Mask use, hand hygiene, and seasonal influenza-like illness among young adults: A randomized intervention trial

Aiello, Allison E.; Murray, Genevra F.; Pérez, Vanessa; Coulborn, Rebecca M.; Davis, Brian M.; Uddin, Monica; Shay, David K.; Waterman, Stephen H.; Monto, Arnold S.

doi:10.1086/650396

Cited by 296 publications

(370 citation statements)

References 26 publications

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“…On account of this, the health care system needs to be aware of the safety of their HCWs because they are at significant risk of getting infected and also of transmitting the disease to patients 15 . Besides vaccination (as far as available), hand hygiene (disinfection and/or washing), masks, protective clothing, gloves and protective goggles were reported to be the most effective personal protective equipment against the influenza virus 4 , 17 , 18 . However, required protective measures should be evaluated with regard to practicability and effectiveness.…”

Section: Discussionmentioning

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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Section: Discussionmentioning

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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“…Three newer cluster randomised trials with influenza and influenza-like illness as outcomes were not eligible for inclusion as they examined the effect of hand hygiene only in combination with facemask use. All three studies (two in university halls of residence in the USA 38,39 and one of secondary transmission in German households 40 ) suggested a reduction in influenza and ⁄ or ILI in groups receiving hand hygiene and facemasks compared with controls but results were generally not statistically significant. A recently published cluster randomised trial 41 of regular hand sanitiser use on ILI absence in Thai pre-schools was not eligible for inclusion because insufficient data were presented on ILI episodes to allow an effect measure to be calculated.…”

Section: Laboratory-con Irmed In Luenza Outcomesmentioning

confidence: 98%

Hand hygiene to reduce community transmission of influenza and acute respiratory tract infection: a systematic review

Warren‐Gash

Fragaszy

Hayward

2012

Influenza Resp Viruses

102

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Hand hygiene may be associated with modest protection against some acute respiratory tract infections, but its specific role in influenza transmission in different settings is unclear. We aimed to review evidence that improving hand hygiene reduces primary and secondary transmission of (i) influenza and (ii) acute respiratory tract infections in community settings. We searched Medline, Embase, Global Health and Cochrane databases up to 13 February 2012 for reports in any language of original research investigating the effect of hand hygiene on influenza or acute respiratory tract infection where aetiology was unspecified in community settings including institutions such as schools, and domestic residences. Data were presented and quality rated across outcomes according to the Grading of Recommendations Assessment, Development and Evaluation system. Sixteen articles met inclusion criteria. There was moderate to low-quality evidence of a reduction in both influenza and respiratory tract infection with hand hygiene interventions in schools, greatest in a lower-middle-income setting. There was high-quality evidence of a small reduction in respiratory infection in childcare settings. There was high-quality evidence for a large reduction in respiratory infection with a hand hygiene intervention in squatter settlements in a low-income setting. There was moderate-to highquality evidence of no effect on secondary transmission of influenza in households that had already experienced an index case. While hand hygiene interventions have potential to reduce transmission of influenza and acute respiratory tract infections, their effectiveness varies depending on setting, context and compliance.

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“…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%

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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Mask use, hand hygiene, and seasonal influenza-like illness among young adults: A randomized intervention trial

Abstract: ClinicalTrials.gov identifier: NCT00490633.

Cited by 296 publications

References 26 publications

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

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

Hand hygiene to reduce community transmission of influenza and acute respiratory tract infection: a systematic review

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

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