Have you ever wondered, “Are ear infections contagious?”
It may surprise you, but while it may seem that ear infections spread, especially in settings like schools and daycare centers, they are localized infections that can’t be transferred from person to person.
The most common type of ear infections, middle ear infections, usually start when you have a respiratory virus. “The middle ear infection, in of itself, doesn’t spread and isn’t contagious,” explains David Shimunov, MD, an otolaryngologist and head and neck surgeon at Stony Brook Medicine. “It’s the virus before that which sets up the environment for the ear infection, and that is the contagious part.”
It’s common to feel confused about how ear infections spread. Dr. Shimunov shares further insights about whether ear infections are contagious, what causes ear infections, and how to prevent ear infections.
What Causes Ear Infections?
To answer the questions, “Can ear infections spread?” and “Are ear infections contagious to others?” it’s helpful to go back to the basics and understand what causes ear infections in the first place.
First, there are two main types of ear infections: outer ear infections and middle ear infections. Neither middle nor outer ear infections are contagious, but each type has a different cause.
Outer Ear Infection Causes
Outer ear infections are often referred to as “swimmer’s ear.” These types of ear infections happen when there’s an abrasion in the skin of the outer ear or a change to the environment of the ear’s skin, Dr. Shimunov says.
“If somebody goes swimming and now the ear is full of water for a while, that could reduce some of the protective barriers of the skin, and this could provide the environment for bacteria to cause an infection,” he explains.
Middle Ear Infection Causes
Middle ear infections occur in the part of your ear canal right behind your eardrum. These types of ear infections are associated with respiratory viruses and infections.
“Middle ear infections are usually a downstream consequence of some sort of eustachian tube dysfunction,” Dr. Shimunov says. This tube connects the back of your nose with your middle ear.
Middle ear infections usually happen when a virus, like those that cause an upper respiratory infection, triggers inflammation around the eustachian tube. “This causes poor ventilation in the middle ear and can cause bacteria in the middle ear to then turn into an infection,” Dr. Shimunov explains. Usually, it’s bacteria that cause the infection, but sometimes it’s a virus.
Similar to outer ear infections, middle ear infections are not contagious. Rather, it’s the changes to the ear canal that happen as a result of the virus that set the stage for a secondary infection in the ear.
What Are the Symptoms of an Ear Infection?
The most common ear infection symptoms are:
- Ear pain
- Fussiness
- Tugging at the ear
- Trouble sleeping
- Fever
Fundamentally, the symptoms are the same between children and adults. “The hallmark symptom of ear infections is ear pain,” Dr. Shimunov says.
The main difference between adults and children is that children aren’t able to verbalize how they are feeling, so they’ll exhibit symptoms like crying and extra fussiness, Dr. Shimunov says. Children often “won’t be consolable,” he adds. “They’ll be crying a lot. If they could verbalize, they’d tell you about their pain.”
Another difference is children are simply more likely than adults to get ear infections, due to the smaller size of their eustachian tubes and the fact that the tubes are positioned more horizontally than in adults, making it harder for fluid to drain from the ear.
Can Ear Infections Spread to Other People?
Can you catch an ear infection? You might feel certain that ear infections are spread among kids, and you might also ask, “Are ear infections contagious in adults?”
Despite what experience may have taught you, ear infections aren’t contagious, in either kids or adults. The reason why people are so certain they are contagious is because many people who have ear infections start off by having cold-like symptoms, and the viruses that cause these symptoms can spread.
“Many, many ear infections start off as a non-ear infection,” Dr. Shimunov says. “They start off as a cold. You have a runny nose, congestion, inflammation in the back of your nose, and then that sets up the environment for a down-the-road ear infection to occur.”
Still, there’s a common misconception that ear infections are contagious. “Many parents think, well, maybe ear infections are contagious because you’ll see a bunch of people at daycare get back-to-back ear infections,” Dr. Shimunov says.
Again, though, it’s not the ear infection itself that’s contagious. The contagious part is the respiratory virus that started the whole cascade of symptoms and infections.
How to Prevent Ear Infections
Not all ear infections can be prevented, but warding off infection with the viruses that cause ear infections, like respiratory viruses, can help.
Here are some tips to consider:
- Practice thorough and frequent hand washing.
- Avoid exposing yourself or your child to cigarette smoke, as doing so can increase your risk of ear infections.
- Don’t spend time with others who are sick.
It can be difficult to prevent young children from getting ear infections, partly because of their anatomy, but also “because their immune systems are so immature” and they are more prone to getting respiratory infections, Dr. Shimunov says.
While you can’t prevent every infection in a young child, “being vaccinated helps a lot,” he adds. These days, children are offered vaccines for some of the most common infections that contribute to ear infections. It’s recommended that children get the flu shot and pneumococcal conjugate vaccine to prevent ear infections.
When to See a Doctor
If your ear infection symptoms aren’t getting better, especially if they are accompanied by symptoms like fever, it makes sense to reach out to your doctor.
For children, it’s a good idea to contact a pediatrician if they just generally seem unwell, Dr. Shimunov recommends. Some warning signs would include a child who’s extremely tired, isn’t acting like themselves, and whose fevers aren’t improving, he describes. You should also go to the doctor “if there’s pretty much any kind of drainage from the ear,” he says.
Sometimes, but not always, middle ear infections require treatment with antibiotics. “It’s reasonable in the right patient, like an otherwise healthy child, to maybe wait 48 hours to see if things are getting better on their own,” before trying antibiotics, Dr. Shimunov advises.
Ear infections typically aren’t an emergency. But overall, you shouldn’t hesitate to reach out to your child’s pediatrician if their symptoms continue to get worse or if you have any questions or concerns about them.
