Are Ear Infections Contagious?

Ear infections are extremely common, especially in young children. According to the Centers for Disease Control and Prevention (CDC), nearly 5 out of 6 children will have at least one ear infection by the time they are 3 years old. But are these painful infections contagious themselves? Or are they caused by other contagious illnesses?

What Causes Ear Infections?

To understand if ear infections are contagious, it is important to first look at what causes them. The most common type of ear infection is called acute otitis media (AOM). This is an infection of the middle ear, which is located just behind the eardrum.

Bacteria and Viruses

Most cases of AOM are caused by bacteria or viruses that infect the area and lead to inflammation and buildup of fluid behind the eardrum. Some of the most common culprits include:

Streptococcus pneumoniae – This bacteria is the cause of pneumococcal infections and is spread by respiratory droplets from coughing and sneezing. S. pneumoniae is responsible for about 1/3 to 1/2 of AOM cases.
Haemophilus influenzae – Another bacteria that infects the respiratory system and can travel to the middle ear. It accounts for 20-30% of AOM episodes.
Moraxella catarrhalis – This bacterium is also associated with upper respiratory tract infections and causes approximately 15-20% of AOM cases.
Rhinovirus and respiratory syncytial virus (RSV) – These viruses are often the cause of the common cold and other upper respiratory infections. They only cause about 10% of ear infections on their own, but studies show they precede up to 40% of bacterial-caused AOM cases.

Eustachian Tube Dysfunction

The bacteria and viruses listed above most commonly reach the middle ear through the Eustachian tube, which connects the middle ear to the back of the nose and throat. When the Eustachian tube becomes inflamed or blocked due to an upper respiratory infection, fluid and bacteria can become trapped in the middle ear space, causing an infection.

Other Risk Factors

There are also some factors that may make a child more prone to developing an ear infection:

Exposure to tobacco smoke
Use of a bottle instead of breastfeeding
Attending daycare, especially at a young age
Family history of ear infections
Down syndrome or cleft palate
Season (more common in winter)

Are Ear Infections Themselves Contagious?

Now that we have reviewed the most common causes, we can look at the answer to our original question:

No, the ear infection itself is not contagious.

Ear infections develop when bacteria or viruses from another contagious illness get trapped behind the eardrum. But the infection itself does not spread to others.

You cannot “catch” someone else's ear infection directly. The infected fluid and inflammation stays localized to the middle ear space and does not directly transmit to others.

However, this does not mean that ear infections have no connection to contagious illnesses. As explained earlier, the bacteria and viruses that cause colds, flu, and other respiratory illnesses are the most common source of ear infections.

So while the ear infection itself is not contagious, the underlying sickness that leads to it often is.

Are the Illnesses That Cause Ear Infections Contagious?

Most of the bacteria and viruses that can lead to ear infections affect the respiratory tract and are spread in the same way as the common cold. They are passed from person to person by:

Touching contaminated surfaces – Viruses and bacteria from an infected person can survive on doorknobs, countertops, toys, and other surfaces. Anyone who touches these objects can pick up the germs and become infected.
Respiratory droplets – When an infected person coughs, sneezes, or even just breathes within close contact of others, tiny droplets carrying the illness can spread to those nearby. Larger droplets may spray directly onto the faces of people within 3-6 feet. Smaller droplets can float in the air for several minutes.
Direct contact – Touching tissues or hands contaminated with secretions from an infected person provides another route for germs to spread. Kissing or sharing food/drink with someone who is ill also facilitates transmission.

Therefore, the contagious respiratory illnesses that often lead to ear infections can easily pass between children and families. Practicing good hygiene and limiting contact with sick individuals are keys to reducing transmission risk.

Preventing Illnesses That Lead to Ear Infections

While ear infections themselves do not directly spread from person to person, you can take steps to avoid catching or passing on the contagious illnesses that contribute to ear infections developing:

Hand Hygiene

Frequent hand washing with soap and water is one of the best defenses against contagious illnesses. Hands should be washed:

After using the bathroom
Before eating
After sneezing, coughing or blowing nose
After touching contaminated surfaces

Alcohol-based hand sanitizer can be used when soap is unavailable.

Respiratory Hygiene

Cover mouth and nose with sleeve or tissue when coughing or sneezing to reduce spread of droplets.
Avoid touching eyes, nose and mouth to lessen transmission from hands.
Dispose of used tissues immediately and wash hands afterward.

Routine Cleaning

Disinfect frequently touched surfaces like doorknobs, counters, keyboards and toys.
Avoid sharing cups, utensils, towels and bedding with those who are sick.

Avoid Sick Contacts

Keep children home from school/daycare when ill to limit the spread of infection.
Limit visitors and avoid contact with those exhibiting symptoms.
Consider wearing a face mask when sick and around others at home.

Vaccines

Getting recommended vaccinations helps prevent infections with some bacteria and viruses linked to ear infections, like pneumococcal and flu vaccines.
The PCV13 vaccine protects against 13 strains of S. pneumoniae.
Annual influenza vaccines reduce likelihood of flu-related complications.

Breastfeeding

Babies who are exclusively breastfed have fewer ear infections compared to bottle-fed infants according to the CDC. Breastfeeding for at least 6 months is recommended.

Treating Ear Infections

While ear infections are not themselves contagious, they can still be incredibly painful and impact sleep and hearing. So it is important to seek prompt medical treatment if your child develops symptoms which may include:

Ear pain, often severe, that suddenly begins and does not improve
Fever
Drainage from the ear
Hearing loss or sounds seeming muffled in the affected ear
Problems sleeping
Loss of balance
Vomiting or diarrhea (especially in infants)

Doctors may prescribe antibiotics to treat bacterial infections, but they are not effective against viral ear infections. Over-the-counter pain relievers like ibuprofen or acetaminophen can help ease discomfort. Keeping the child well hydrated and resting is also recommended.

Severe or recurring ear infections may require surgery to insert small tubes that drain fluid from the middle ear and prevent buildup of pressure. Removing the adenoid tissue in the back of the throat is another surgical option for kids who develop frequent ear infections.

The Bottom Line

While ear infections themselves do not spread through direct contact, the viruses and bacteria that cause them can be quite contagious. Practicing good hygiene and limiting interactions with sick individuals are the best ways to avoid infection.

There are also preventative measures parents can take to reduce the frequency of ear infections in children, including breastfeeding and staying up to date on vaccinations. If an ear infection does develop, treatment is focused on pain relief, antibiotics, and draining built-up fluid to prevent complications. Paying attention to the contagious nature of the underlying illnesses can help reduce transmission risk within families and daycares.

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