The role of facemasks and hand hygiene in the prevention of influenza transmission in households: results from a cluster randomised trial; Berlin, Germany, 2009-2011.
Identifieur interne : 000227 ( Main/Exploration ); précédent : 000226; suivant : 000228The role of facemasks and hand hygiene in the prevention of influenza transmission in households: results from a cluster randomised trial; Berlin, Germany, 2009-2011.
Auteurs : Thorsten Suess [Allemagne] ; Cornelius Remschmidt ; Susanne B. Schink ; Brunhilde Schweiger ; Andreas Nitsche ; Kati Schroeder ; Joerg Doellinger ; Jeanette Milde ; Walter Haas ; Irina Koehler ; Gérard Krause ; Udo BuchholzSource :
- BMC infectious diseases [ 1471-2334 ] ; 2012.
Descripteurs français
- KwdFr :
- Adolescent, Adulte, Adulte d'âge moyen, Berlin, Caractéristiques familiales, Désinfection des mains (), Enfant, Enfant d'âge préscolaire, Enquêtes et questionnaires, Femelle, Grippe humaine (), Grippe humaine (transmission), Humains, Jeune adulte, Masques (), Mâle, Observance thérapeutique (), Résultat thérapeutique, Santé de la famille, Sujet âgé, Sujet âgé de 80 ans ou plus.
- MESH :
- Adolescent, Adulte, Adulte d'âge moyen, Berlin, Caractéristiques familiales, Désinfection des mains, Enfant, Enfant d'âge préscolaire, Enquêtes et questionnaires, Femelle, Grippe humaine, Humains, Jeune adulte, Masques, Mâle, Observance thérapeutique, Résultat thérapeutique, Santé de la famille, Sujet âgé, Sujet âgé de 80 ans ou plus.
English descriptors
- KwdEn :
- Adolescent, Adult, Aged, Aged, 80 and over, Berlin, Child, Child, Preschool, Family Characteristics, Family Health, Female, Hand Disinfection (methods), Humans, Influenza, Human (prevention & control), Influenza, Human (transmission), Male, Masks (statistics & numerical data), Middle Aged, Patient Compliance (statistics & numerical data), Surveys and Questionnaires, Treatment Outcome, Young Adult.
- MESH :
- methods : Hand Disinfection.
- prevention & control : Influenza, Human.
- statistics & numerical data : Masks, Patient Compliance.
- transmission : Influenza, Human.
- Adolescent, Adult, Aged, Aged, 80 and over, Berlin, Child, Child, Preschool, Family Characteristics, Family Health, Female, Humans, Male, Middle Aged, Surveys and Questionnaires, Treatment Outcome, Young Adult.
Abstract
BACKGROUND
Previous controlled studies on the effect of non-pharmaceutical interventions (NPI) - namely the use of facemasks and intensified hand hygiene - in preventing household transmission of influenza have not produced definitive results. We aimed to investigate efficacy, acceptability, and tolerability of NPI in households with influenza index patients.
METHODS
We conducted a cluster randomized controlled trial during the pandemic season 2009/10 and the ensuing influenza season 2010/11. We included households with an influenza positive index case in the absence of further respiratory illness within the preceding 14 days. Study arms were wearing a facemask and practicing intensified hand hygiene (MH group), wearing facemasks only (M group) and none of the two (control group). Main outcome measure was laboratory confirmed influenza infection in a household contact. We used daily questionnaires to examine adherence and tolerability of the interventions.
RESULTS
We recruited 84 households (30 control, 26 M and 28 MH households) with 82, 69 and 67 household contacts, respectively. In 2009/10 all 41 index cases had a influenza A (H1N1) pdm09 infection, in 2010/11 24 had an A (H1N1) pdm09 and 20 had a B infection. The total secondary attack rate was 16% (35/218). In intention-to-treat analysis there was no statistically significant effect of the M and MH interventions on secondary infections. When analysing only households where intervention was implemented within 36 h after symptom onset of the index case, secondary infection in the pooled M and MH groups was significantly lower compared to the control group (adjusted odds ratio 0.16, 95% CI, 0.03-0.92). In a per-protocol analysis odds ratios were significantly reduced among participants of the M group (adjusted odds ratio, 0.30, 95% CI, 0.10-0.94). With the exception of MH index cases in 2010/11 adherence was good for adults and children, contacts and index cases.
CONCLUSIONS
Results suggest that household transmission of influenza can be reduced by the use of NPI, such as facemasks and intensified hand hygiene, when implemented early and used diligently. Concerns about acceptability and tolerability of the interventions should not be a reason against their recommendation.
TRIAL REGISTRATION
The study was registered with ClinicalTrials.gov (Identifier NCT00833885).
DOI: 10.1186/1471-2334-12-26
PubMed: 22280120
Affiliations:
Links toward previous steps (curation, corpus...)
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Schink</name></author><author><name sortKey="Schweiger, Brunhilde" sort="Schweiger, Brunhilde" uniqKey="Schweiger B" first="Brunhilde" last="Schweiger">Brunhilde Schweiger</name></author><author><name sortKey="Nitsche, Andreas" sort="Nitsche, Andreas" uniqKey="Nitsche A" first="Andreas" last="Nitsche">Andreas Nitsche</name></author><author><name sortKey="Schroeder, Kati" sort="Schroeder, Kati" uniqKey="Schroeder K" first="Kati" last="Schroeder">Kati Schroeder</name></author><author><name sortKey="Doellinger, Joerg" sort="Doellinger, Joerg" uniqKey="Doellinger J" first="Joerg" last="Doellinger">Joerg Doellinger</name></author><author><name sortKey="Milde, Jeanette" sort="Milde, Jeanette" uniqKey="Milde J" first="Jeanette" last="Milde">Jeanette Milde</name></author><author><name sortKey="Haas, Walter" sort="Haas, Walter" uniqKey="Haas W" first="Walter" last="Haas">Walter Haas</name></author><author><name sortKey="Koehler, Irina" sort="Koehler, Irina" uniqKey="Koehler I" first="Irina" last="Koehler">Irina Koehler</name></author><author><name sortKey="Krause, Gerard" sort="Krause, Gerard" uniqKey="Krause G" first="Gérard" last="Krause">Gérard Krause</name></author><author><name sortKey="Buchholz, Udo" sort="Buchholz, Udo" uniqKey="Buchholz U" first="Udo" last="Buchholz">Udo Buchholz</name></author></analytic><series><title level="j">BMC infectious diseases</title><idno type="eISSN">1471-2334</idno><imprint><date when="2012" type="published">2012</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Adolescent</term><term>Adult</term><term>Aged</term><term>Aged, 80 and over</term><term>Berlin</term><term>Child</term><term>Child, Preschool</term><term>Family Characteristics</term><term>Family Health</term><term>Female</term><term>Hand Disinfection (methods)</term><term>Humans</term><term>Influenza, Human (prevention & control)</term><term>Influenza, Human (transmission)</term><term>Male</term><term>Masks (statistics & numerical data)</term><term>Middle Aged</term><term>Patient Compliance (statistics & numerical data)</term><term>Surveys and Questionnaires</term><term>Treatment Outcome</term><term>Young Adult</term></keywords><keywords scheme="KwdFr" xml:lang="fr"><term>Adolescent</term><term>Adulte</term><term>Adulte d'âge moyen</term><term>Berlin</term><term>Caractéristiques familiales</term><term>Désinfection des mains ()</term><term>Enfant</term><term>Enfant d'âge préscolaire</term><term>Enquêtes et questionnaires</term><term>Femelle</term><term>Grippe humaine ()</term><term>Grippe humaine (transmission)</term><term>Humains</term><term>Jeune adulte</term><term>Masques ()</term><term>Mâle</term><term>Observance thérapeutique ()</term><term>Résultat thérapeutique</term><term>Santé de la famille</term><term>Sujet âgé</term><term>Sujet âgé de 80 ans ou plus</term></keywords><keywords scheme="MESH" qualifier="methods" xml:lang="en"><term>Hand Disinfection</term></keywords><keywords scheme="MESH" qualifier="prevention & control" xml:lang="en"><term>Influenza, Human</term></keywords><keywords scheme="MESH" qualifier="statistics & numerical data" xml:lang="en"><term>Masks</term><term>Patient Compliance</term></keywords><keywords scheme="MESH" qualifier="transmission" xml:lang="en"><term>Influenza, Human</term></keywords><keywords scheme="MESH" xml:lang="en"><term>Adolescent</term><term>Adult</term><term>Aged</term><term>Aged, 80 and over</term><term>Berlin</term><term>Child</term><term>Child, Preschool</term><term>Family Characteristics</term><term>Family Health</term><term>Female</term><term>Humans</term><term>Male</term><term>Middle Aged</term><term>Surveys and Questionnaires</term><term>Treatment Outcome</term><term>Young Adult</term></keywords><keywords scheme="MESH" xml:lang="fr"><term>Adolescent</term><term>Adulte</term><term>Adulte d'âge moyen</term><term>Berlin</term><term>Caractéristiques familiales</term><term>Désinfection des mains</term><term>Enfant</term><term>Enfant d'âge préscolaire</term><term>Enquêtes et questionnaires</term><term>Femelle</term><term>Grippe humaine</term><term>Humains</term><term>Jeune adulte</term><term>Masques</term><term>Mâle</term><term>Observance thérapeutique</term><term>Résultat thérapeutique</term><term>Santé de la famille</term><term>Sujet âgé</term><term>Sujet âgé de 80 ans ou plus</term></keywords></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><p><b>BACKGROUND</b></p><p>Previous controlled studies on the effect of non-pharmaceutical interventions (NPI) - namely the use of facemasks and intensified hand hygiene - in preventing household transmission of influenza have not produced definitive results. We aimed to investigate efficacy, acceptability, and tolerability of NPI in households with influenza index patients.</p></div><div type="abstract" xml:lang="en"><p><b>METHODS</b></p><p>We conducted a cluster randomized controlled trial during the pandemic season 2009/10 and the ensuing influenza season 2010/11. We included households with an influenza positive index case in the absence of further respiratory illness within the preceding 14 days. Study arms were wearing a facemask and practicing intensified hand hygiene (MH group), wearing facemasks only (M group) and none of the two (control group). Main outcome measure was laboratory confirmed influenza infection in a household contact. We used daily questionnaires to examine adherence and tolerability of the interventions.</p></div><div type="abstract" xml:lang="en"><p><b>RESULTS</b></p><p>We recruited 84 households (30 control, 26 M and 28 MH households) with 82, 69 and 67 household contacts, respectively. In 2009/10 all 41 index cases had a influenza A (H1N1) pdm09 infection, in 2010/11 24 had an A (H1N1) pdm09 and 20 had a B infection. The total secondary attack rate was 16% (35/218). In intention-to-treat analysis there was no statistically significant effect of the M and MH interventions on secondary infections. When analysing only households where intervention was implemented within 36 h after symptom onset of the index case, secondary infection in the pooled M and MH groups was significantly lower compared to the control group (adjusted odds ratio 0.16, 95% CI, 0.03-0.92). In a per-protocol analysis odds ratios were significantly reduced among participants of the M group (adjusted odds ratio, 0.30, 95% CI, 0.10-0.94). With the exception of MH index cases in 2010/11 adherence was good for adults and children, contacts and index cases.</p></div><div type="abstract" xml:lang="en"><p><b>CONCLUSIONS</b></p><p>Results suggest that household transmission of influenza can be reduced by the use of NPI, such as facemasks and intensified hand hygiene, when implemented early and used diligently. Concerns about acceptability and tolerability of the interventions should not be a reason against their recommendation.</p></div><div type="abstract" xml:lang="en"><p><b>TRIAL REGISTRATION</b></p><p>The study was registered with ClinicalTrials.gov (Identifier NCT00833885).</p></div></front></TEI><pubmed><MedlineCitation Status="MEDLINE" Owner="NLM"><PMID Version="1">22280120</PMID><DateCompleted><Year>2012</Year><Month>05</Month><Day>17</Day></DateCompleted><DateRevised><Year>2018</Year><Month>12</Month><Day>01</Day></DateRevised><Article PubModel="Electronic"><Journal><ISSN IssnType="Electronic">1471-2334</ISSN><JournalIssue CitedMedium="Internet"><Volume>12</Volume><PubDate><Year>2012</Year><Month>Jan</Month><Day>26</Day></PubDate></JournalIssue><Title>BMC infectious diseases</Title><ISOAbbreviation>BMC Infect. Dis.</ISOAbbreviation></Journal><ArticleTitle>The role of facemasks and hand hygiene in the prevention of influenza transmission in households: results from a cluster randomised trial; Berlin, Germany, 2009-2011.</ArticleTitle><Pagination><MedlinePgn>26</MedlinePgn></Pagination><ELocationID EIdType="doi" ValidYN="Y">10.1186/1471-2334-12-26</ELocationID><Abstract><AbstractText Label="BACKGROUND" NlmCategory="BACKGROUND">Previous controlled studies on the effect of non-pharmaceutical interventions (NPI) - namely the use of facemasks and intensified hand hygiene - in preventing household transmission of influenza have not produced definitive results. We aimed to investigate efficacy, acceptability, and tolerability of NPI in households with influenza index patients.</AbstractText><AbstractText Label="METHODS" NlmCategory="METHODS">We conducted a cluster randomized controlled trial during the pandemic season 2009/10 and the ensuing influenza season 2010/11. We included households with an influenza positive index case in the absence of further respiratory illness within the preceding 14 days. Study arms were wearing a facemask and practicing intensified hand hygiene (MH group), wearing facemasks only (M group) and none of the two (control group). Main outcome measure was laboratory confirmed influenza infection in a household contact. We used daily questionnaires to examine adherence and tolerability of the interventions.</AbstractText><AbstractText Label="RESULTS" NlmCategory="RESULTS">We recruited 84 households (30 control, 26 M and 28 MH households) with 82, 69 and 67 household contacts, respectively. In 2009/10 all 41 index cases had a influenza A (H1N1) pdm09 infection, in 2010/11 24 had an A (H1N1) pdm09 and 20 had a B infection. The total secondary attack rate was 16% (35/218). In intention-to-treat analysis there was no statistically significant effect of the M and MH interventions on secondary infections. When analysing only households where intervention was implemented within 36 h after symptom onset of the index case, secondary infection in the pooled M and MH groups was significantly lower compared to the control group (adjusted odds ratio 0.16, 95% CI, 0.03-0.92). In a per-protocol analysis odds ratios were significantly reduced among participants of the M group (adjusted odds ratio, 0.30, 95% CI, 0.10-0.94). With the exception of MH index cases in 2010/11 adherence was good for adults and children, contacts and index cases.</AbstractText><AbstractText Label="CONCLUSIONS" NlmCategory="CONCLUSIONS">Results suggest that household transmission of influenza can be reduced by the use of NPI, such as facemasks and intensified hand hygiene, when implemented early and used diligently. Concerns about acceptability and tolerability of the interventions should not be a reason against their recommendation.</AbstractText><AbstractText Label="TRIAL REGISTRATION" NlmCategory="BACKGROUND">The study was registered with ClinicalTrials.gov (Identifier NCT00833885).</AbstractText></Abstract><AuthorList CompleteYN="Y"><Author ValidYN="Y"><LastName>Suess</LastName><ForeName>Thorsten</ForeName><Initials>T</Initials><AffiliationInfo><Affiliation>Department of Infectious Disease Epidemiology, Robert Koch Institute, DGZ-Ring 1, 13086 Berlin, Germany. SuessT@rki.de</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Remschmidt</LastName><ForeName>Cornelius</ForeName><Initials>C</Initials></Author><Author ValidYN="Y"><LastName>Schink</LastName><ForeName>Susanne B</ForeName><Initials>SB</Initials></Author><Author ValidYN="Y"><LastName>Schweiger</LastName><ForeName>Brunhilde</ForeName><Initials>B</Initials></Author><Author ValidYN="Y"><LastName>Nitsche</LastName><ForeName>Andreas</ForeName><Initials>A</Initials></Author><Author ValidYN="Y"><LastName>Schroeder</LastName><ForeName>Kati</ForeName><Initials>K</Initials></Author><Author ValidYN="Y"><LastName>Doellinger</LastName><ForeName>Joerg</ForeName><Initials>J</Initials></Author><Author ValidYN="Y"><LastName>Milde</LastName><ForeName>Jeanette</ForeName><Initials>J</Initials></Author><Author ValidYN="Y"><LastName>Haas</LastName><ForeName>Walter</ForeName><Initials>W</Initials></Author><Author ValidYN="Y"><LastName>Koehler</LastName><ForeName>Irina</ForeName><Initials>I</Initials></Author><Author ValidYN="Y"><LastName>Krause</LastName><ForeName>Gérard</ForeName><Initials>G</Initials></Author><Author ValidYN="Y"><LastName>Buchholz</LastName><ForeName>Udo</ForeName><Initials>U</Initials></Author></AuthorList><Language>eng</Language><DataBankList CompleteYN="Y"><DataBank><DataBankName>ClinicalTrials.gov</DataBankName><AccessionNumberList><AccessionNumber>NCT00833885</AccessionNumber></AccessionNumberList></DataBank></DataBankList><PublicationTypeList><PublicationType UI="D016428">Journal Article</PublicationType><PublicationType UI="D016449">Randomized Controlled Trial</PublicationType><PublicationType UI="D013485">Research Support, Non-U.S. Gov't</PublicationType></PublicationTypeList><ArticleDate DateType="Electronic"><Year>2012</Year><Month>01</Month><Day>26</Day></ArticleDate></Article><MedlineJournalInfo><Country>England</Country><MedlineTA>BMC Infect Dis</MedlineTA><NlmUniqueID>100968551</NlmUniqueID><ISSNLinking>1471-2334</ISSNLinking></MedlineJournalInfo><CitationSubset>IM</CitationSubset><MeshHeadingList><MeshHeading><DescriptorName UI="D000293" MajorTopicYN="N">Adolescent</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D000328" MajorTopicYN="N">Adult</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D000368" MajorTopicYN="N">Aged</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D000369" MajorTopicYN="N">Aged, 80 and over</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D001604" MajorTopicYN="N">Berlin</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D002648" MajorTopicYN="N">Child</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D002675" MajorTopicYN="N">Child, Preschool</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D005191" MajorTopicYN="Y">Family Characteristics</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D005192" MajorTopicYN="Y">Family Health</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D005260" MajorTopicYN="N">Female</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D006235" MajorTopicYN="N">Hand Disinfection</DescriptorName><QualifierName UI="Q000379" MajorTopicYN="Y">methods</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D006801" MajorTopicYN="N">Humans</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D007251" MajorTopicYN="N">Influenza, Human</DescriptorName><QualifierName UI="Q000517" MajorTopicYN="Y">prevention & control</QualifierName><QualifierName UI="Q000635" MajorTopicYN="Y">transmission</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D008297" MajorTopicYN="N">Male</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D008397" MajorTopicYN="N">Masks</DescriptorName><QualifierName UI="Q000706" MajorTopicYN="Y">statistics & numerical data</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D008875" MajorTopicYN="N">Middle Aged</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D010349" MajorTopicYN="N">Patient Compliance</DescriptorName><QualifierName UI="Q000706" MajorTopicYN="N">statistics & numerical data</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D011795" MajorTopicYN="N">Surveys and Questionnaires</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D016896" MajorTopicYN="N">Treatment Outcome</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D055815" MajorTopicYN="N">Young Adult</DescriptorName></MeshHeading></MeshHeadingList></MedlineCitation><PubmedData><History><PubMedPubDate PubStatus="received"><Year>2011</Year><Month>11</Month><Day>03</Day></PubMedPubDate><PubMedPubDate PubStatus="accepted"><Year>2012</Year><Month>01</Month><Day>26</Day></PubMedPubDate><PubMedPubDate 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IdType="pubmed">14600109</ArticleId></ArticleIdList></Reference></ReferenceList></PubmedData></pubmed><affiliations><list><country><li>Allemagne</li></country><region><li>Berlin</li></region><settlement><li>Berlin</li></settlement></list><tree><noCountry><name sortKey="Buchholz, Udo" sort="Buchholz, Udo" uniqKey="Buchholz U" first="Udo" last="Buchholz">Udo Buchholz</name><name sortKey="Doellinger, Joerg" sort="Doellinger, Joerg" uniqKey="Doellinger J" first="Joerg" last="Doellinger">Joerg Doellinger</name><name sortKey="Haas, Walter" sort="Haas, Walter" uniqKey="Haas W" first="Walter" last="Haas">Walter Haas</name><name sortKey="Koehler, Irina" sort="Koehler, Irina" uniqKey="Koehler I" first="Irina" last="Koehler">Irina Koehler</name><name sortKey="Krause, Gerard" sort="Krause, Gerard" uniqKey="Krause G" first="Gérard" last="Krause">Gérard Krause</name><name sortKey="Milde, Jeanette" sort="Milde, Jeanette" uniqKey="Milde J" first="Jeanette" last="Milde">Jeanette Milde</name><name sortKey="Nitsche, Andreas" sort="Nitsche, Andreas" uniqKey="Nitsche A" first="Andreas" last="Nitsche">Andreas Nitsche</name><name sortKey="Remschmidt, Cornelius" sort="Remschmidt, Cornelius" uniqKey="Remschmidt C" first="Cornelius" last="Remschmidt">Cornelius Remschmidt</name><name sortKey="Schink, Susanne B" sort="Schink, Susanne B" uniqKey="Schink S" first="Susanne B" last="Schink">Susanne B. Schink</name><name sortKey="Schroeder, Kati" sort="Schroeder, Kati" uniqKey="Schroeder K" first="Kati" last="Schroeder">Kati Schroeder</name><name sortKey="Schweiger, Brunhilde" sort="Schweiger, Brunhilde" uniqKey="Schweiger B" first="Brunhilde" last="Schweiger">Brunhilde Schweiger</name></noCountry><country name="Allemagne"><region name="Berlin"><name sortKey="Suess, Thorsten" sort="Suess, Thorsten" uniqKey="Suess T" first="Thorsten" last="Suess">Thorsten Suess</name></region></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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