Pandemic flu is on everyone’s mind at the moment.  While vaccines and anti-viral drugs are often quoted as the mainstay of pandemic planning, we ought not to overlook the role that simple hygiene and physical barriers can play in stopping the spread of viruses. 

In the UK, it looks as if this message is beginning to be taken on board – for hand wash dispensers are now appearing in many public places as part of the fight against pandemic flu.  Professor Tom Jefferson of the Cochrane Acute Respiratory Infections Group in Rome now presents a timely review of how effective hygiene and physical barriers are in preventing the spread of respiratory viruses, of which H1NI swine flu is currently the most concerning example because of its pandemic potential.

The review extends a study from 2007 by the same group that showed how hand washing, wearing masks, gloves and gowns are effective in blocking the spread of respiratory viruses which could otherwise cause a pandemic.  The update covers another 59 studies on any intervention – save vaccines and anti-viral – that could stop animal to human or human to human respiratory virus transmission.

Hand washing, more than ten times a day, and wearing masks, gloves and gowns are effective against all forms of respiratory virus and are even more so when combined. Spread of pandemic flu could, the review suggests, be best prevented by applying such measures in younger children, who tend to have no immunity to H1N1, and in households.

Simple surgical masks are as effective as more expensive ones but it is not clear whether it is worthwhile adding antiseptic to hand washing products.  It is not clear whether social distancing (that is, staying indoors) and screening at airports is really effective as a pandemic planning measure.  The good news is that the measures that do work against pandemics are cheap and simple – regular hand washing may be more effective than any vaccine.  So, hand washing should be the mainstay, with gloves, masks and gowns being used where there is a high risk of transmission.  Likely cases of pandemic flu should be isolated, the researchers conclude. 

Source:

Jefferson T, Del Mar C et al Physical  interventions to interrupt or reduce the spread of respiratory viruses: systematic review BMJ Online  First 23^rd September 2009 DOI: 10.1136/bmj.b3675