Flu Prevention

Face mask and respirator use:
N95 respirator may not be more effective than surgical mask for prevention of influenza among nurses (level 2 [mid-level] evidence)
based on randomized trial with non-significant trend for reduced influenza-like illness
446 nurses working in hospitals in Ontario randomized to surgical mask vs. fit-tested N95 respirator when providing care to patients with febrile respiratory illness during 2008-2009 influenza season
most laboratory-confirmed influenza infections were asymptomatic and based on ≥ 4-fold increase in serology
comparing surgical mask group vs. N95 respirator group
- 2008-2009 trivalent inactivated influenza vaccine previously received by 30.2% vs. 28.1% (not significant)
- laboratory-confirmed influenza infection occurred in 23.6% vs. 22.9% (not significant)
- influenza-like illness in 4.2% vs. 1% (p = 0.06), all laboratory-confirmed influenza (95% CI for absolute difference -0.28% to +6.31%)
- fever in 5.66% vs. 0.9% (p = 0.007)
- work-related absenteeism in 19.8% v s. 18.6% (not significant)
- physician visits for respiratory illness in 6.1% vs. 6.2% (not significant)
Reference - JAMA 2009 Nov 4;302(17):1865 full-text, editorial can be found in JAMA 2009 Nov 4;302(17):1903 full-text
DynaMed commentary -- trial evaluates comparative efficacy but unable to establish if either mask provides protection

Public health interventions:
non-pharmaceutical public health interventions for pandemic influenza (grade C recommendation [lacking direct evidence]) based on expert opinion (systematic review found no direct evidence)
hand hygiene
respiratory etiquette (covering mouth and nose with tissue or into upper sleeve when coughing or sneezing, refraining from spitting)
surveillance and case reporting
rapid viral diagnosis
patient and provider use of masks and other personal protective equipment
voluntary self-isolation of patients
interventions rejected as likely to be ineffective or unacceptable
- mask use and other personal protective equipment for general public
- school and workplace closures early in epidemic
- mandatory travel restrictions

Use of Air Purifier:
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