Effect of two-step hygiene management on the prevention of nosocomial influenza in a season with high influenza activity

Ambrosch, Andreas; Rockmann, Felix

doi:10.1016/j.jhin.2016.07.006

Cited by 16 publications

(18 citation statements)

References 28 publications

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“…In a recently published meta-analysis on preventive strategies for transmission of SARS-CoV-2, a distance of one meter or more has been shown to be the most effective measure, followed by the wearing of face masks [ 5 ]. With regard to influenza, we have already shown that a strict mask policy for hospital employees leads to a 50% reduction in nosocomial infections [ 18 ] as it is also hypothesed for the present study on SARS-CoV-2. However, there are contradictory experimental and clinical studies on the functionality of surgical masks with regard to their preventive effect: in the study by Tang et al [ 19 ], it could basically be shown that wearing surgical masks significantly reduced an aerosol cloud in the sagittal direction; theoretical and experimental considerations suggest that surgical masks filter both large and medium droplet sizes and can therefore reduce aerosol SARS-CoV-2 transmission [ 20 ]; indeed, in animal studies a reduction of SARS-CoV-2 infection transmission by wearing surgical masks could be demonstrated [ 21 ].…”

Section: Discussionsupporting

confidence: 72%

Effect of a strict hygiene bundle for the prevention of nosocomial transmission of SARS-CoV-2 in the hospital: a practical approach from the field

Ambrosch

Rockmann

Klawonn

et al. 2020

Journal of Infection and Public Health

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Background During the novel coronavirus disease (COVID-19) pandemic it is crucial for hospitals to implement infection prevention strategies to reduce nosocomial transmission to the lowest possible number. This is all the more important because molecular tests for identifying SARS-CoV-2 infected patients are uncertain, and the resources available for them are limited. In this view, a monocentric, retrospective study with an interventional character was conducted to investigate the extent to which the introduction of a strict hygiene bundle including a general mask requirement and daily screening for suspicious patients has an impact on the SARS-CoV-2 nosocomial rate in the pandemic environment. Methods All inpatients from a maximum care hospital in Regensburg (Bavaria) between March 1 st and June 10 th 2020 were included. Patient with respiratory symptoms were tested for SARS-CoV-2 at admission, patients were managed according to a standard hygiene protocol. At the end of March a strict hygiene bundle was introduced including a general mask obligation and a daily clinical screening of inpatients for respiratory symptoms. Nosocomial infection rate for COVID-19 and the risk for infection transmission estimated by the nosocomial incidence density before and after introduction the hygiene bundle were compared. The infection pressure for the hospital during the entire observational period was characterized by the infection reports in the region in relation to the number of hospitalized COVID-19 patients and the number of infected employees. Results In fact, after the introduction of a strict hygiene bundle including a general mouth and nose protection obligation and a daily clinical screening of suspicious patients, a significant reduction of the nosocomial rate from 0.28 to 0.06 (p = 0.026) was observed. Furthermore, the risk of spreading hospital-acquired infections also decreased dramatically from 0.0007 to 0.00018 (p = 0.031; rate ratio after/before 0.25 (95%CI 0.06, 1.07) despite a slow decrease of the hospital COVID 19-prevalence and an increase of infected employees. Conclusion The available data underline that a strict hygiene bundle seem to be associated with a decrease of nosocomial SARS-CoV-2 transmission in the pandemic situation.

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Section: Discussionsupporting

confidence: 72%

Effect of a strict hygiene bundle for the prevention of nosocomial transmission of SARS-CoV-2 in the hospital: a practical approach from the field

Ambrosch

Rockmann

Klawonn

et al. 2020

Journal of Infection and Public Health

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“…A number of studies focus on influenza. A study of a hospital in Germany found that once staff began wearing masks continuously, the number of patients contracting influenza in the hospital declined by half (9). In a study of German households, use of masks and hand-washing reduced the spread of influenza between family members (10).…”

Section: Masks Reduce Viral Spreading In Laboratory and Real World Sementioning

confidence: 99%

Public Use of Masks to Control the Coronavirus Pandemic

Longrich¹,

Sheppard²

2020

Preprint

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The US and UK governments, as well as the World Health Organization, currently advise against the use of masks by the public to fight the ongoing Coronavirus Disease 19 (COVID-19) pandemic (1). But could they be wrong? The governments of China, South Korea, Hong Kong, Viet Nam, Czechia, Slovakia, Bosnia and Taiwan all recommend that the public wear masks to slow the spread of the coronavirus. In some countries, like Japan, masks aren’t officially recommended, but are still widely used by the public. Many countries treat masks as a strategic resource. China has ramped up production of facemasks, converting Foxconn factories that once made iPhones to make face masks. Taiwan has also ramped up the production of facemasks, prohibited their export, and implemented price controls and rationing. It’s hard to see how both approaches could be right. Increasingly, advice against the use of face masks has been questioned (1) (2) (3), including by the head of China’s CDC (4). Common sense, scientific studies, but perhaps most of all the success of countries using masks to fight the coronavirus suggest that masks may make a difference. There are fewer scientific studies available to guide decision making than we might like, and the evidence is not always clear-cut. However, decision-making in a crisis requires that decisions be made in the absence of perfect clarity. What is clear is that the exponential mathematics of pandemics mean that even if masks are of limited benefit in reducing infection rates, masks could make a large difference over time, potentially slowing the pace of the pandemic, limiting its spread, saving lives, and finally, letting countries to restart the economies that their people depend on for their livelihoods.

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“…However, there are reasons to consider a nonconstant transmission rate. Higher prevalence (and awareness) of the disease may lead to social distancing, increased hygiene behaviors (i.e., hand washing), or higher intensity cleaning procedures at healthcare facilities, which reduces the transmission rate as the prevalence increases (Aleman et al 2009, Nigmatulina and Larson 2009, Manfredi and D'Onofrio 2013, Gilchrist et al 2015, Ambrosch and Rockmann 2016. In addition, even when the number of infections has remained low for many years, the possibility of resurgence remains as eradication of many diseases is very difficult (e.g., Singh et al 2007 andMoran-Gilad et al 2016).…”

Section: Structural Sensitivity Analysismentioning

confidence: 99%

“…In plain language, this means that it is optimal to use the drug for everyone regardless of disease prevalence until the level of resistance is so high that it is no longer economical to treat anyone. However, in practice, it is not uncommon for the disease transmission rate to be a (decreasing) function of prevalence as higher prevalence and awareness of the disease may lead to social distancing, increased adoption of prevention behaviors, or higher intensity cleaning procedures at healthcare facilities (Aleman et al 2009, Nigmatulina and Larson 2009, Manfredi and D'Onofrio 2013, Gilchrist et al 2015, Ambrosch and Rockmann 2016. If the disease transmission rate is not constant, we find that it is optimal to reserve the drug for relatively larger outbreaks and, in some cases, to use the drug to treat some, but not all, infected individuals.…”

Section: Introductionmentioning

confidence: 99%