Helicobacter pylori plays a significant role in the pathogenesis of chronic gastritis, peptic ulcer, and gastric cancer. Its worldwide distribution and high level prevalence and the importance of associated pathologies make the elimination of H. pylori a very useful approach to treating and controlling these gastroduodenal diseases. Its eradication results in a marked reduction in the rate of recurrence of duodenal and gastric ulcer. In December 1995, the FDA advisory committee recommended approval of two new four-week treatments, involving clarithromycin, with either omeprazole or ranitildine bismuth citrate. Although the treatment is successful, it is only useful after the person has been infected. Presently, prevention of infection is not known because the route of transmission is unclear. Recent evidence that shows that H. pylori is culturable from both the mouth and feces suggests a fecal-oral route of transmission, food is the most likely source. Environmental contamination by human sewage in shellfish growing waters is more common in less developed countries due to inadequate sewage treatment and the lack of monitoring the shellfish and the shellfish growing waters. A large percentage of imported seafood is from less developed countries. In order to prevent infection, sources of H. pylori must be avoided. Recent methods of detection of H. pylori are developed to be used in clinical labs with little association with food. H. pylori exists in a culturable (bacillary) and nonculturable (coccoid) form of which both are equally pathogenic with the reversion of the coccoid form to bacillary form in vivo. To accurately detect the two forms of H. pylori, immunomagnetic separation in conjuction with a two-step polymerase chain reaction will be used. These newer methods, if adapted to routine use, can provide FDA with a rapid and accurate way to detect H. pylori in shellfish and shellfish growing waters.