Washing hands and covering coughs may help limit the spread of pandemic flu, but more research on such nonpharmaceutical interventions is needed, a new study has found.
The study, published in the May issue of the American Journal of Infection Control, found that while significant knowledge has been gained about using nonpharmaceutical interventions and the transmission of pandemic flu, key concerns and gaps in the research related to the acceptability and effectiveness of such measures remain.
The H1N1 influenza pandemic may provide an opportunity to address many of the research gaps “and ultimately create a broad, comprehensive strategy for pandemic mitigation,” said Allison E. Aiello, PhD, MS, assistant professor of epidemiology at the University of Michigan School of Public Health.
“The emergence of (the H1N1) pandemic in 2009 demonstrated that there are still more questions than answers,” Aiello said. “More research is urgently needed, especially in light of the potential for mutations in (H1N1). If mutations do occur, or if new pandemic strains emerge in the future, (nonpharmaceutical interventions) likely will play a crucial role in mitigating the spread of infection when vaccines are unable to provide sufficient protection.”
Nonpharmaceutical interventions are measures other than vaccines and antiviral treatments that can reduce the harm and spread of disease, including frequent handwashing with soap and water, using alcohol-based hand sanitizers, covering sneezes and coughs, wearing face masks, closing schools, working from home and restricting public gatherings.
In compiling the study, researchers assessed data from 11 studies funded by the Centers for Disease Control and Prevention from 2007 to 2009 evaluating the potential for interventions other than vaccines and antiviral medications to slow or limit the transmission of pandemic influenza, both in communities and across international air, land and sea borders. The researchers used seasonal influenza outbreaks as a model for testing preventive measures for future influenza pandemics, as well as historical research of past pandemics.
The studies assessed the effectiveness of using combinations of nonpharmaceutical interventions based on CDC’s hypothesis that the approach could create multiple barriers to stop the transmission of influenza. Results from several of the studies suggest that protective measures perceived as part of typical daily routines were frequently practiced. For example, researchers found high compliance in regard to sanitizing hands with alcoholbased preparations, washing hands with soap and water, and covering sneezes and coughs. However, most of the studies showed low compliance in regard to using face masks.
“Taken together, the data provide some evidence that face masks, hand hygiene, cough etiquette, reduced crowding and school closures are effective in reducing the spread of influenza,” the study authors concluded. “Nonetheless, further studies with larger sample sizes, common methodologies to allow pooling of data and study durations that cover multiple influenza seasons are needed.”
The researchers also noted a need to include assessments of psychosocial and cultural factors that influence compliance with nonpharmaceutical interventions, such as why certain groups accept them while others do not, and whether barriers to compliance are lifted during a global pandemic.
The study is available at http://ajicjournal.org.
- Copyright The Nation’s Health, American Public Health Association
