The studies assessed the effectiveness of multiple NPIs used in conjunction with one another based on CDC's hypothesis that this approach could create multiple barriers to stop the transmission of influenza. Results from several studies suggest that personal protective measures perceived as part of typical daily routine were frequently practiced. For example, hand sanitizing with alcohol-based preparations, hand washing with soap, covering sneezes/coughs, and hand awareness (ie, touching the face) showed relatively high compliance, whereas compliance with face mask use was low in most of the studies.

The following is a summary of the key studies assessed in the analysis:

A study from the University of Michigan found that hand hygiene with alcohol-based hand sanitizers and mask use among university students was associated with a 50%-65% reduction in the rate of influenza-like illness (ILI) over a 6-week intervention period.

A University of Hong Kong study suggests substantial reductions in the spread of influenza and ILI throughout the household when all members practice frequent hand washing and wear face masks within 36 hours of the first appearance of illness.

The University of Pittsburgh found that after implementation of a 5-layer NPI approach, including hand hygiene and cough etiquette, elementary school students had significantly fewer laboratory-confirmed influenza A infections and a significant reduction in total absences compared with a control group.

Research conducted by RTI International, Research Triangle Park, NC, identified that the acceptability of NPIs depends largely on early planning, consistent and targeted communication during implementation, and clear delineation of responsibilities and lines of authority. Acceptability also requires communication from both traditional (eg, emergency response organizations, public health departments, media) and nontraditional (eg, churches, child care centers, businesses) sources.

A Columbia University study showed that although household members had misunderstandings regarding influenza, their knowledge, attitudes, and practices improved through a community education program.

Source: Elsevier Health Sciences