August 15, 2016
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Surgical mask policy reduces respiratory viral infections in HSCT patients

A universal surgical mask policy led to a significant reduction in respiratory viral infections among patients who underwent hematopoietic stem cell transplants at Duke University Medical Center.

According to Anthony D. Sung, MD, medical instructor in the department of medicine at Duke University, and colleagues, respiratory viral infections (RVIs) affect up to 30% of hematopoietic stem cell transplant (HSCT) patients and can lead to potentially deadly lower respiratory tract infections.

“Although modern infection control practices have helped decrease viral infections and curtail outbreaks, RVIs remain problematic after HSCT,” Sung and colleagues wrote in Clinical Infectious Diseases.

Sung and colleagues created a policy that required all individuals with direct access to an HSCT patient — including medical and support staff, visitors, caregivers and patients — to wear a surgical mask while within 3 feet of the patient, regardless of the season or whether the patient was symptomatic. The policy took effect in December 2009, and the study ran from Jan. 12, 2010, to Jan. 11, 2014.

The investigators compared the results with those of patients who received an HSCT between Dec. 1, 2003, and Nov. 30, 2009.

Among patients who received HSCT while the mask policy was in place (n = 911), the overall incidence of RVI was 4.4%, down from 10.3% in patients who underwent transplantation during the pre-mask period (n = 920). Much of the overall decrease was seen in parainfluenza virus 3 (PIV3), where incidence dropped from 8.3% to 2.2%.

Sung and colleagues observed significant decreases in RVIs among allogeneic (16.9% to 8.3%) and autologous transplant patients (5.7% to 2.6%).

An adjacent hematologic malignancy unit observed no decrease in RVIs during the same time period while following similar infection control practices, without the universal mask policy, Sung and colleagues reported.

“We have shown that universal surgical mask usage … is associated with a significant decrease in clinically significant RVI, particularly PIV3,” they concluded. “This suggests that universal surgical mask usage could be a potent adjunct to standard infection control practices in bone marrow transplant units.” – by Gerard Gallagher

Disclosure: The researchers report no relevant financial disclosures.