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Fighting flu: Stricter hand hygiene in schools only a short-term measure

16.10.2009
Increased hand hygiene in primary schools is only a short-term measure in preventing infections such as H1N1 from spreading. Researchers writing in the open access journal, BMC Public Health, found stricter hand hygiene practices are difficult to maintain in a school setting.

School children may be twice as likely to catch H1N1 influenza as adults, as such health policies often stress hand hygiene among school children as one low cost intervention that may prevent influenza from spreading.

A research team led by Wolf-Peter Schmidt at the London School of Hygiene and Tropical Medicine, London, UK used qualitative methods to explore teachers' and students' views on different hand hygiene protocols, as well as interviewing school nurses. Their pilot study in four East London primary schools examined both practical issues and attitudes, and included class exercises in hand washing or lining up to use hand sanitizer.

The researchers found that staff are motivated to contribute to hygiene education over and above what children learn from their parents, provided that expectations are realistic for the school environment. But very frequent and highly monitored hand washing would be hard to keep up over the longer term without the motivation of a major perceived public health threat like the current influenza pandemic. During a busy school day, time was a major factor in deciding what level of hand hygiene could be achieved.

School nurses were more focused on reducing infection, whereas teachers saw hygiene as an important education topic – particularly among the younger age groups. Rinse-free alcohol gel hand sanitizer was the fastest and least messy option. But teachers highlighted to children that this was only for situations where soap and water was in short supply.

"Intensive hand hygiene interventions are feasible and acceptable but only temporarily during a period of a particular health threat like an influenza pandemic and only if rinse-free hand sanitizers are used," according to Schmidt. "In many settings there may be logistical issues in providing all schools with an adequate supply," he added. "Hand hygiene is important in particular for the prevention of gastro-intestinal infections. The effect of hand hygiene on the spread of influenza is less clear, but may be promoted as a precautionary measure, even in the absence of evidence. Our study highlights the practical issues of bringing improved hand hygiene to scale."

Notes to Editors:

1. To increase awareness of the importance of handwashing, the 15th of October will mark the 2nd Global Handwashing Day. Global Handwashing Day 2009 will be the centerpiece of a week of activities that will mobilize millions of people in more than 70 countries across all five continents to wash their hands with soap.

2. Formative research on the feasibility of hygiene interventions for influenza control in UK primary schools
Wolf-Peter Schmidt, Catherine Wloch, Adam Biran, Val Curtis and Punam Pangtani
BMC Public Health (in press)
3. BMC Public Health is an open access journal publishing original peer-reviewed research articles in the epidemiology of disease and the understanding of all aspects of public health. The journal has a special focus on the social determinants of health, the environmental, behavioral, and occupational correlates of health and disease, and the impact of health policies, practices and interventions on the community. BMC Public Health (ISSN 1471-2458) is indexed/tracked/covered by PubMed, MEDLINE, CAS, Scopus, EMBASE, Current Contents, Thomson Reuters (ISI) and Google Scholar.

4. BioMed Central (http://www.biomedcentral.com/) is an STM (Science, Technology and Medicine) publisher which has pioneered the open access publishing model. All peer-reviewed research articles published by BioMed Central are made immediately and freely accessible online, and are licensed to allow redistribution and reuse. BioMed Central is part of Springer Science+Business Media, a leading global publisher in the STM sector.

Charlotte Webber | EurekAlert!
Further information:
http://www.biomedcentral.com

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