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Article: Preliminary findings of a randomized trial of non-pharmaceutical interventions to prevent influenza transmission in households

TitlePreliminary findings of a randomized trial of non-pharmaceutical interventions to prevent influenza transmission in households
Authors
Issue Date2008
PublisherPublic Library of Science. The Journal's web site is located at http://www.plosone.org/home.action
Citation
Plos One, 2008, v. 3 n. 5 How to Cite?
AbstractBackground: There are sparse data on whether non-pharmaceutical interventions can reduce the spread of influenza. We implemented a study of the feasibility and efficacy of face masks and hand hygiene to reduce influenza transmission among Hong Kong household members. Methodology/Principal Findings: We conducted a cluster randomized controlled trial of households (composed of at least 3 members) where an index subject presented with influenza-like-illness of <48 hours duration. After influenza was confirmed in an index case by the QuickVue Influenza A+B rapid test, the household of the index subject was randomised to 1) control or 2) surgical face masks or 3) hand hygiene. Households were visited within 36 hours, and 3, 6 and 9 days later. Nose and throat swabs were collected from index subjects and all household contact at each home visit and tested by viral culture. The primary outcome measure was laboratory culture confirmed influenza in a household contact; the secondary outcome was clinically diagnosed influenza (by self-reported symptoms). We randomized 198 households and completed follow up home visits in 128; the index cases in 122 of those households had laboratory-confirmed influenza. There were 21 household contacts with laboratory confirmed influenza corresponding to a secondary attack ratio of 6%. Clinical secondary attack ratios varied from 5% to 18% depending on case definitions. The laboratory-based or clinical secondary attack ratios old not significantly differ across the intervention arms. Adherence to interventions was variable. Conclusions/Significance: The secondary attack ratios were lower than anticipated, and lower than reported in other countries, perhaps due to differing patterns of susceptibility, lack of significant antigenic drift in circulating influenza virus strains recently, and/or issues related to the symptomatic recruitment design. Lessons learn from this pilot have informed changes for the main study in 2008.
Persistent Identifierhttp://hdl.handle.net/10722/86944
ISSN
2015 Impact Factor: 3.057
2015 SCImago Journal Rankings: 1.395
PubMed Central ID
ISI Accession Number ID
Funding AgencyGrant Number
US Centers for Disease Control and Prevention1 U01 CI000439-01
Research Fund for the Control of Infectious Disease
Food and Health Bureau
Government of the Hong Kong SAR
Area of Excellence Scheme of the Hong Kong UniversityAoE/M-12/06
Funding Information:

This work has received financial support from the US Centers for Disease Control and Prevention (grant no. 1 U01 CI000439-01), the Research Fund for the Control of Infectious Disease, Food and Health Bureau, Government of the Hong Kong SAR, and the Area of Excellence Scheme of the Hong Kong University Grants Committee (grant no. AoE/M-12/06). The sponsors had no role in data collection and analysis, or the decision to publish, but the CDC was involved in study design and preparation of the manuscript. This work represents the views of the authors and not their institutions, including the Centers for Disease Control and Prevention.

References
Grants

 

DC FieldValueLanguage
dc.contributor.authorCowling, BJen_HK
dc.contributor.authorFung, ROPen_HK
dc.contributor.authorCheng, CKYen_HK
dc.contributor.authorFang, VJen_HK
dc.contributor.authorChan, KHen_HK
dc.contributor.authorSeto, WHen_HK
dc.contributor.authorYung, Ren_HK
dc.contributor.authorChiu, Ben_HK
dc.contributor.authorLee, Pen_HK
dc.contributor.authorUyeki, TMen_HK
dc.contributor.authorHouck, PMen_HK
dc.contributor.authorPeiris, JSMen_HK
dc.contributor.authorLeung, GMen_HK
dc.date.accessioned2010-09-06T09:23:15Z-
dc.date.available2010-09-06T09:23:15Z-
dc.date.issued2008en_HK
dc.identifier.citationPlos One, 2008, v. 3 n. 5en_HK
dc.identifier.issn1932-6203en_HK
dc.identifier.urihttp://hdl.handle.net/10722/86944-
dc.description.abstractBackground: There are sparse data on whether non-pharmaceutical interventions can reduce the spread of influenza. We implemented a study of the feasibility and efficacy of face masks and hand hygiene to reduce influenza transmission among Hong Kong household members. Methodology/Principal Findings: We conducted a cluster randomized controlled trial of households (composed of at least 3 members) where an index subject presented with influenza-like-illness of <48 hours duration. After influenza was confirmed in an index case by the QuickVue Influenza A+B rapid test, the household of the index subject was randomised to 1) control or 2) surgical face masks or 3) hand hygiene. Households were visited within 36 hours, and 3, 6 and 9 days later. Nose and throat swabs were collected from index subjects and all household contact at each home visit and tested by viral culture. The primary outcome measure was laboratory culture confirmed influenza in a household contact; the secondary outcome was clinically diagnosed influenza (by self-reported symptoms). We randomized 198 households and completed follow up home visits in 128; the index cases in 122 of those households had laboratory-confirmed influenza. There were 21 household contacts with laboratory confirmed influenza corresponding to a secondary attack ratio of 6%. Clinical secondary attack ratios varied from 5% to 18% depending on case definitions. The laboratory-based or clinical secondary attack ratios old not significantly differ across the intervention arms. Adherence to interventions was variable. Conclusions/Significance: The secondary attack ratios were lower than anticipated, and lower than reported in other countries, perhaps due to differing patterns of susceptibility, lack of significant antigenic drift in circulating influenza virus strains recently, and/or issues related to the symptomatic recruitment design. Lessons learn from this pilot have informed changes for the main study in 2008.en_HK
dc.languageengen_HK
dc.publisherPublic Library of Science. The Journal's web site is located at http://www.plosone.org/home.actionen_HK
dc.relation.ispartofPLoS ONEen_HK
dc.rightsCreative Commons: Attribution 3.0 Hong Kong License-
dc.subject.meshFamily Characteristics-
dc.subject.meshHandwashing-
dc.subject.meshHygiene-
dc.subject.meshInfluenza, Human - epidemiology - prevention and control - transmission-
dc.subject.meshMasks - statistics and numerical data-
dc.titlePreliminary findings of a randomized trial of non-pharmaceutical interventions to prevent influenza transmission in householdsen_HK
dc.typeArticleen_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.naturepublished_or_final_version-
dc.identifier.doi10.1371/journal.pone.0002101en_HK
dc.identifier.pmid18461182-
dc.identifier.pmcidPMC2364646-
dc.identifier.scopuseid_2-s2.0-47749102139en_HK
dc.identifier.hkuros142479en_HK
dc.relation.referenceshttp://www.scopus.com/mlt/select.url?eid=2-s2.0-47749102139&selection=ref&src=s&origin=recordpageen_HK
dc.identifier.volume3en_HK
dc.identifier.issue5en_HK
dc.identifier.spagee2101-
dc.identifier.epagee2101-
dc.identifier.isiWOS:000261642400023-
dc.publisher.placeUnited Statesen_HK
dc.relation.projectControl of Pandemic and Inter-pandemic Influenza-
dc.identifier.scopusauthoridCowling, BJ=8644765500en_HK
dc.identifier.scopusauthoridFung, ROP=24474481300en_HK
dc.identifier.scopusauthoridCheng, CKY=24474272100en_HK
dc.identifier.scopusauthoridFang, VJ=24474130400en_HK
dc.identifier.scopusauthoridChan, KH=7406034307en_HK
dc.identifier.scopusauthoridSeto, WH=7005799377en_HK
dc.identifier.scopusauthoridYung, R=7005594277en_HK
dc.identifier.scopusauthoridChiu, B=24474324500en_HK
dc.identifier.scopusauthoridLee, P=24474606700en_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
dc.identifier.citeulike4645805-

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