Hepatitis B is spread through blood-to-blood contact and through sexual fluids (semen and vaginal fluids). Hepatitis B can be transmitted by:  vertical transmission (from mother with hepatitis B to baby during birth)  having unprotected sex (sex without a condom)  having unprotected oral sex when there are open cuts, ulcers or sores in the mouth  blood transfusions (performed in Australia before 1990 or currently overseas in countries that don’t screen blood or blood products)  traditional or cultural ceremonies and blood rituals (using unsterilised equipment)  occupational needle stick injury  injecting drug use (sharing needles, filters, spoons, tourniquets or swabs)  tattooing and body piercing (using unsterilised equipment)  sharing personal grooming items (e.g. toothbrushes, razors or tweezers) Hepatitis B is not transmitted by social contact. Things such as sharing food, utensils, cups, plates, hugging, shaking hands, kissing, sneezing, tears, mosquitoes, pets, sharing toilets or showers cannot transmit hepatitis B.