objects.
In places with wet and dry seasons, water quality typically worsens during the wet season, and this correlates with the time of outbreaks.
In areas of the world with seasons, infections are more common in the winter.
Bottle-feeding of babies with improperly sanitized bottles is a significant cause on a global scale.
Transmission rates are also related to poor hygiene, especially among children, in crowded households, and in those with pre-existing poor nutritional status.
After developing tolerance, adults may carry certain organisms without exhibiting signs or symptoms, and thus act as natural reservoirs of contagion.
While some agents ( such as Shigella ) only occur in primates, others may occur in a wide variety of animals ( such as Giardia ).

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