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Article: Facemasks and hand hygiene to prevent influenza transmission in households: A cluster randomized trial

TitleFacemasks and hand hygiene to prevent influenza transmission in households: A cluster randomized trial
Authors
Issue Date2009
PublisherAmerican College of Physicians. The Journal's web site is located at http://www.annals.org
Citation
Annals Of Internal Medicine, 2009, v. 151 n. 7, p. 437-446 How to Cite?
AbstractBackground: Few data are available about the effectiveness of nonpharmaceutical interventions for preventing influenza virus transmission. Objective: To investigate whether hand hygiene and use of face-masks prevents household transmission of influenza. Design: Cluster randomized, controlled trial. Randomization was computer generated; allocation was concealed from treating physicians and clinics and implemented by study nurses at the time of the initial household visit. Participants and personnel administering the interventions were not blinded to group assignment. (Clinical-Trials.gov registration number: NCT00425893) Setting: Households in Hong Kong. Patients: 407 people presenting to outpatient clinics with influenza-like illness who were positive for influenza A or B virus by rapid testing (index patients) and 794 household members (contacts) in 259 households. Intervention: Lifestyle education (control) (134 households), hand hygiene (136 households), or surgical facemasks plus hand hygiene (137 households) for all household members. Measurements: Influenza virus infection in contacts, as confirmed by reverse-transcription polymerase chain reaction (RT-PCR) or diagnosed clinically after 7 days. Results: Sixty (8%) contacts in the 259 households had RT-PCR-confirmed influenza virus infection in the 7 days after intervention. Hand hygiene with or without facemasks seemed to reduce influenza transmission, but the differences compared with the control group were not significant. In 154 households in which interventions were implemented within 36 hours of symptom onset in the index patient, transmission of RT-PCR-confirmed infection seemed reduced, an effect attributable to fewer infections among participants using facemasks plus hand hygiene (adjusted odds ratio, 0.33 [95% CI, 0.13 to 0.87]). Adherence to interventions varied. Limitation: The delay from index patient symptom onset to intervention and variable adherence may have mitigated intervention effectiveness. Conclusion: Hand hygiene and facemasks seemed to prevent household transmission of influenza virus when implemented within 36 hours of index patient symptom onset. These findings suggest that nonpharmaceutical interventions are important for mitigation of pandemic and interpandemic influenza. Primary Funding Source: Centers for Disease Control and Prevention. © 2009 American College of Physicians.
Persistent Identifierhttp://hdl.handle.net/10722/86684
ISSN
2015 Impact Factor: 16.44
2015 SCImago Journal Rankings: 5.378
ISI Accession Number ID
References

 

DC FieldValueLanguage
dc.contributor.authorCowling, BJen_HK
dc.contributor.authorChan, KHen_HK
dc.contributor.authorFang, VJen_HK
dc.contributor.authorCheng, CKYen_HK
dc.contributor.authorFung, ROPen_HK
dc.contributor.authorWai, Wen_HK
dc.contributor.authorSin, Jen_HK
dc.contributor.authorSeto, WHen_HK
dc.contributor.authorYung, Ren_HK
dc.contributor.authorChu, DWSen_HK
dc.contributor.authorChiu, BCFen_HK
dc.contributor.authorLee, PWYen_HK
dc.contributor.authorChiu, MCen_HK
dc.contributor.authorLee, HCen_HK
dc.contributor.authorUyeki, TMen_HK
dc.contributor.authorHouck, PMen_HK
dc.contributor.authorPeiris, JSMen_HK
dc.contributor.authorLeung, GMen_HK
dc.date.accessioned2010-09-06T09:20:03Z-
dc.date.available2010-09-06T09:20:03Z-
dc.date.issued2009en_HK
dc.identifier.citationAnnals Of Internal Medicine, 2009, v. 151 n. 7, p. 437-446en_HK
dc.identifier.issn0003-4819en_HK
dc.identifier.urihttp://hdl.handle.net/10722/86684-
dc.description.abstractBackground: Few data are available about the effectiveness of nonpharmaceutical interventions for preventing influenza virus transmission. Objective: To investigate whether hand hygiene and use of face-masks prevents household transmission of influenza. Design: Cluster randomized, controlled trial. Randomization was computer generated; allocation was concealed from treating physicians and clinics and implemented by study nurses at the time of the initial household visit. Participants and personnel administering the interventions were not blinded to group assignment. (Clinical-Trials.gov registration number: NCT00425893) Setting: Households in Hong Kong. Patients: 407 people presenting to outpatient clinics with influenza-like illness who were positive for influenza A or B virus by rapid testing (index patients) and 794 household members (contacts) in 259 households. Intervention: Lifestyle education (control) (134 households), hand hygiene (136 households), or surgical facemasks plus hand hygiene (137 households) for all household members. Measurements: Influenza virus infection in contacts, as confirmed by reverse-transcription polymerase chain reaction (RT-PCR) or diagnosed clinically after 7 days. Results: Sixty (8%) contacts in the 259 households had RT-PCR-confirmed influenza virus infection in the 7 days after intervention. Hand hygiene with or without facemasks seemed to reduce influenza transmission, but the differences compared with the control group were not significant. In 154 households in which interventions were implemented within 36 hours of symptom onset in the index patient, transmission of RT-PCR-confirmed infection seemed reduced, an effect attributable to fewer infections among participants using facemasks plus hand hygiene (adjusted odds ratio, 0.33 [95% CI, 0.13 to 0.87]). Adherence to interventions varied. Limitation: The delay from index patient symptom onset to intervention and variable adherence may have mitigated intervention effectiveness. Conclusion: Hand hygiene and facemasks seemed to prevent household transmission of influenza virus when implemented within 36 hours of index patient symptom onset. These findings suggest that nonpharmaceutical interventions are important for mitigation of pandemic and interpandemic influenza. Primary Funding Source: Centers for Disease Control and Prevention. © 2009 American College of Physicians.en_HK
dc.languageengen_HK
dc.publisherAmerican College of Physicians. The Journal's web site is located at http://www.annals.orgen_HK
dc.relation.ispartofAnnals of Internal Medicineen_HK
dc.subject.meshAdolescenten_HK
dc.subject.meshAdulten_HK
dc.subject.meshChilden_HK
dc.subject.meshChild, Preschoolen_HK
dc.subject.meshFamily Characteristicsen_HK
dc.subject.meshHandwashingen_HK
dc.subject.meshHong Kong - epidemiologyen_HK
dc.subject.meshHumansen_HK
dc.subject.meshInfluenza A virus - isolation & purificationen_HK
dc.subject.meshInfluenza B virus - isolation & purificationen_HK
dc.subject.meshInfluenza, Human - diagnosis - prevention & control - transmissionen_HK
dc.subject.meshMaleen_HK
dc.subject.meshMasksen_HK
dc.subject.meshMiddle Ageden_HK
dc.subject.meshPatient Complianceen_HK
dc.subject.meshPatient Education as Topicen_HK
dc.subject.meshProspective Studiesen_HK
dc.subject.meshReverse Transcriptase Polymerase Chain Reactionen_HK
dc.subject.meshRisk Factorsen_HK
dc.subject.meshTime Factorsen_HK
dc.subject.meshYoung Adulten_HK
dc.titleFacemasks and hand hygiene to prevent influenza transmission in households: A cluster randomized trialen_HK
dc.typeArticleen_HK
dc.identifier.openurlhttp://library.hku.hk:4550/resserv?sid=HKU:IR&issn=0003-4819&volume=151&issue=7&spage=437&epage=446&date=2009&atitle=Facemasks+and+hand+hygiene+to+prevent+influenza+transmission+in+households:+a+cluster+randomized+trialen_HK
dc.identifier.emailCowling, BJ: bcowling@hku.hken_HK
dc.identifier.emailPeiris, JSM: malik@hkucc.hku.hken_HK
dc.identifier.emailLeung, GM: gmleung@hku.hken_HK
dc.identifier.authorityCowling, BJ=rp01326en_HK
dc.identifier.authorityPeiris, JSM=rp00410en_HK
dc.identifier.authorityLeung, GM=rp00460en_HK
dc.description.naturelink_to_subscribed_fulltext-
dc.identifier.pmid19652172-
dc.identifier.scopuseid_2-s2.0-69249138556en_HK
dc.identifier.hkuros168209en_HK
dc.relation.referenceshttp://www.scopus.com/mlt/select.url?eid=2-s2.0-69249138556&selection=ref&src=s&origin=recordpageen_HK
dc.identifier.volume151en_HK
dc.identifier.issue7en_HK
dc.identifier.spage437en_HK
dc.identifier.epage446en_HK
dc.identifier.isiWOS:000270470500001-
dc.publisher.placeUnited Statesen_HK
dc.identifier.scopusauthoridCowling, BJ=8644765500en_HK
dc.identifier.scopusauthoridChan, KH=7406034307en_HK
dc.identifier.scopusauthoridFang, VJ=24474130400en_HK
dc.identifier.scopusauthoridCheng, CKY=24474272100en_HK
dc.identifier.scopusauthoridFung, ROP=24474481300en_HK
dc.identifier.scopusauthoridWai, W=35185575700en_HK
dc.identifier.scopusauthoridSin, J=35185795200en_HK
dc.identifier.scopusauthoridSeto, WH=7005799377en_HK
dc.identifier.scopusauthoridYung, R=7005594277en_HK
dc.identifier.scopusauthoridChu, DWS=35108889000en_HK
dc.identifier.scopusauthoridChiu, BCF=24474324500en_HK
dc.identifier.scopusauthoridLee, PWY=24474606700en_HK
dc.identifier.scopusauthoridChiu, MC=35184802200en_HK
dc.identifier.scopusauthoridLee, HC=35185221000en_HK
dc.identifier.scopusauthoridUyeki, TM=6603544967en_HK
dc.identifier.scopusauthoridHouck, PM=7004317844en_HK
dc.identifier.scopusauthoridPeiris, JSM=7005486823en_HK
dc.identifier.scopusauthoridLeung, GM=7007159841en_HK

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