CoChat
Sign Up
Cited by 805Infection Control and VentilationRespiratory viral infections researchInfection Control in Healthcare

The DOI matches its Crossref record; 289 of the 292 references it cites were found in a registry or an index.

Physical interventions to interrupt or reduce the spread of respiratory viruses

Open access
Jefferson, Tom, Del Mar, Chris B, Dooley, Liz, Ferroni, Eliana, Al-Ansary, Lubna A, Bawazeer, Ghada A, van Driel, Mieke L, Nair, N Sreekumaran, Jones, Mark A, Thorning, Sarah, Conly, John M·2011·Cochrane Database of Systematic Reviews
DOI 10.1002/14651858.cd006207.pub4PMC PMC8094623
Open this paper in CoChat — free accountOpen PDF

Abstract

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

Overview

The claims and statistics of this paper haven’t been checked yet.

Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.

A few free checks a day · papers already verified open instantly · results are public

Integrity signals

Registry

Crossref · 10.1002/14651858.cd006207.pub4

Cites

289 of 289 references verified0 citation errors · 0 not checkable

Statistics

Verification

Claims the paper makes

The claims and statistics of this paper haven’t been checked yet.

Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.

A few free checks a day · papers already verified open instantly · results are public

Claims other papers make about this one

Each is checked against this paper’s own text: does it say what the citing paper says it does?

Self-check

Percentages, sums and reported differences re-computed from the paper’s own numbers.

The self-check needs the paper’s full text.

Citations

Cites

Flagged first, then by citations

Show all 292 references

3 of the 292 references couldn’t be matched to a known paper.

Research works printed but not linked: 9

  1. Farr, 1988, Two randomised controlled trials of virucidal nasal tissues in the prevention of natural upper respiratory infection, American Journal of Epidemiology, 128, 1162, 10.1093/oxfordjournals.aje.a115059 · DOI
  2. Turner, 2004, Efficacy of organic acids in hand cleansers for prevention of rhinovirus infections, Antimicrobial Agents and Chemotherapy, 48, 2595, 10.1128/AAC.48.7.2595-2598.2004 · DOI
  3. Anonymous, 2002, Antiseptic skin cleansers may prevent rhinovirus transmission, Clinical Infectious Diseases, 34, ii
  4. Bauer, 2009, Impacto de un programa de prevención de infecciones respiratorias en lactantes prematuros de alto riesgo: estudio prospectivo y multicéntrico, Archivos Argentinos de Pediatria, 107, 111
  5. Garcia, 2010, The protection against influenza provided by surgical masks is not inferior to what the FFP2 (N95) respiratory protector can give, FMC Formacion Medica Continuada en Atencion Primaria, 17, 365
  6. Heymann, 2009, School closure may be effective in reducing transmission of respiratory viruses in the community, Epidemiology and Infection, 137, 1369, 10.1017/S0950268809002556 · DOI
  7. Khan, 2000, Stage II Conducting the review: Phase 5: Study quality assessment, 2.5.1
  8. Kitamura, 2007, Can we prevent influenza-like illnesses by gargling?, Japanese Society of Internal Medicine, 46, 1623, 10.2169/internalmedicine.46.0104 · DOI
  9. Lefebvre, 2009, Chapter 6: Searching for studies

Cited by

Sorted by citations

Items 601–700 of 803

Related

See all

Metadata

Authors
Jefferson, T., Del Mar, C. B., Dooley, L., Ferroni, E., Al-Ansary, L. A., Bawazeer, G. A., van Driel, M. L., Nair, N. S., Jones, M. A., Thorning, S., & Conly, J. M.
Affiliations
  • University of Oxford (GB)
  • Bond University; Centre for Research in Evidence-Based Practice (CREBP); University Drive Gold Coast Queensland Australia 4229
  • Bond University (AU)
  • Regione del Veneto (IT)
  • World Health Organization; Department of Health Metrics and Measurement; Geneva Switzerland
  • King Saud University (SA)
  • The University of Queensland; Primary Care Clinical Unit, Faculty of Medicine; Brisbane Queensland Australia 4029
  • Government of India (IN)
  • Gold Coast Hospital (AU)
  • Foothills Medical Centre (CA)
ORCID
Venue
Cochrane Database of Systematic Reviews
Publisher
Wiley
Published
2011-07-06
Volume
11
Issue
7
Pages
CD006207-CD006207
ISSN
  • 1361-6137 (ISSN-L)
  • 1465-1858
DOI
10.1002/14651858.cd006207.pub4
PMC
PMC8094623
OpenAlex
W1534533078
Cited by
805
References
292
Citations by year
2026: 5 · 2025: 19 · 2024: 54 · 2023: 81 · 2022: 95 · 2021: 135 · 2020: 191 · 2019: 20 · 2018: 20 · 2017: 16 · 2016: 26 · 2015: 41 · 2014: 31 · 2013: 33 · 2012: 20
FWCI
4.98
Type
journal article
Language
en
Update notices
new_version (2020-11-20)
Open access
Locations
  • Cochrane Database of Systematic Reviews (publishedVersion)
  • PubMed Central (publishedVersion)
  • PubMed (publishedVersion)
  • Ghent University Academic Bibliography (Ghent University) (submittedVersion)
  • Bond University Research Portal (Bond University) (submittedVersion, other-oa)
Topics
  • Health Sciences › Medicine › Pulmonary and Respiratory Medicine › Infection Control and Ventilation
  • Health Sciences › Medicine › Epidemiology › Respiratory viral infections research
  • Health Sciences › Medicine › Infectious Diseases › Infection Control in Healthcare
Keywords
physical interventions, respiratory virus transmission, acute respiratory infections, face masks, hand hygiene, social distancing, quarantine, isolation, personal protection, gargling, influenza, SARS, COVID-19 pandemic, pandemic preparedness, infection control, non-pharmaceutical interventions, harms of interventions, randomized controlled trials
MeSH terms
Humans, Influenza, Human, Respiratory Tract Infections, Virus Diseases, Case-Control Studies, Randomized Controlled Trials as Topic, Virus Shedding

About these checks

Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.

Statistics and arithmetic are recomputed, not judged.

Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.

What counts as a claim ›How we measure confidence ›How we check this ›

Are you an author, or do you see a problem with this page? Request a review