Facemasks and Hand Hygiene to Prevent Influenza Transmission in Households

Cowling, Benjamin J.; Chan, Kwok‐Hung; Fang, Vicky J.; Cheng, C.; Fung, Rita O. P.; Wai, Winnie; Sin, Joey; Seto, W. H.; Yung, R; Chu, Daniel Wai‐Sing; Chiu, Billy C F; Lee, Paco W Y; Chiu, Ming Chi; Lee, Hoi Che; Uyeki, Timothy M.; Houck, Peter M.; Peiris, J. S. Malik; Leung, Gabriel M.

doi:10.7326/0003-4819-151-7-200910060-00142

Cited by 504 publications

(644 citation statements)

References 31 publications

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“…Although the main focus of these studies was the effectiveness of interventions, adherence and in some cases tolerability of measures were also investigated. Of these three studies two reported on adherence to wearing facemasks [2,3], which was lower compared to our study. Furthermore, we noted substantially increasing adherence after participants had received detailed instructions during a first household visit (Figs 1 and 2).…”

contrasting

confidence: 95%

“…In recent years, evidence has emerged suggesting that non-pharmaceutical interventions (NPI) such as surgical facemasks or intensified hand hygiene may be effective in preventing influenza transmission when used in households or university residence halls [1][2][3]. In addition to the effectiveness of these interventions, however, it seems equally important to understand which factors influence adherence and tolerability of NPI [4].…”

mentioning

confidence: 99%

“…In recent years, three studies examining the effectiveness of NPI on household (or dormitory) level have been published [1][2][3]. Although the main focus of these studies was the effectiveness of interventions, adherence and in some cases tolerability of measures were also investigated.…”

mentioning

confidence: 99%

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Facemasks and intensified hand hygiene in a German household trial during the 2009/2010 influenza A(H1N1) pandemic: adherence and tolerability in children and adults

et al. 2011

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SUMMARYNon-pharmaceutical interventions (NPI) such as facemasks and intensified hand hygiene may be effective in preventing influenza infections in households. It may be equally important that household members, especially children, can learn to use, maintain and tolerate these measures. We monitored adherence and tolerability of these NPI within a cluster-randomized trial in households with influenza index patients. We recruited 147 participants in 41 households, 39 (95 %) out of 41 index patients were children (aged <14 years). In households assigned to wear facemasks, their use peaked on day 4 after symptom onset of the index patient at 73% and at 65 % for children and adults, respectively. Mean daily frequency of hand disinfection in households assigned to intensified hand hygiene measures peaked at 7 . 7 (day 6) for children and at 10 . 1 (day 5) for adults. The majority of participants reported no problems with mask wearing. Data suggest that usage of NPI can be taught and that measures are well tolerated by adults and even sick children alike.

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Facemasks and intensified hand hygiene in a German household trial during the 2009/2010 influenza A(H1N1) pandemic: adherence and tolerability in children and adults

et al. 2011

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“…Little data is available concerning the effectiveness of non‐pharmaceutical intervention for the prevention of influenza transmission in households 12 , 13 . Hand hygiene with or without the use of masks seemed to reduce influenza transmission in households in Hong Kong 13 .…”

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confidence: 99%

Attitudes of influenza-vaccinated health care workers toward masks to prevent nosocomial transmission of influenza

Brandt

Rabenau

Wicker

2010

Influenza and Other Respiratory Viruses

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Please cite this paper as: Brandt et al. (2010) Attitudes of influenza‐vaccinated health care workers toward masks to prevent nosocomial transmission of influenza. . Influenza and Other Respiratory Viruses 5(1), 61–66. Background Influenza viruses are highly contagious. Health care workers (HCWs) are at risk of occupational exposure to influenza and may transmit the infection to their patients and coworkers. Objectives The aim of the study was to characterize the attitudes of HCWs regarding the use of surgical masks to prevent nosocomial influenza transmission. Furthermore, we assessed the informational needs of HCWs with regard to infection control measures. Methods A survey was conducted among HCWs, using an anonymous questionnaire, at a German University Hospital during an influenza vaccination campaign. Results Overall, 40·5% of the HCWs were vaccinated against seasonal influenza, and 35·2% were vaccinated against Influenza A/H1N1 (“swine flu”). In total, 1445 vaccinees completed the anonymous questionnaire. Of all respondents, 70·5% stated that the infection control recommendation “wearing a surgical” mask was appropriate to avoid influenza transmission. The percentage of HCWs who would like to have had more information about the infection control measures was 67·5%. Conclusions Appropriate interventions ought to be taken to reduce the risk of exposure to influenza viruses among HCWs. Adherence to recommendations for the use of masks among HCWs needs to be evaluated. Further work is required to highlight the informational needs of HCWs to gain an appreciation of infection control measures.

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“…In the current study, analyzing large prospective studies of influenza A virus transmission in Hong Kong households conducted in influenza seasons from 2008 to 2012 [3,15], we examined the relationship between viral shedding and infectivity.…”

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confidence: 99%

Influenza A Virus Shedding and Infectivity in Households

Tsang¹,

Cowling²,

Fang³

et al. 2015

J Infect Dis.

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101

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Background. Viral shedding is often considered to correlate with the infectivity of influenza, but the evidence for this is limited.Methods. In a detailed study of influenza virus transmission within households in 2008-2012, index case patients with confirmed influenza were identified in outpatient clinics, and we collected nose and throat swab specimens for testing by reverse-transcription polymerase chain reaction from all household members regardless of illness. We used individual-based hazard models to characterize the relationship between viral load (V ) and infectivity.Results. Assuming that infectivity was proportional to viral load V gave the worst fit, because it strongly overestimated the proportion of transmission occurring at symptom onset. Alternative models assuming that infectivity was proportional to a various functions of V provided better fits, although they all overestimated the proportion of transmission occurring >3 days after symptom onset. The best fitting model assumed that infectivity was proportion to V γ , with estimates of γ = 0.136 and γ = 0.156 for seasonal influenza A(H1N1) and A(H3N2) respectively.Conclusions. All the models we considered that used viral loads to approximate infectivity of a case imperfectly explained the timing of influenza secondary infections in households. Identification of more accurate correlates of infectivity will be important to inform control policies and disease modeling.

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Facemasks and Hand Hygiene to Prevent Influenza Transmission in Households

Abstract: Centers for Disease Control and Prevention.

Cited by 504 publications

References 31 publications

Facemasks and intensified hand hygiene in a German household trial during the 2009/2010 influenza A(H1N1) pandemic: adherence and tolerability in children and adults

Facemasks and intensified hand hygiene in a German household trial during the 2009/2010 influenza A(H1N1) pandemic: adherence and tolerability in children and adults

Attitudes of influenza-vaccinated health care workers toward masks to prevent nosocomial transmission of influenza

Influenza A Virus Shedding and Infectivity in Households

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