tetano
Editor, Senior Moderator
Pediatric Infectious Disease Journal:
POST AUTHOR CORRECTIONS, 17 June 2011
doi: 10.1097/INF.0b013e3182218656
Original Studies: PDF Only
Reduction in the Incidence of Influenza A But Not Influenza B Associated With Use of Hand Sanitizer and Cough Hygiene in Schools: A Randomized Controlled Trial
Stebbins, Samuel MD, MPH; Cummings, Derek A. T. PhD; Stark, James H. MPH; Vukotich, Chuck MS; Mitruka, Kiren MD, MPH; Thompson, William PhD; Rinaldo, Charles PhD; Roth, Loren MD; Wagner, Michael PhD; Wisniewski, Stephen R. PhD; Dato, Virginia MD, MPH; Eng, Heather MS; Burke, Donald S. MD
Published Ahead-of-Print
Abstract
Background: Laboratory-based evidence is lacking regarding the efficacy of nonpharmaceutical interventions (NPIs) such as alcohol-based hand sanitizer and respiratory hygiene to reduce the spread of influenza.
Methods: The Pittsburgh Influenza Prevention Project was a cluster-randomized trial conducted in 10 elementary schools in Pittsburgh, PA, during the 2007 to 2008 influenza season. Children in 5 intervention schools received training in hand and respiratory hygiene, and were provided and encouraged to use hand sanitizer regularly. Children in 5 schools acted as controls. Children with influenza-like illness were tested for influenza A and B by reverse-transcriptase polymerase chain reaction.
Results: A total of 3360 children participated in this study. Using reverse-transcriptase polymerase chain reaction, 54 cases of influenza A and 50 cases of influenza B were detected. We found no significant effect of the intervention on the primary study outcome of all laboratory-confirmed influenza cases (incidence rate ratio [IRR]: 0.81; 95% confidence interval [CI]: 0.54, 1.23). However, we did find statistically significant differences in protocol-specified ancillary outcomes. Children in intervention schools had significantly fewer laboratory-confirmed influenza A infections than children in control schools, with an adjusted IRR of 0.48 (95% CI: 0.26, 0.87). Total absent episodes were also significantly lower among the intervention group than among the control group; adjusted IRR 0.74 (95% CI: 0.56, 0.97).
Conclusions: NPIs (respiratory hygiene education and the regular use of hand sanitizer) did not reduce total laboratory-confirmed influenza. However, the interventions did reduce school total absence episodes by 26% and laboratory-confirmed influenza A infections by 52%. Our results suggest that NPIs can be an important adjunct to influenza vaccination programs to reduce the number of influenza A infections among children.
http://journals.lww.com/pidj/Abstra...e_Incidence_of_Influenza_A_But_Not.98975.aspx
POST AUTHOR CORRECTIONS, 17 June 2011
doi: 10.1097/INF.0b013e3182218656
Original Studies: PDF Only
Reduction in the Incidence of Influenza A But Not Influenza B Associated With Use of Hand Sanitizer and Cough Hygiene in Schools: A Randomized Controlled Trial
Stebbins, Samuel MD, MPH; Cummings, Derek A. T. PhD; Stark, James H. MPH; Vukotich, Chuck MS; Mitruka, Kiren MD, MPH; Thompson, William PhD; Rinaldo, Charles PhD; Roth, Loren MD; Wagner, Michael PhD; Wisniewski, Stephen R. PhD; Dato, Virginia MD, MPH; Eng, Heather MS; Burke, Donald S. MD
Published Ahead-of-Print
Abstract
Background: Laboratory-based evidence is lacking regarding the efficacy of nonpharmaceutical interventions (NPIs) such as alcohol-based hand sanitizer and respiratory hygiene to reduce the spread of influenza.
Methods: The Pittsburgh Influenza Prevention Project was a cluster-randomized trial conducted in 10 elementary schools in Pittsburgh, PA, during the 2007 to 2008 influenza season. Children in 5 intervention schools received training in hand and respiratory hygiene, and were provided and encouraged to use hand sanitizer regularly. Children in 5 schools acted as controls. Children with influenza-like illness were tested for influenza A and B by reverse-transcriptase polymerase chain reaction.
Results: A total of 3360 children participated in this study. Using reverse-transcriptase polymerase chain reaction, 54 cases of influenza A and 50 cases of influenza B were detected. We found no significant effect of the intervention on the primary study outcome of all laboratory-confirmed influenza cases (incidence rate ratio [IRR]: 0.81; 95% confidence interval [CI]: 0.54, 1.23). However, we did find statistically significant differences in protocol-specified ancillary outcomes. Children in intervention schools had significantly fewer laboratory-confirmed influenza A infections than children in control schools, with an adjusted IRR of 0.48 (95% CI: 0.26, 0.87). Total absent episodes were also significantly lower among the intervention group than among the control group; adjusted IRR 0.74 (95% CI: 0.56, 0.97).
Conclusions: NPIs (respiratory hygiene education and the regular use of hand sanitizer) did not reduce total laboratory-confirmed influenza. However, the interventions did reduce school total absence episodes by 26% and laboratory-confirmed influenza A infections by 52%. Our results suggest that NPIs can be an important adjunct to influenza vaccination programs to reduce the number of influenza A infections among children.
http://journals.lww.com/pidj/Abstra...e_Incidence_of_Influenza_A_But_Not.98975.aspx