Are Ear Infections Contagious? - Verywell Health

An ear infection—also called otitis media—is an infection in the middle ear, the air-filled space behind the eardrum. Acute otitis media is an ear infection that comes on quickly. An ear infection usually results from viruses, bacteria, a combination of viruses and bacteria, or allergies.

Ear infections are not contagious, but the colds, sore throats, and respiratory infections that often precede them are. Most ear infections are easy to treat, but if symptoms become severe or are accompanied by a fever, you may need medical attention.

Ear infections are most common in children, with more than 80% of kids having one by the time they're 3 years old. But they can also occur in adults.

This article will discuss the causes of ear infections, whether ear infections are contagious, symptoms, and treatment.

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Causes

Ear infections are generally caused by infections with viruses and bacteria. Some viruses that commonly produce ear infections are cold viruses and influenza viruses (flu). Infection by the respiratory syncytial virus (RSV), a virus that affects the lungs, may predispose to a bacterial ear infection, as may other respiratory viruses.

The most frequent bacterial causes of ear infections are Streptococcus pneumoniae and Haemophilus influenzae. These are bacteria commonly found in the nose and throat without causing illness.

Ear infections are also sometimes the byproduct of allergies, in which the immune system reacts to substances that are not usually harmful. These include allergies to environmental factors like tree pollens, dust, and pet dander.

The connection between viruses, bacteria, allergies, and ear infections is that these can cause congestion and inflammation extending from the nose to the eustachian tubes. These tubes (one in each ear) connect the back of the throat to the middle ear. They help keep pressure and the fluid that's normally secreted from building up in your ear.

When the eustachian tubes swell, they allow for less ventilation and more buildup of fluid and germs. This invites an ear infection to develop.

Children are more prone to ear infections than adults because their eustachian tubes are shorter and less sloped, making them more likely to get clogged and blocked. That damp, dark environment is often perfect for infections to take hold and grow. 

Adenoids—structures that sit at the back of the throat—are larger in children than in adults and can block the eustachian tubes.

Because of their immature immune systems, children also tend to catch more colds and other infections that can produce ear infections.

Symptoms

Ear infection symptoms include:

• Ear pain (in one or both ears)
• Fluid drainage from the ear
• Muffled hearing
• Sore throat
• Fever
• Balance problems (rarely)

Young babies can't tell you they have ear pain, so look for these signs:

• Tugging on one or both ears
• Irritability
• Fever
• Change in hearing (for example, not responding when you call their name)
• Balance problems
• Fluid draining from ears

Certain people have a higher risk of ear infections than others. They include:

• Babies or young children: Children between 6 and 12 months of age are most likely to get ear infections. By age 5, many kids have outgrown their tendency toward ear infections.
• Children who attend day care
• Those with allergies
• Those exposed to cigarette smoke
• People who have a family history of ear infections

Are Ear Infections Contagious?

You can't "catch" ear infections, but you can catch the viruses that can trigger them. Viruses like the common cold and flu, for example, are spread when you breathe in virus-containing droplets that have been spread by the cough or sneeze of an infected person. You can also get infected by touching a surface those droplets have landed on.

The bacteria most often found in ear infections are normally present in the respiratory tract, so they are not contagious in the usual sense. Instead, people acquire them throughout their life and they cause ear infections only in some circumstances, such as having a blocked eustachian tube.

Treatment

Getting evaluated by your doctor due to an ear infection is important. Repeated ear infections in children, for example, can lead to hearing loss and speech delays. Treatment for ear infections varies depending on the severity of the infection, how long it has lasted, and a person's age.

Because many ear infections improve in a couple of days without intervention and because of worldwide antibiotic resistance (germs become "resistant" to the drugs used to fight them), some doctors take a wait-and-see approach before prescribing an antibiotic.

This is especially true if the pain is mild and has lasted for no more than three days. In children with an ear infection, 80% of them get better without antibiotic treatment, and they are unlikely to develop a serious illness.

An exception is that babies (under 6 months) diagnosed with an ear infection are generally treated with antibiotics right away. Bacteria from an ear infection in a young baby can spread to other parts of the body, having serious consequences.

To ease pain and manage any fever, your doctor may recommend an over-the-counter medication such as Tylenol (acetaminophen) or Advil or Motrin (ibuprofen). Get your doctor's guidance before using these; babies younger than 6 months, for instance, should not be given ibuprofen.

However, if the pain is severe at the get-go or symptoms get worse after a few days, your doctor may prescribe an antibiotic, such as Moxatag or Amoxil (amoxicillin).

Ear tubes are small, cylindrical tubes surgically inserted into the eardrum to help drain fluid and stabilize air pressure. They are an option for some children. Adults can also receive ear tubes, but it's not common.

They're generally recommended for kids who get recurrent ear infections (defined as three or more over six months), have fluid in their ears for months on end, and/or have a collapsed eardrum. The tubes fall out naturally—usually within 18 months after their insertion—as the child's ear grows.

Prevention

To prevent ear infections, you need to prevent the infections that cause them. Measures include:

• Do your best to steer clear of coughing, sneezing people.
• Wash your hands frequently (for a full 20 seconds).
• Avoid touching your eyes, nose, or mouth with unwashed hands (viruses like to gain entry into your body via these moist areas).
• Get vaccinated against viruses and bacteria like the flu, COVID-19, and Streptococcus pneumonia. Make sure your children are current on their vaccinations, too.
• Don't smoke and avoid exposure to secondhand smoke.
• Breastfeed your baby for at least six months. Breast milk has antibodies that can ward off infections.
• Don't let your baby lie down while feeding. Drinking while in a prone posture increases the likelihood of ear infections.

Summary

Ear infections are common, especially in children. They're usually caused by viruses, bacteria, and (in some cases) allergies. Most ear infections resolve on their own or can be treated with a short course of antibiotics. The pain associated with ear infections can be treated with pain relievers. 

In rare cases, an untreated ear infection can lead to hearing loss and/or more widespread infection. If you suspect an ear infection, consult your healthcare provider. They can best advise you about any possible treatments.

A Word From Verywell

While ear infections can be uncomfortable and (in extreme cases) lead to hearing loss, they are usually not a serious condition. Most people respond well to watchful waiting or treatments like antibiotics or ear tube surgery when needed. To avoid ear infections, treat your allergies and do your best to avoid viruses and bacteria.

Frequently Asked Questions

• Without culturing the fluid behind the eardrum, there is no definitive way to determine if the infection is caused by a virus or bacteria. However, most ear infections are viral.

  Some red flags the infections might be bacterial include:

  • Having an ear infection that lasts longer than it should (most get better in a couple of days)
  • Fever, especially worsening fever

• Most ear infections improve within a couple of days, even without antibiotic treatment. If symptoms don't improve or even get worse, contact your doctor.

• Many ear infections get better within a few days without antibiotic therapy. That's why a lot of doctors suggest a "watchful waiting" strategy before prescribing antibiotics.