Giuseppe
Emeritus
[Source: PLoS ONE, full text: (LINK). Abstract, edited.]
Facemasks, Hand Hygiene, and Influenza among Young Adults: A Randomized Intervention Trial
Clinicaltrials.gov NCT00490633
Allison E. Aiello<SUP>1</SUP><SUP>,</SUP><SUP>2</SUP><SUP>*</SUP>, Vanessa Perez<SUP>1</SUP><SUP>,</SUP><SUP>2</SUP>, Rebecca M. Coulborn<SUP>1</SUP><SUP>,</SUP><SUP>2</SUP>, Brian M. Davis<SUP>1</SUP><SUP>,</SUP><SUP>2</SUP>, Monica Uddin<SUP>1</SUP><SUP>,</SUP><SUP>2</SUP>, Arnold S. Monto<SUP>1</SUP>
1 Department of Epidemiology, University of Michigan-School of Public Health, Ann Arbor, Michigan, United States of America, 2 Center for Social Epidemiology & Population, University of Michigan-School of Public Health, Ann Arbor, Michigan, United States of America
Abstract
Limited vaccine availability and the potential for resistance to antiviral medications have led to calls for establishing the efficacy of non-pharmaceutical measures for mitigating pandemic influenza. Our objective was to examine if the use of face masks and hand hygiene reduced rates of influenza-like illness (ILI) and laboratory-confirmed influenza in the natural setting. A cluster-randomized intervention trial was designed involving 1,178 young adults living in 37 residence houses in 5 university residence halls during the 2007?2008 influenza season. Participants were assigned to face mask and hand hygiene, face mask only, or control group during the study. Discrete-time survival models using generalized estimating equations to estimate intervention effects on ILI and confirmed influenza A/B infection over a 6-week study period were examined. A significant reduction in the rate of ILI was observed in weeks 3 through 6 of the study, with a maximum reduction of 75% during the final study week (rate ratio [RR] = 0.25, [95% CI, 0.07 to 0.87]). Both intervention groups compared to the control showed cumulative reductions in rates of influenza over the study period, although results did not reach statistical significance. Generalizability limited to similar settings and age groups. Face masks and hand hygiene combined may reduce the rate of ILI and confirmed influenza in community settings. These non-pharmaceutical measures should be recommended in crowded settings at the start of an influenza pandemic.
Trail Registration: Clinicaltrials.gov NCT00490633
Citation: Aiello AE, Perez V, Coulborn RM, Davis BM, Uddin M, et al. (2012) Facemasks, Hand Hygiene, and Influenza among Young Adults: A Randomized Intervention Trial. PLoS ONE 7(1): e29744. doi:10.1371/journal.pone.0029744
Editor: Yang Yang, Fred Hutchinson Cancer Research Center, United States of America
Received: July 29, 2011; Accepted: December 2, 2011; Published: January 25, 2012
Copyright: ? 2012 Aiello et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
Funding: This work was supported by funding from the Centers for Disease Control (CDC) and Prevention Grant U01 C1000441 (www.cdc.gov)(PIs: AM and AA). The findings and conclusions in this report are those of the authors and do not necessarily represent the views of the CDC. The CDC had a role in the design and conduct of the study and interpretation of data; they did not have a role in the collection, management, write-up or analysis of the data. Warner Lambert provided hand sanitizer without any involvement in the study design, analysis, results, or writing of the manuscript.
Competing interests: Warner Lambert provided hand sanitizer without any involvement in the study design, analysis, results, or writing of the manuscript. This does not alter the authors' adherence to all the PLoS ONE policies on sharing data and materials.
* E-mail: aielloa@umich.edu
- ------Clinicaltrials.gov NCT00490633
Allison E. Aiello<SUP>1</SUP><SUP>,</SUP><SUP>2</SUP><SUP>*</SUP>, Vanessa Perez<SUP>1</SUP><SUP>,</SUP><SUP>2</SUP>, Rebecca M. Coulborn<SUP>1</SUP><SUP>,</SUP><SUP>2</SUP>, Brian M. Davis<SUP>1</SUP><SUP>,</SUP><SUP>2</SUP>, Monica Uddin<SUP>1</SUP><SUP>,</SUP><SUP>2</SUP>, Arnold S. Monto<SUP>1</SUP>
1 Department of Epidemiology, University of Michigan-School of Public Health, Ann Arbor, Michigan, United States of America, 2 Center for Social Epidemiology & Population, University of Michigan-School of Public Health, Ann Arbor, Michigan, United States of America
Abstract
Limited vaccine availability and the potential for resistance to antiviral medications have led to calls for establishing the efficacy of non-pharmaceutical measures for mitigating pandemic influenza. Our objective was to examine if the use of face masks and hand hygiene reduced rates of influenza-like illness (ILI) and laboratory-confirmed influenza in the natural setting. A cluster-randomized intervention trial was designed involving 1,178 young adults living in 37 residence houses in 5 university residence halls during the 2007?2008 influenza season. Participants were assigned to face mask and hand hygiene, face mask only, or control group during the study. Discrete-time survival models using generalized estimating equations to estimate intervention effects on ILI and confirmed influenza A/B infection over a 6-week study period were examined. A significant reduction in the rate of ILI was observed in weeks 3 through 6 of the study, with a maximum reduction of 75% during the final study week (rate ratio [RR] = 0.25, [95% CI, 0.07 to 0.87]). Both intervention groups compared to the control showed cumulative reductions in rates of influenza over the study period, although results did not reach statistical significance. Generalizability limited to similar settings and age groups. Face masks and hand hygiene combined may reduce the rate of ILI and confirmed influenza in community settings. These non-pharmaceutical measures should be recommended in crowded settings at the start of an influenza pandemic.
Trail Registration: Clinicaltrials.gov NCT00490633
Citation: Aiello AE, Perez V, Coulborn RM, Davis BM, Uddin M, et al. (2012) Facemasks, Hand Hygiene, and Influenza among Young Adults: A Randomized Intervention Trial. PLoS ONE 7(1): e29744. doi:10.1371/journal.pone.0029744
Editor: Yang Yang, Fred Hutchinson Cancer Research Center, United States of America
Received: July 29, 2011; Accepted: December 2, 2011; Published: January 25, 2012
Copyright: ? 2012 Aiello et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
Funding: This work was supported by funding from the Centers for Disease Control (CDC) and Prevention Grant U01 C1000441 (www.cdc.gov)(PIs: AM and AA). The findings and conclusions in this report are those of the authors and do not necessarily represent the views of the CDC. The CDC had a role in the design and conduct of the study and interpretation of data; they did not have a role in the collection, management, write-up or analysis of the data. Warner Lambert provided hand sanitizer without any involvement in the study design, analysis, results, or writing of the manuscript.
Competing interests: Warner Lambert provided hand sanitizer without any involvement in the study design, analysis, results, or writing of the manuscript. This does not alter the authors' adherence to all the PLoS ONE policies on sharing data and materials.
* E-mail: aielloa@umich.edu