Effectiveness of non-pharmaceutical measures in preventing pediatric influenza: a case–control study

Abstract

BackgroundHygiene behavior plays a relevant role in infectious disease transmission. The aim of this study was to evaluate non-pharmaceutical interventions (NPI) in preventing pediatric influenza infections.MethodsLaboratory confirmed influenza cases occurred during 2009–10 and 2010–11 seasons matched by age and date of consultation. NPI (frequency of hand washing, alcohol-based hand sanitizer use and hand washing after touching contaminated surfaces) during seven days prior to onset of symptoms were obtained from parents of cases and controls.ResultsCases presented higher prevalence of underlying conditions such as pneumonia [OR = 3.23; 95 % CI: 1.38 – 7.58 p = 0.007], asthma [OR = 2.45; 95 % CI: 1.17 – 5.14 p = 0.02] and having more than 1 risk factor [OR = 1.67; 95 % CI: 0.99 – 2.82 p = 0.05]. Hand washing more than 5 times per day [aOR = 0.62; 95 % CI: 0.39 – 0.99 p = 0.04] was the only statistically significant protective factor. When considering two age groups (pre-school age 0–4 yrs and school age 5–17) yrs , only the school age group showed a negative association for influenza infection for both washing more than 5 times per day [aOR = 0.47; 95 % CI: 0.22 – 0.99 p = 0.04] and hand washing after touching contaminated surfaces [aOR = 0.19; 95 % CI: 0.04 – 0.86 p = 0.03].ConclusionFrequent hand washing should be recommended to prevent influenza infection in the community setting and in special in the school age group.

Estimates of seasonal influenza‐associated mortality in Bangladesh, 2010‐2012

“…In addition to seasonal vaccinations and antiviral drugs, hand washing has been shown to be effective for influenza prevention in some high‐income countries . However, a reactive approach to influenza prevention through hand washing was ineffective in rural Bangladesh suggesting alternative approaches may be required.…”

Assessing the State of Knowledge Regarding the Effectiveness of Interventions to Contain Pandemic Influenza Transmission: A Systematic Review and Narrative Synthesis

“…This limits the ability to evaluate the effectiveness of interventions such as school closure, facemask use, or quarantine of infected individuals, which would be inappropriate during standard seasonal influenza seasons. As a consequence, there is no conclusive evidence on the impact of these strategies: there was, in fact, substantial uncertainty about which measures to implement during the 2009 pandemic [53, 54]. Second, the assertion that seasonal influenza research remains relevant to pandemic influenza situations remains controversial [55].…”

“…Second, the assertion that seasonal influenza research remains relevant to pandemic influenza situations remains controversial [55]. Some suggest that intervention effectiveness may increase in pandemic situations, due to media attention and public anxiety increasing rates of adherence [56]; this was the case during the SARS epidemic [53, 57]. Additionally, the uncertain timing of pandemic influenza outbreaks, relative to usual influenza seasons, may alter non-pharmaceutical intervention effectiveness by impacting the relative importance of different modes of transmission, which have been suggested to vary with ambient temperature and relative humidity [39, 58].…”

Travellers and influenza: risks and prevention

“…42 Hand hygiene would be relatively simple for travellers to implement and several studies suggest that the use of alcohol based sanitizers and hand washing after touching contaminated surfaces can be effective. 43,44 However, these trials were not conducted in travellers. Facemask usage in travellers is particularly controversial and may only have measurable impact when a close companion (i.e.…”