A wealth of knowledge has become available concerning influenza prevention and control in the wake of the 2009 H1N1 pandemic. The purpose of this review is to summarize the recent literature on several non-pharmaceutical interventions: masks; quarantine, isolation, and social distancing; and hand hygiene, respiratory hygiene, and cleaning of fomites.
Mask use by cases and/or household contacts may be efficacious in reducing the transmission of influenza, but that effectiveness is likely reduced by poor compliance. Mask use in the community setting is of dubious benefit, as is the use of N95 respirators rather than surgical masks outside of health care settings.
Isolation and quarantine are effective and acceptable interventions to reduce the spread of influenza, particularly pandemic influenza. Social distancing measures (excluding school closures and prohibitions on mass gatherings, which are covered in another paper in this series (Roth, 2011)), however, are of unproven value and associated with low uptake.
Special attention should be paid to providing tools and supports to those in quarantine or isolation, particularly to vulnerable groups.
Moderate evidence exists to support recommendations for hand and respiratory hygiene, especially in children. Further research is needed to show benefits from cleaning and disinfection of surfaces in household and public spaces.