School-implemented Hygiene Program Decreases Influenza A by 50%

A recent study has found that elementary schools which exercised a hand and respiratory hygiene program—including routine use of alcohol-based hand sanitizer—experienced a reduction in illness caused by influenza A, which resulted in a decline in missed school days for students.

"Respiratory hygiene education and the regular use of hand sanitizer can be an important adjunct to influenza vaccination programs to reduce the number of influenza A infections among children," stated research Dr Samuel Stebbins of the University of Pittsburgh and colleagues. The researchers studied ten elementary schools in Pittsburgh; five of the schools were given a five-step training "cough etiquette and hand hygiene" program to implicate. The program, named "WHACK the Flu," taught children the following hygiene etiquette:

• Wash (or sanitize) hands frequently

• Home is where you belong when you are sick

• Avoid touching your eyes, nose, and mouth

• Cover your mouth and nose when you coughs and sneeze

• Keep away from sick people

The other five schools were given no particular training in hygiene etiquette.

The program recommended the students use the sanitizer four times per day, once when the children arrived to school, before and after lunch, and the last time when the children were leaving school. They reported that the schools who implemented the WHACK program were able to get the students to use hand sanitizer regularly, averaging around 2.4 times per day.

Over the course of the school year, the researchers tested children who developed a flu-like illness for influenza, and whether they had influenza type A or B. The researchers determined that, out of the 279 children they tested, 104 had cases of influenza.

The researchers determined that the schools who instructed their children the WHACK etiquette saw a 52% reduction in the rate of confirmed illness caused by influenza A, and a 26% reduction in total school absences was also observed. The hygiene program was also linked to possible improvements in other school attendance measures, including a lower rate of absences during flu season.

There was no notable difference, though, in neither the overall rate of laboratory-confirmed influenza or in the rate of illness caused by influenza B.

It is not clear why there was no decrease seen in influenza B cases, though it may be possibly due to the "basic differences in the biology or epidemiology" of influenza B, or because it took place later in the flu season and mainly in younger children.

Although the "WHACK the Flu" program did not affect the overall influenza frequency, it did reduce influenza A by roughly 50%, and school absences were reduced by 25%. The study was in the November issue of The Pediatric Infectious Disease Journal.