Mask Use, Hand Hygiene, and Seasonal Influenza-Like Illness among Young Adults: A Randomized Intervention Trial
Mask Use, Hand Hygiene, and Seasonal Influenza-Like Illness among Young Adults: A Randomized Intervention Trial
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DOI：
10.1086/650396
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发表时间：
2010-02-15
影响因子：
6.4
通讯作者：
Monto, Arnold S.
中科院分区：
文献类型：
--
作者：
Aiello, Allison E.;Murray, Genevra F.;Monto, Arnold S.
背景。在甲型H1N1流感大流行期间，抗病毒处方有限，疫苗无法及早获得，非药物干预措施（npi）的有效性也不确定。我们的研究考察了使用口罩和手卫生是否能减少流感样疾病（ILI）的发病率。设计了一项随机干预试验，涉及2006-2007年流感季节期间住在大学宿舍的1437名年轻人。学生宿舍被随机分配到三组中的一组，分别使用口罩、手卫生口罩或对照组，为期6周。广义模型估计临床诊断或调查报告的每周和累计ILI的比率。在调整了疫苗接种和其他协变量后，我们观察到，与对照组相比，在4-6周内，口罩和手卫生组的ILI显著减少，范围从35%（置信区间[CI]， 9%-53%）到51% （CI, 13%-73%）。与对照组相比，单独使用口罩也显示出类似的ILI减少，但调整后的估计值没有统计学意义。无论是使用口罩和手卫生，还是单独使用口罩，都与ILI累积发病率的显著降低无关。这些发现表明，口罩和手部卫生可能会减少共用生活环境中的呼吸道疾病，并减轻甲型H1N1流感大流行的影响。
Background. During the influenza A(H1N1) pandemic, antiviral prescribing was limited, vaccines were not available early, and the effectiveness of nonpharmaceutical interventions (NPIs) was uncertain. Our study examined whether use of face masks and hand hygiene reduced the incidence of influenza-like illness (ILI).Methods. A randomized intervention trial involving 1437 young adults living in university residence halls during the 2006-2007 influenza season was designed. Residence halls were randomly assigned to 1 of 3 groups face mask use, face masks with hand hygiene, or control-for 6 weeks. Generalized models estimated rate ratios for clinically diagnosed or survey-reported ILI weekly and cumulatively.Results. We observed significant reductions in ILI during weeks 4-6 in the mask and hand hygiene group, compared with the control group, ranging from 35% (confidence interval [CI], 9%-53%) to 51% (CI, 13%-73%), after adjusting for vaccination and other covariates. Face mask use alone showed a similar reduction in ILI compared with the control group, but adjusted estimates were not statistically significant. Neither face mask use and hand hygiene nor face mask use alone was associated with a significant reduction in the rate of ILI cumulatively.Conclusions. These findings suggest that face masks and hand hygiene may reduce respiratory illnesses in shared living settings and mitigate the impact of the influenza A(H1N1) pandemic.