Reduction in the Incidence of Influenza A But Not Influenza B Associated With Use of Hand Sanitizer and Cough Hygiene in Schools

Stebbins, Samuel; Cummings, Derek A. T.; Stark, James H.; Vukotich, Chuck; Mitruka, Kiren; Thompson, W.; Rinaldo, Charles R.; Roth, Loren H.; Wagner, Michael; Wisniewski, Stephen R.; Dato, Virginia; Eng, Heather; Burke, Donald S.

doi:10.1097/inf.0b013e3182218656

Cited by 81 publications

(92 citation statements)

References 23 publications

(21 reference statements)

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“…In the same two cluster randomised studies in schools reported above, 12,13 hand hygiene interventions were In subgroup analysis in one study, there was a significantly lower incidence of influenza A in the intervention group: adjusted IRR = 0AE48 (95% CI 0AE26-0AE87) but not for influenza B: adjusted IRR = 1AE45 (95% CI 0AE79-2AE67). Outcome rated 'moderate quality' due to serious risk of bias associated with low rates of influenza testing which may have been differential across intervention and control groups: in one study, only 34% of school absences had a reason given (so many ILIs may have been missed) and up to 24% of ILIs identified were not tested for influenza.…”

Section: Hand Hygiene and Influenza-like Illness Or Acute Respiratorymentioning

confidence: 83%

“…Outcome rated 'moderate quality' due to serious risk of bias associated with low rates of influenza testing which may have been differential across intervention and control groups: in one study, only 34% of school absences had a reason given (so many ILIs may have been missed) and up to 24% of ILIs identified were not tested for influenza. 12 In a second study, only 33%…”

Section: Hand Hygiene and Influenza-like Illness Or Acute Respiratorymentioning

confidence: 92%

“…In the second study, there was a significant reduction in incidence of influenza A [RR 0AE48 (0AE26-0AE87)] but not influenza B [RR 1AE45 (0AE79-2AE67)] in subgroup analysis. 12 Overall, this evidence was rated moderate quality.…”

Section: Hand Hygiene and Laboratory-confirmed Influenza -Institutionmentioning

confidence: 98%

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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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Section: Hand Hygiene and Influenza-like Illness Or Acute Respiratorymentioning

confidence: 83%

Section: Hand Hygiene and Influenza-like Illness Or Acute Respiratorymentioning

confidence: 92%

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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

View full text Add to dashboard Cite

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“…Remarkably, the incidences of vomiting/nausea and diarrhea in our series were significantly higher in pediatric patients as compared to their adult counterpart (Table 1). It is unknown whether or not the higher incidences of vomiting/nausea and diarrhea in pediatric patients resulted from the higher burden of the 2009 pandemic influenza A (H1N1) virus in the affected children, 26 higher chances of exposure to the crowding environments at school, 28 , 29 and/or poorer compliance to the widely advised hand hygiene in the 2009 influenza A (H1N1) epidemic 30 , 31 …”

Section: Discussionmentioning

confidence: 99%

2009 pandemic Influenza A (H1N1): clinical and laboratory characteristics in pediatric and adult patients and in patients with pulmonary involvement

Lee

Liu

Wang

et al. 2012

Influenza Resp Viruses

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Please cite this paper as: Lee and Liu et al. (2012) 2009 pandemic Influenza A (H1N1): clinical and laboratory characteristics in pediatric and adult patients and in patients with pulmonary involvement. Influenza and Other Respiratory Viruses 6(601), e152–e161. Background To better understand clinical and laboratory characteristics in children, adults, and patients with lung involvement suffering 2009 pandemic influenza A (H1N1). Methods A total of 442 patients with 2009 pandemic influenza A (H1N1) were retrospectively analyzed. Results Comparing to their adult counterpart (n = 55), pediatric patients (n = 387) had significantly higher frequencies of fever, rhinorrhea, cough, sore throat, nausea/vomiting, and longer length of fever; lower frequencies of chest pain and dyspnea; higher incidence of lymphopenia; and lower incidence of elevated serum C‐reactive protein. Among the 227 patients with radiographs available, lung involvement was found in 19 (8·4%) (52·6% consolidation and 47·4% interstitial infiltrations), including 18 children and one adult. One child with lung consolidation died of multiorgan failure. Significant findings in patients with lung involvement included predominant young age (≤10 years), prolonged fever, and delayed oseltamivir therapy (≥48 hours after onset of illness); higher frequencies of dyspnea, nausea/vomiting, and altered consciousness; and higher incidences of leukopenia, elevated serum creative kinase, and lactic dehydrogenase. Conclusions Among patients with 2009 pandemic influenza A (H1N1), we found significant difference in clinical manifestations between children and adults, and significant differences in clinical and laboratory manifestations between patients with lung involvement and those without. On the basis of data from this study and the existing literature, early treatment with oseltamivir is recommended for patients with 2009 pandemic influenza A (H1N1), regardless of age.

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“…The U.S. Centers for Disease Control and Prevention cited "avoid touching your eyes, nose, or mouth" as a behavior to further prevent influenza infection in the home, school and workplace 4) . In a school setting, Stebbins S, et al studied the efficacy of nonpharmaceutical intervention including the recommendation to "avoid touching your eyes, nose, or mouth" to reduce the spread of influenza 5) . To the extent known, however, no studies appear to have epidemiologically studied the practice of touching the eyes or nose and susceptibility to URTI (including influenza) in workers.…”

Section: Discussionmentioning

confidence: 99%

Susceptibility to Upper Respiratory Tract Infection and Touching of the Eyes or Nose: A Cross‐sectional Study of Japanese Workers

Fukunaka

Sawada

Nishiura

et al. 2013

Journal of Occupational Health

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Susceptibility to Upper Respiratory Tract Infection and Touching of the Eyes or Nose:A Cross-sectional Study of Japanese Workers: Yasushi FUKUNAKA, et al. Department of Safety and Health, Tokyo Gas Co., Ltd.-Objectives: This study was a cross-sectional survey of Japanese workers regarding the relationship between touching the eyes or nose and susceptibility to URTI in workers. Methods: The survey respondents were 4,663 Japanese workers. Subjects were surveyed via a self-administered questionnaire regarding their susceptibility to URTI and how often they touched their eyes or nose. In addition, subjects were surveyed regarding their preventive behaviors and routine behaviors thought to be associated with URTIs. A multiple logistic regression model was used to assess the relationship between susceptibility to URTI and how often the eyes or nose are touched. Results: Responses from 3,663 individuals who answered the self-administered questionnaire were analyzed. There were 1,590 individuals (42.9%) with a "frequent incidence of URTIs", defined as URTIs more than once a year. In terms of how often the eyes or nose are touched, the odds ratios (95% CI) for a frequent incidence of URTIs among the groups responding "sometimes" and "often" were 1.41 (1.21−1.63) and 1.96 (1.59−2.42) (trend test: p<0.001) compared with the groups responding "never" and "almost never". Multivariate-adjusted odds ratios adjusted for confounding factors, i.e., behaviors to prevent URTIs, routine behaviors associated with URTIs, age, sex and BMI, were 1.33 (1.14−1.54) and 1.69 (1.36−2.09) (trend test: p<0.001). Conclusions:The present cross-sectional study indicates that suscep-

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Reduction in the Incidence of Influenza A But Not Influenza B Associated With Use of Hand Sanitizer and Cough Hygiene in Schools

Cited by 81 publications

References 23 publications

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

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

2009 pandemic Influenza A (H1N1): clinical and laboratory characteristics in pediatric and adult patients and in patients with pulmonary involvement

Susceptibility to Upper Respiratory Tract Infection and Touching of the Eyes or Nose: A Cross‐sectional Study of Japanese Workers

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