Physical interventions to interrupt or reduce the spread of respiratory viruses.

摘要: Background Viral epidemics or pandemics of acute respiratory infections like influenza severe syndrome pose a global threat. Antiviral drugs and vaccinations may be insufficient to prevent their spread. Objectives To review the effectiveness physical interventions interrupt reduce spread viruses. Search methods We searched The Cochrane Library, Central Register Controlled Trials (CENTRAL 2010, Issue 3), which includes Acute Respiratory Infections Group's Specialised Register, MEDLINE (1966 October 2010), OLDMEDLINE (1950 1965), EMBASE (1990 CINAHL (1982 LILACS (2008 Indian MEDLARS 2010) IMSEAR 2010). Selection criteria In this update, two authors independently applied inclusion criteria all identified retrieved articles extracted data. We scanned 3775 titles, excluded 3560 full papers 215 studies, include 66 67 studies. included (screening at entry ports, isolation, quarantine, social distancing, barriers, personal protection, hand hygiene) virus transmission. randomised controlled trials (RCTs), cohorts, case-controls, before-after time series studies. Data collection analysis We used standardised form assess trial eligibility. assessed RCTs by randomisation method, allocation generation, concealment, blinding follow up. non-RCTs for potential confounders classified them as low, medium high risk bias. Main results We studies including trials observational with mixed bias. A total number participants is not would made up heterogenous set observations (participant people, on countries (object some studies)). bias five most cluster-RCTs was high. Observational were quality. Only case-control data sufficiently homogeneous allow meta-analysis. highest quality suggest can prevented hygienic measures, such handwashing, especially around younger children. Benefit from reduced transmission children household members broadly supported also in other study designs where confounding greater. Nine suggested implementing isolation measures are effective containing epidemics. Surgical masks N95 respirators consistent comprehensive supportive measures. non-inferior simple surgical but more expensive, uncomfortable irritating skin. Adding virucidals antiseptics normal handwashing decrease disease remains uncertain. Global screening led non-significant marginal delay spread. There limited evidence that distancing effective, if related exposure. Authors' conclusions Simple low-cost useful reducing epidemic viruses. Routine long-term implementation might difficult without threat an epidemic.