Wednesday, 7 October 2015

Pharmaceutical interventions vs non-pharmaceutical interventions for the flu

SPHPM’s Professor Allen Cheng has co-authored a systematic review with researchers from the Imperial College of London, the National Institute of Health, the School of Medicine and Pharmacology and the University of Western Australia. The review assessed the existing literature on non-pharmaceutical interventions to reduce transmission of influenza.  

Influenza is one of the major causes of respiratory illness in winter; there is an ongoing concern that another pandemic could occur again. The use of non-pharmaceutical interventions (NPI) is an important tool in the public health armamentarium to slow the spread of infection. The three modes of transmission for influenza are droplet transmission, contact through hard non-porous surfaces and airborne transmission.

The Center for Disease Control and Prevention has a recommendation for the use of NPIs based on two categories; personal or community based. Personal mechanisms include advocating for individuals to cover their mouth when coughing or sneezing, regular hand washing and quarantining themselves if they feel they may be sick. Community interventions are focused more on communicating strategies on an educational level and limiting the number of public gatherings.

After a systematic search of the literature only seven eligible studies were identified and all had some scientific flaws. The studies compared disinfection and hygiene practices, barriers and the use of combined NPI against usual (or no) advice or care.  They found evidence that interventions such as professional oral hygiene strategies within the elderly and hand washing had a positive impact.

The authors conclude that regardless of the potential role that NPIs could play in reducing and preventing influenza transmission, there is a paucity of research within the area. While the incorporation of dental hygiene and hand washing can be effective, there is a need for further appraisal of other interventions. Therefore, the researchers made suggestions about improved methods for further studies, including using larger communities of vulnerable patients.

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