Simple measures such as hand washing better than drugs in dealing with flu viruses

Scientists say using physical barriers, such as regular hand washing and wearing masks, gloves and gowns, may be far more effective than drugs to prevent the spread of respiratory viruses such as influenza and SARS.

A study by an international team of scientists has reached the conclusion that simple, low-cost physical measures ought be given a higher priority when it comes to national pandemic contingency plans.

The news comes shortly after an announcement by the British government that it was doubling its stockpile of antiviral medicines in preparation for any future flu pandemic.

The team of researchers led by Professor Chris Del Mar, from the faculty of health sciences and medicine, at Bond University, in Australia, reviewed over 50 studies which compared any intervention to prevent animal-to-human or human-to-human transmission of respiratory viruses.

These included strategies such as isolation, quarantine, social distancing, barriers, personal protection and hygiene, to doing nothing or to other types of intervention but excluded vaccines and antiviral drugs.

Differences in study design and quality were taken into account to minimise the bias.

They say there is mounting evidence which suggests that the use of vaccines and antiviral drugs will be insufficient to interrupt the spread of influenza.

They found instead that hand washing and wearing masks, gloves and gowns were all effective individually in preventing the spread of respiratory viruses, and were even more effective when combined.

The effect of adding antiseptics to normal hand washing to reduce respiratory disease remains uncertain.

The team say the systematic review of available research provides important insights and offers a clear mandate to carry out further large trials to evaluate the best combinations.

Their findings are supported by earlier research which also found hand washing with just soap and water to be a simple and effective way to curb the spread of respiratory viruses, from everyday cold viruses to deadly pandemic strains.

The authors say combining these measures along with the isolation of people with suspected respiratory tract infections may be more effective than prescribing antiviral drugs in the event of a pandemic.

They say simple public health measures appear to be highly effective, especially when they are part of a structured programme including education, and when they are delivered together.

There is increasing concern about global pandemic viral infections such as avian influenza and SARS and experts have been warning in recent years that the world is due for another pandemic.

Though they cannot say which strain will strike, the H5N1 avian flu virus that has killed more than 200 people globally since 2003 is considered to be a prime suspect.

An accompanying editorial suggests governments should continue to fund research to confirm these findings and to investigate other areas of uncertainty that it identifies in the management of people with suspected influenza.

The study is published by the British Medical Journal and can be accessed on bmj.com.