lancet-header

Preprints with The Lancet is part of SSRN´s First Look, a place where journals identify content of interest prior to publication. Authors have opted in at submission to The Lancet family of journals to post their preprints on Preprints with The Lancet. The usual SSRN checks and a Lancet-specific check for appropriateness and transparency have been applied. Preprints available here are not Lancet publications or necessarily under review with a Lancet journal. These preprints are early stage research papers that have not been peer-reviewed. The findings should not be used for clinical or public health decision making and should not be presented to a lay audience without highlighting that they are preliminary and have not been peer-reviewed. For more information on this collaboration, see the comments published in The Lancet about the trial period, and our decision to make this a permanent offering, or visit The Lancet´s FAQ page, and for any feedback please contact preprints@lancet.com.

Non-Pharmaceutical Measures to Reduce Influenza Transmission in Households: A Systematic Review and Meta-Analysis

29 Pages Posted: 3 May 2024

See all articles by Jessica Y. Wong

Jessica Y. Wong

The University of Hong Kong - WHO Collaborating Centre for Infectious Disease Epidemiology and Control

Wey Wen Lim

The University of Hong Kong - WHO Collaborating Centre for Infectious Disease Epidemiology and Control

Justin Cheung

The University of Hong Kong - WHO Collaborating Centre for Infectious Disease Epidemiology and Control

Caitriona Murphy

The University of Hong Kong - WHO Collaborating Centre for Infectious Disease Epidemiology and Control

Eunice Shiu

The University of Hong Kong - WHO Collaborating Centre for Infectious Disease Epidemiology and Control

Jingyi Xiao

The University of Hong Kong - WHO Collaborating Centre for Infectious Disease Epidemiology and Control

Dongxuan Chen

The University of Hong Kong - WHO Collaborating Centre for Infectious Disease Epidemiology and Control

Yanmin Xie

The University of Hong Kong - WHO Collaborating Centre for Infectious Disease Epidemiology and Control

Mingwei Li

The University of Hong Kong - WHO Collaborating Centre for Infectious Disease Epidemiology and Control

Hualei Xin

The University of Hong Kong - WHO Collaborating Centre for Infectious Disease Epidemiology and Control

Michelle Szeto

The University of Hong Kong - WHO Collaborating Centre for Infectious Disease Epidemiology and Control

Sammi Choi

The University of Hong Kong - WHO Collaborating Centre for Infectious Disease Epidemiology and Control

Benjamin J. Cowling

The University of Hong Kong - WHO Collaborating Centre for Infectious Disease Epidemiology and Control

More...

Abstract

Background: Influenza pandemic plans often recommend a number of non-pharmaceutical measures in household settings, including hand hygiene and face masks. We reviewed the evidence supporting recommendations of these measures to prevent the spread of influenza in households.

Methods: We reviewed the recommendations issued by national health authorities for the use of non-pharmaceutical measures in household settings during influenza epidemics or pandemics and identified a list of measures for the evidence review. We then performed systematic reviews on 26 May to 30 August 2022 in Medline, PubMed, EMBASE, and CENTRAL to identify evidence for the effectiveness of selected measures. We prioritized evidence from randomized controlled trials and excluded studies that were conducted in shared residences and institutions. Fixed-effects models were used to estimate the overall effects.

Findings: We selected nine non-pharmaceutical interventions for evidence review. We found nine studies related to hand hygiene and face masks in household settings. Some studies reported that measures could delay the introduction of influenza virus infections into households. However, no available evidence indicated that hand hygiene and face mask would have a substantial effect in preventing the spread of pandemic influenza within households.

Interpretation: The limited evidence indicated that within-household measures would likely only be effective when implemented before or as soon as possible after symptom onset in an infected case. Improving the evidence base for non-pharmaceutical interventions in households and elsewhere is a continuing priority, including for example evidence to support self-isolation policies.

Funding: This project was supported by a grant from the World Health Organization and the Strategic Topic Grants Scheme (Project No. STG4/M-701/23-N) of the Research Grants Council of the Hong Kong Special Administrative Region, China.

Declaration of Interest: B.J.C. has consulted for AstraZeneca, Fosun Pharma, GlaxoSmithKline, Haleon, Moderna, Novavax, Pfizer, Roche, and Sanofi Pasteur. All other authors report no potential conflicts of interest.

Suggested Citation

Wong, Jessica Y. and Lim, Wey Wen and Cheung, Justin and Murphy, Caitriona and Shiu, Eunice and Xiao, Jingyi and Chen, Dongxuan and Xie, Yanmin and Li, Mingwei and Xin, Hualei and Szeto, Michelle and Choi, Sammi and Cowling, Benjamin J., Non-Pharmaceutical Measures to Reduce Influenza Transmission in Households: A Systematic Review and Meta-Analysis. Available at SSRN: https://ssrn.com/abstract=4814968 or http://dx.doi.org/10.2139/ssrn.4814968

Jessica Y. Wong

The University of Hong Kong - WHO Collaborating Centre for Infectious Disease Epidemiology and Control ( email )

Hong Kong
China

Wey Wen Lim

The University of Hong Kong - WHO Collaborating Centre for Infectious Disease Epidemiology and Control ( email )

Justin Cheung

The University of Hong Kong - WHO Collaborating Centre for Infectious Disease Epidemiology and Control ( email )

Hong Kong
China

Caitriona Murphy

The University of Hong Kong - WHO Collaborating Centre for Infectious Disease Epidemiology and Control ( email )

Eunice Shiu

The University of Hong Kong - WHO Collaborating Centre for Infectious Disease Epidemiology and Control ( email )

Jingyi Xiao

The University of Hong Kong - WHO Collaborating Centre for Infectious Disease Epidemiology and Control ( email )

Dongxuan Chen

The University of Hong Kong - WHO Collaborating Centre for Infectious Disease Epidemiology and Control ( email )

Hong Kong
China

Yanmin Xie

The University of Hong Kong - WHO Collaborating Centre for Infectious Disease Epidemiology and Control ( email )

Mingwei Li

The University of Hong Kong - WHO Collaborating Centre for Infectious Disease Epidemiology and Control ( email )

Hualei Xin

The University of Hong Kong - WHO Collaborating Centre for Infectious Disease Epidemiology and Control ( email )

Michelle Szeto

The University of Hong Kong - WHO Collaborating Centre for Infectious Disease Epidemiology and Control ( email )

Sammi Choi

The University of Hong Kong - WHO Collaborating Centre for Infectious Disease Epidemiology and Control ( email )

Benjamin J. Cowling (Contact Author)

The University of Hong Kong - WHO Collaborating Centre for Infectious Disease Epidemiology and Control ( email )

7 Sassoon Road
Hong Kong
China
+852 3917 6711 (Phone)