Tuesday, 4 August 2009

Proven: Masks do help

So let us all wear masks.



From Mexico to China, people around the world have worn face masks to
protect against swine flu, also known as the H1N1 virus. The problem?
Experts could never say for sure whether such masks actually help you
stay healthy.
In tandem with hand-washing, face masks seem to work better than hand-
washing alone.

In tandem with hand-washing, face masks seem to work better than hand-
washing alone.

Now, the largest study to date on the subject suggests they do. When
sick people and their families wear surgical face masks and wash their
hands within the first 36 hours of symptoms, healthy family members
are indeed less likely to get seasonal flu, researchers say. They
think the results may apply to H1N1 as well.

So far, 94,512 people around the world have been infected with swine
flu, and there have been 429 deaths in 122 countries.

"Many people believe that coughs and colds are so infectious that
there is really no stopping them, however hard we try," says Benjamin
Cowling, Ph.D., the lead author of the study published this week in
Annals of Internal Medicine. "Our results suggest that is not the
case, and, in fact, transmission can be effectively stopped with just
some simple precautions."

Cowling, an assistant professor in the School of Public Health at the
University of Hong Kong, and his colleagues looked at 407 locals who
came down with regular seasonal flu (not swine flu), which was
confirmed by laboratory tests. Health.com: Four things you didn't know
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The patients were divided into three groups: One group (the control
group) was told about the benefits of a healthy diet and lifestyle in
terms of preventing illness; members of a second group were told to
wash their hands with soap and water frequently, including when they
coughed or sneezed, and to use an alcohol hand rub after touching
contaminated surfaces; and a third group's member were told to wash
their hands and use surgical face masks as often as possible at home
(except when they were eating or sleeping).
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The researchers found that when people and their families wore face
masks and washed their hands within 36 hours of the first symptoms,
their family members were less likely to become infected. However,
those who started using masks or washing their hands after the 36-hour
time period had passed saw no benefit.

In tandem with hand-washing, face masks seem to work better than hand-
washing alone, but the authors could not conclusively prove which
intervention was responsible for the drop in infections of family

Cowling says these results definitely apply to the H1N1 virus too,
because swine flu is transmitted much as seasonal flu. Health.com:
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Currently, the Centers for Disease Control and Prevention, which
partly funded the study, does not generally recommend the use of face
masks or respirators to prevent the spread of H1N1 because of their
uncertain benefit. The CDC says face masks are recommended only if a
person is at a very high risk of flu complications (such as someone
who is pregnant), and has no other choice but to be the primary
caregiver for a family member with H1N1. (The CDC says this scenario
should be avoided if at all possible.)

Despite the new study, CDC spokesperson Artealia Gilliard says the
current guidelines for face masks will not change. "This is another
piece of great information, but this study alone shouldn't have an
effect on current CDC guidelines about face masks," says Gilliard.

It's still not clear whether healthy people who wear face masks in
public can prevent themselves from getting the flu. The researchers
could not determine whether the masks worked because they prevented
sick people from transmitting viruses or if they helped prevent
healthy people from picking up the virus. Health.com: Eat smarter in
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Cowling explains that the healthy subjects had a hard time wearing the
face masks and were less likely than sick people to do so. Only about
half of the sick patients used the face masks routinely, and some
people in the control group wore them because their use is common in
Hong Kong.

"Perhaps with better compliance even more transmission could be
prevented," he says.

Cowling says his research is different from past studies because it
didn't rely on symptoms alone; the researchers swabbed the healthy
family members at three-day intervals and confirmed infections in the
laboratory. (Nearly one-third of people with influenza may not develop
classic flu symptoms, such as a cough, fever, and muscle aches.)
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Henry Chambers, M.D., the chief of infectious diseases at San
Francisco General Hospital, says the results aren't surprising. The
flu virus is spread in droplets in the air, so face masks may help
prevent sick people from spreading these infectious droplets, or
healthy ones from inhaling them, he says. Hand-washing helps kill
germs too.

According to Gilliard, the CDC recommends that people with H1N1 remain
home for seven days after symptoms begin, or until they've been
symptom free for at least 24 hours. People should avoid touching their
eyes, nose, and ears, because infections can get started when the
virus is picked up by the hands and transmitted to the face.
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Health Library

* MayoClinic.com: Swine flu (H1N1 flu)

Cowling believes a surgical face mask is an effective way to reduce
flu transmission; even the World Health Organization advises health-
care workers to wear face masks when treating H1N1 patients, he says.
He adds that N95 respirators, which are tight-fitting masks that
filter airborne particles, are also beneficial, but they can be
uncomfortable to wear for long periods of time.

A second study in Annals of Internal Medicine found that long-term
treatment (more than four weeks) with the antiviral drugs zanamivir
(Relenza) and oseltamivir (Tamiflu) could prevent seasonal flu with
symptoms, but did not prevent symptom-free influenza infections. In
terms of efficacy, there was no difference between the two drugs,
according to the research team from Stanford University School of
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