# 3045
Even though we are seeing `mild’ cases of Swine Flu reported here in the US right now, there are no guarantees that situation will continue.
In Mexico, we have heard of dozens of swine-flu-related fatalities. If it can happen there, it is at least possible other regions could see more severe effects from this virus.
With that in mind, we are all probably interested in how we can avoid infection.
Hand washing and avoidance of crowds or situations where you might be in close contact with those infected is your best protection, but facemasks and respirators are also an option.
The CDC has, in the past few hours, released updated interim recommendations for facemask/respirator use in a Swine Flu outbreak.
The word `interim’ is important to stress here, since actual data about the transmissibility of this new virus is extremely limited.
This is their recommendation as of today.
Tomorrow, if the facts warrant doing so, they could revise them.
First, the Interim Guidelines, then some discussion.
April 26, 2009 01:00 ET
This document provides interim guidance and will be updated as needed.
Detailed background information and recommendations regarding the use of masks and respirators in non-occupational community settings can be found on PandemicFlu.gov in the document Interim Public Health Guidance for the Use of Facemasks and Respirators in Non-Occupational Community Settings during an Influenza Pandemic
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Information on the effectiveness of facemasks1 and respirators2 for the control of influenza in community settings is extremely limited. Thus, it is difficult to assess their potential effectiveness in controlling swine influenza A (H1N1) virus transmission in these settings. In the absence of clear scientific data, the interim recommendations below have been developed on the basis of public health judgment and the historical use of facemasks and respirators in other settings.
In areas with confirmed human cases of swine influenza A (H1N1) virus infection, the risk for infection can be reduced through a combination of simple actions. No single action will provide complete protection, but an approach combining the following steps can help decrease the likelihood of transmission. These actions include frequent handwashing, covering coughs, and having ill persons stay home, except to seek medical care, and minimize contact with others in the household.
Additional measures that can limit transmission of a new influenza strain include voluntary home quarantine of members of households with confirmed or probable swine influenza cases, reduction of unnecessary social contacts, and avoidance whenever possible of crowded settings.
When it is absolutely necessary to enter a crowded setting or to have close contact3 with persons who might be ill, the time spent in that setting should be as short as possible.
If used correctly, facemasks and respirators can help prevent some exposures, but they should be used along with other preventive measures, such as avoiding close contact and maintaining good hand hygiene. When crowded settings or close contact with others cannot be avoided, the use of facemasks1 or respirators2 in areas where transmission of swine influenza A (H1N1) virus has been confirmed should be considered as follows:
- Whenever possible, rather than relying on the use of facemasks or respirators, close contact with people who might be ill and being in crowded settings should be avoided.
- Facemasks1 should be considered for use by individuals who enter crowded settings, both to protect their nose and mouth from other people's coughs and to reduce the wearers' likelihood of coughing on others; the time spent in crowded settings should be as short as possible.
- Respirators2 should be considered for use by individuals for whom close contact with an infectious person is unavoidable. This can include selected individuals who must care for a sick person (e.g., family member with a respiratory infection) at home.
These interim recommendations will be revised as new information about the use of facemasks and respirators in the current setting becomes available.
For more information about human infection with swine influenza virus, visit the CDC Swine Flu website.
1 Unless otherwise specified, the term "facemasks" refers to disposable masks cleared by the U.S. Food and Drug Administration (FDA) for use as medical devices. This includes facemasks labeled as surgical, dental, medical procedure, isolation, or laser masks. Such facemasks have several designs. One type is affixed to the head with two ties, conforms to the face with the aid of a flexible adjustment for the nose bridge, and may be flat/pleated or duck-billed in shape. Another type of facemask is pre-molded, adheres to the head with a single elastic band, and has a flexible adjustment for the nose bridge. A third type is flat/pleated and affixes to the head with ear loops. Facemasks cleared by the FDA for use as medical devices have been determined to have specific levels of protection from penetration of blood and body fluids.
2 Unless otherwise specified, "respirator" refers to an N95 or higher filtering facepiece respirator certified by the U.S. National Institute for Occupational Safety and Health (NIOSH).
3 Three feet has often been used by infection control professionals to define close contact and is based on studies of respiratory infections; however, for practical purposes, this distance may range up to 6 feet. The World Health Organization uses "approximately 1 meter"; the U.S. Occupational Safety and Health Administration uses "within 6 feet." For consistency with these estimates, this document defines close contact as a distance of up to 6 feet.
Protecting yourself from a respiratory virus isn’t easy, and the recommended methods aren’t foolproof. During an outbreak, you can do everything right and still get infected.
Still, if you follow the recommendations presented by the CDC, you can probably significantly reduce your chances of infection.
As this recent study from the University of South Wales shows, wearing facemasks can cut the odds of respiratory infection by as much as 75%.
Unmasked and vulnerable
World-first clinical trial shows mask-wearing significantly boosts flu protection
Donning a face mask is an easy way to boost protection from severe respiratory illnesses such as influenza and SARS, new research from the University of New South Wales (UNSW) has found, but convincing a reluctant public and health workers is proving a struggle.
In a world-first clinical trial of the efficacy of masks, researchers found adult mask wearers* in the home were four times more likely than non-wearers to be protected against respiratory viruses, including the common cold.
Last year, in the face of growing concerns over the H5N1 virus, the HHS released recommendations on the stockpiling of facemasks and respirators by the public.
Although the details follow, they suggest that it would be reasonable for every family obtain 20 N95 respirators, and 100 or more surgical masks.
It should be pointed out that these protective supplies are likely to be in short supply if this virus continues to spread. If you want to have masks available, you probably better get some now.
In an Interim guidance on the use and purchase of facemasks and respirators by individuals and families for pandemic influenza preparedness the American public has been given a much stronger recommendation for the home stockpiling, and use, of facemasks and respirators than we've seen before.
Some excerpts from this guidance:
Although not all households will have someone who becomes ill with influenza during a pandemic, because one cannot predict in which households an infection will occur, it would be reasonable for each household to stockpile some respirators that can be used, if needed, when caring for an ill family member.
With proper precautions, a single caregiver can use the same respirator several times over a day for brief care visits with the same ill person in the household,[2] so a stockpile of 20 respirators per household would be reasonable.
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Pandemic outbreaks in communities may last 6 to 12 weeks.[3] Persons who cannot avoid commuting on public transit may choose to purchase 100 facemasks for use when going to and from work.
An additional supply of facemasks also could be purchased for other times when exposure in a crowded setting is unavoidable or for use by an ill person in the home when they come in close contact with others.[4]
Of course, wearing masks is just part of an overall strategy of avoiding infection. Used without taking other precautions, they probably won’t provide much protection.
Once a virus has reached your community, you should avoid crowds, practice social distancing, wash your hands frequently, and stay home if you (or any family member) is ill.
For additional information about facemasks and respirators, you should visit the CDC web page:
