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November 23, 2014

Hygiene should be priority in pandemic plans

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Hygiene and physical measures, such as handwashing, wearing masks and isolating potentially infected patients, are highly effective in preventing the spread of viral infections and should be given higher priority in national pandemic preparation plans, according to researchers.
Those recommendations followed an analysis of 59 published studies on the effectiveness of physical measures to interrupt or reduce the spread of respiratory viruses.


They included any intervention to prevent viral animal-to-human or human-to-human transmission of respiratory viruses – isolation, quarantine, social distancing, barriers, personal protection and hygiene – compared with do-nothing or with another intervention. They excluded vaccines and antiviral drugs.
Differences in study design and quality were taken into account to minimise bias.
The results show that washing hands more than 10 times a day and wearing masks, gloves and gowns were effective individually against all forms of acute infectious respiratory disease, and were even more effective when combined.
The highest quality trials suggested that spread of respiratory viruses can best be prevented by hygienic measures in younger children and within households.
The team found limited evidence that the more uncomfortable and expensive N95 masks were superior to simple surgical masks and they can also cause skin irritation.
However, the effect of adding antiseptics to normal handwashing to reduce respiratory disease remains uncertain.
Global measures, such as screening at entry ports were not properly evaluated, and there was limited evidence that social distancing was effective.
Many simple and low cost measures can be highly effective at reducing transmission of epidemic respiratory viruses around high risk of transmission, especially when they are part of a structured programme including education, and when they are delivered together, say the study’s authors.
BMJ Online, available at: http://www.bmj.com/cgi/doi/10.1136/bmj.b3675