We write in response to the recent controversy over the effectiveness of hand hygiene to prevent influenza virus transmission. 1 Recent studies provide more updated data than the Council of Canadian Academies report from two years ago. A study conducted in Hong Kong found that hand hygiene with or without surgical face masks can prevent influenza virus transmission in households. 2 N95 respirators are highly effective in theory, but they may not be feasible for use in the household setting. N95 respirators can be uncomfortable to wear for extended periods and have been associated with headaches and other adverse effects in health care workers. Furthermore, a recent study by a Canadian group found that surgical masks were not inferior to N95 respirators in preventing seasonal influenza virus infections in health care workers in hospitals in Toronto. 3 Current WHO and CDC guidance recommends the use of hand hygiene to reduce transmission in households and community settings. We believe this recommendation is evidence-based and health authorities should support and strengthen this message as pandemic (H1N1) 2009 continues to threaten public health.
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For the full letter, go to: www.cmaj.ca/cgi/eletters/cmaj.109-3066v1#214369