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It's Flu Season Again...

It's Flu season and now is the time to start thinking of how you can mitigate the chances of you and your family from being infected. The CDC gives this advice:

Personal Protective Measures for Everyday Use

Personal protective measures are preventive actions that can be used daily to slow the spread of respiratory viruses (https://www.cdc.gov/nonpharmaceutical-interventions/personal/index.html; supplementary Chapter 3 https://stacks.cdc.gov/view/cdc/44313). These measures include the following:

  • Voluntary home isolation (i.e., staying home when ill or self-isolation): Persons with influenza stay home for at least 24 hours after a fever or signs of a fever (chills, sweating, and feeling warm or flushed)** are gone (https://www.cdc.gov/flu/protect/preventing.htm), except to obtain medical care or other necessities.†† To ensure that the fever is gone, patients’ temperature should be measured in the absence of medication that lowers fever (e.g., acetaminophen or ibuprofen). In addition to fever, common influenza symptoms include cough or chest discomfort, muscle or body aches, headache, and fatigue. Persons also might experience sneezing, a runny or stuffy nose, sore throat, vomiting, and diarrhea (https://www.cdc.gov/flu/consumer/symptoms.htm).

  • Respiratory etiquette: Persons cover coughs and sneezes, preferably with a tissue, and then dispose of tissues and disinfect hands immediately after a cough or sneeze, or (if a tissue is not available) cough or sneeze into a shirt sleeve. Touching the eyes, nose, and mouth should be avoided to help slow the spread of germs (https://www.cdc.gov/flu/protect/covercough.htm).

  • Hand hygiene: Persons perform regular and thorough hand washing with soap and water (or use alcohol-based hand sanitizers containing at least 60% ethanol or isopropanol when soap and water are not available).

Use of Face Masks in Community Settings

Face masks (disposable surgical, medical, or dental procedure masks) are widely used by health care workers to prevent respiratory infections both in health care workers and patients. They also might be worn by ill persons during severe, very severe, or extreme pandemics to prevent spread of influenza to household members and others in the community. However, little evidence supports the use of face masks by well persons in community settings, although some trials conducted during the 2009 H1N1 pandemic found that early combined use of face masks and other NPIs (such as hand hygiene) might be effective (supplementary Chapter 3 https://stacks.cdc.gov/view/cdc/44313).

Rationale for use as a public health strategy. Face masks provide a physical barrier that prevents the transmission of influenza viruses from an ill person to a well person by blocking large-particle respiratory droplets propelled by coughing or sneezing. Face mask use by well persons is not routinely needed in most situations to prevent acquiring the influenza virus. However, use of face masks by well persons might be beneficial in certain situations (e.g., when persons at high risk for influenza complications cannot avoid crowded settings or parents are caring for ill children at home). Face mask use by well persons also might reduce self-inoculation (e.g., touching the nose with the hand after touching a contaminated surface).

Social Distancing Measures for Schools, Workplaces, and Mass Gatherings

Social distancing measures can reduce virus transmission by decreasing the frequency and duration of social contact among persons of all ages. These measures are common-sense approaches to limiting face-to-face contact, which reduces person-to-person transmission.

Rationale for use as a public health strategy. Social distancing measures that reduce opportunities for person-to-person virus transmission can help delay the spread and slow the exponential growth of a pandemic. The optimal strategy is to implement these measures simultaneously in places where persons gather. Although direct evidence is limited for the effectiveness of these measures, components of the strategy might include reducing social contacts at the following places:

  • Schools: Children have higher influenza attack rates than adults, and influenza transmission is common in schools.

  • Workplaces: More than half of all U.S. adults participate in the U.S workforce,§§§ and workers often share office space and equipment and have frequent face-to-face contact. Influenza attack rates in working-age adults (aged 18–64 years) might be as high as 15.5% during a single influenza season (88).

  • Mass gatherings: Group events such as concerts, festivals, and sporting events bring people into close contact for extended periods (8992). A systematic literature review of respiratory disease outbreaks related to mass gatherings in the United States during 2005–2014 indicated that 40 of 72 different outbreaks were associated with state or county agriculture fairs and (zoonotic) transmission of influenza A H3N2v, and 25 outbreaks were associated with residential youth summer camps and person-to-person transmission of influenza A H1N1 (93). An infected traveler attending a mass gathering might introduce influenza to a previously unaffected area, and a person who becomes infected at the event can further spread the infection after returning home (89,90,92,9496). Even when a circulating virus has a relatively low basic reproductive rate (R0), intensely crowded settings might lead to high secondary attack rates (92). For example, during the 2013 Hajj (Islamic pilgrimage to Mecca) in Saudi Arabia, influenza A/H1N1 virus was found in only two Indonesians on arrival but spread to 25 persons from Africa, Central Asia, and Southeast Asia after the Hajj because of the extremely crowded conditions when performing rituals (97).

Multiple social distancing measures can be implemented simultaneously. Although there is limited empirical evidence supporting the effectiveness of implementing any individual measure alone (other than school closures and dismissals), the evidence for implementing multiple social distancing measures in combination with other NPIs includes systematic literature reviews, historical analyses of the 1918 pandemic, and mathematical modeling studies (supplementary Chapter 3 https://stacks.cdc.gov/view/cdc/44313 and supplementary Appendix 5 https://stacks.cdc.gov/view/cdc/44314).

 

The flu is never fun. Think ahead now and plan on lessening your chances of catch this years bug.

 

Don

 



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