Masks come in various types based on efficiency. Following are general facts about face masks, respirators, types of masks, classifications, recommendations, about face masks and the influenza virus, stockpiling information and the sources.

Here are some key issues about respirators and face masks followed by more technical information.

The spread of viruses can be restricted by using respirators or face masks as the SARS experience proved. There are several types of faces masks on the market but the shelf-life of masks and or filters is limited. There are three categories of effectiveness which are listed below. Please note:

• * The face mask must fit well: the nose clip, head tapes or elastic and edges must seal.
• * Beards hamper effectiveness: particle-filtering half-masks are impaired by beards. People with beards are recommended to remove them.
• * Particle-filtering face masks should not generally be worn for longer than 8 hours in total. Surgical masks should not generally be worn for longer than 2 to 3 hours in total.
• * Other masks, if used carefully (avoiding contamination of the inner surface when removing the mask), can be worn several times by the same person.
• * The face mask must be changed in the following situations:

1. − If a particle-filtering mask has been worn for 8 hours in total (2 to 3 hours for surgical masks)
2. − If the face mask has come into direct contact with secretions containing pathogens (the virus)
3. − If the face mask has visible defects
4. − If breathing resistance is increased due to moisture

• * Face masks must be kept in a clean place protected from dust and moisture.
• * You must have a plan to properly dispose of used or contaminated masks otherwise they become a health risk in themselves.
• * The manufacturers of face masks can be contacted for information on their shelf-life.
• * It has not been demonstrated unequivocally that face masks protect against infections in general since no well-founded efficacy tests have been carried out with live or inactivated germs. However, experience with SARS suggests that the spread of viruses can be restricted by face masks.
• * There is the question of the psychological value of masks for the population during a pandemic.

Types of Masks

There are several types of respirators and face masks available which offer various levels of protection. The simplest way of protecting against droplet-borne germs is to use surgical masks. These can reduce the spread of germs in the exhaled air of sick people. The type of mask attached to the wearer’s head by an elastic head band is recommended since it is easy to use and stays in place well. Only surgical masks (or those with an elastic band) of type II, or, if possible type IIR (the letter R indicates greater splash resistance) which comply with national standards are recommended. Surgical masks become soaked with moisture after about 2 to 3 hours, which causes them to lose their efficacy.
Classifications

In the USA, N-95 and N-99 filter masks offer a greater degree of protection. The European standard is EN149. Masks come in three classes, FFP1, FFP2 and FFP3.
The filter classification is based on the protection conferred against particles (max. 0.6 μm). The filtration efficiency is at least 95% for FFP2 masks and at least 99% for FFP3 masks. The filtration effect of the masks is achieved by electrostatically charged fibers, the efficiency of which decreases with age and at an ambient humidity level over 80%. FFP masks are soaked through after about 8 hours.

Recommendations

During the SARS epidemic there was some evidence that FFP masks and surgical masks may have been of benefit. The WHO (World Health Organization) does not state that wearing face masks in public is an effective way of protecting the population against infection and thus preventing the spread of the pandemic; however, the organization leaves it to each country to decide whether or not to take this approach. (See Video below)

The Influenza Virus

The influenza virus is transmitted primarily by droplets. It may also spread by hand-to-face contact if a non-infected person touches a person or surface contaminated with infected droplets. It is not certain whether the virus can be spread in the air. Since the potential pandemic virus and its mode of transmission are not yet known, the possibility that it can spread in the air (aerosol-borne) cannot be excluded. The reader’s attention is drawn explicitly to the fact these recommendations are based only on the preliminary findings currently available. Further research is required to provide evidence-based support for the recommendations. The recommendations issued by the WHO and national health organization will be adapted to reflect as accurately as possible current knowledge of the virus’s mode of transmission.

Masks should have a bacterial filtration efficiency (BFE) of ≥ 92%, breathing resistance < 5.0 mm water/cm2 and splash resistance ≥ 120 mm Hg. (Total leakage from the masks is generally around the same as FFP1 masks.)

The Food and Drug Administration has approved types of respirators to help reduce exposure during a flu pandemic: 3M respirators models 8612F and 8670F, and Pasture Pharma respirator models F550G and A520G.

Stockpiling Face Masks

Stockpiling of FFP masks is only possible to a certain extent because of their limited shelf-life of 3 years (see above). Surgical masks do not have a limited shelf-life. Although many federal governments will stockpile a certain number of masks, Healthy members of the general population will be expected to obtain their own surgical masks.

Video (via YouTube): CDC General Instructions for Disposable Respirators

References

* U.S. Department of Health and Human Services. HHS Pandemic Influenza Plan. 2005; 233.
* World Health Organization. WHO global influenza preparedness plan. 2005; 42f.
* BVet. Empfehlungen zum Schutz des zur Bek?pfung der klassischen Gefl?elpest eingesetzten Personals. 2005.
* Deutsches Institut für Normung e.V., Berlin, Operationsmasken – Anforderungen und Prüverfahren, Deutsche Fassung prEN 14683. 2003; 1-15.
* Lange JH. Use of disposable face masks for public health protection against SARS. J Epidemiol Comm Health 2004; 85: 434.

Poll results: Our Quick Poll for January asked “Would you were a face mask?” (in the event of an outbreak)
Yes: 82.4 %
No: 11.8%
Unsure: 5.9%
These percentages were from some 1900 votes from various countries.

Isn't she lovely!

It started with diarrhea, then fever and basic flu-like symptoms. It certainly could be swine flu.

In theory we should all stay home so as not to spread it. But the clinic has other ideas. Although the personnel are well donned in green, almost from head to foot, parents and kids seeking help are not given so much as a mask. Instead we are told to go home and wait for the results. That could days. In the mean time the other kids are back to school and we as parents are told to go about life as normal.

Somehow I had expected something different. Of course we know that the current H1N1 bug isn’t as dangerous as it could be, but we are in a pandemic situation and surely if this thing is to be stopped we should, as a family, have stayed home?

I suppose most people are waiting for the vaccine or hopeful that current medications will be enough to stop the swine flu in its tracks. But truthfully, who is going to get a vaccine anyway? Countries like France want to vaccinate all 64 million people in the country, but how? Working 24 hours per day with every medical, health, first-aid person plus volunteers, the logistics of vaccinating 64 million people are overwhelming. And of course I don’t live in France. Nor is a vaccination ready.

Since June when the global pandemic was declared by the WHO (World Health Organization), I have seen relatively little preparation. Certainly we have the leaflets explaining symptoms and personal hygiene, which needs to be repeated. But running back and forth to a clinic seems more likely to help spread the flu bug, not deter it. I would have been happier if I had the offer of a face mask, perhaps at my local gas station and shopping mall.

One thing is for sure, if my daughter does have swine flu, it’s too late now. It has already been passed on.

If the virus mutates into something even more deadly, I certainly hope the system is prepared to do a better job of containment. At a school close by, the answer by the director was to charge money each time the kids washed their hands. Fortunately that got into the newspapers and the local counsel stepped in and forced them to stop. In some ways it seems for all our plans and “preparedness” we really are not as prepared as I had thought.

This has to get better before the fall flu season hits. In the mean time, I have been advised to send my daughter back to school as soon as possible.

WHO Flag

Dr. Margaret Chan of the World Heath Organization (WHO) has officially raised the status of H1N1 Swine Flu to six, the highest level.

Dr. Chan said there are two main concerns now:

a) a second wave of the flu is to be expected, probably within the next 6 to 9 months, and

b) in developing countries who have not yet come into their influenza season, that they may not be able to cope well with H1N1 when it arrives.

The virus which is currently called Swine Flu is still a somewhat mild version, meaning it is more severe than normal flu but not yet killing too many people.

Influenza viruses are notorious for quickly changing their behaviour and because of that the concern is that it could mutate into something much more severe.

The last Pandemic was in 1968 when Hong Kong Flu killed some 50,000 people.

Almost 30,000 have been infected by the H1N1 virus in some 74 countries according to the WHO.

Much more news on Twitter.

Cases of Swine Flu have surged since the weekend in Japan forcing authorities to close schools and kindergardens as a precaution for the teenager-hit crowd.

Meanwhile the WHO (World Health Organization) says that making swine flu vaccine is harder than thought and will not be available until mid-July.

The WHO says 40 countries are now infected with H1N1 and have officially reported 8480 cases of influenza A(H1N1) infection.

Bird Flu also keeps in headline news as Reuters reports a 4-year-old Egyptian girl has died after contracting the highly pathogenic H5N1 bird flu virus, Egypt’s state news agency MENA said on Monday. Fears continue that the two could mix creating a potent virus deadly to humans. While it is expected that the flu virus will die down until later in the year, it is still an unknown as to what exactly will happen.

Currently the USA leads in cases of Swine flu (4714) followed by Mexico (3103), Canada (496), Japan (176), Spain (103) and the UK (101).

Dr Smith: Each and every year, the flu spreads around the planet. It starts China and then travels, often not noticed in the Northern hemisphere (where most of the world’s population live) until Autumn or Spring.

Q: When and where do swine flu outbreaks occur?

WHO: Outbreaks in pigs occur year round, usually in the autumn and winter in temperate zones. Since international health regulations were implemented in 2007, WHO has been notified of swine influenza cases from the United States and Spain.

Governments do not have to notify international animal health authorities about swine flu outbreaks, therefore its international distribution in animals is not well known. The disease is considered endemic in the United States. Outbreaks in pigs are also known to have occurred in North America, South America, Europe (including the UK, Sweden, and Italy), Africa (Kenya) and in parts of eastern Asia including China and Japan.

Q: This super-virus we’re looking at now is said to be a cross between a pig flu, a human flu and also the bird flu, which has been deadly too. Does this make it even more dangerous?

Dr Smith: Flu is broken down into a number of different types: there’s flu A, flu B and flu C. Flu A is the bird form and, of course, humans also have a flu A. Then we further categorise it according to the surface molecules, the H (for Haemagglutinin) and the N on the surface.

This new strain is a H1N1 virus, which we know circulates in humans, pigs and birds. It’s possible that the pig initially got some of its flu from a bird and then co-mixed that with the human form to produce this hybrid, which is why you can find elements of all three.

It is very much early days and the big focus now, through infection control organisations like the Centres for Disease and Prevention (CDP) and the WHO, will be to interrogate this virus at a molecular level.

In other words, look at the genetic make-up, sequence the virus, and once they’ve got the genetic sequence you can begin to unpick where it’s come from, what its origins are, and therefore begin to build the story as to what its likely outcome will be.

WHO: Swine flu viruses are most commonly of the H1N1 subtype but other subtypes g (H1N2, H3N1 and H3N) are also circulating. The H3N2 swine virus was thought to have been originally introduced into pigs by humans.

An influenza virus containing genes from a number of sources is called a “reassortant” virus. Swine flu viruses are normally species specific and only infect pigs, but sometimes they cross the species barrier to cause disease in humans.

This interview was with the World Health Organization and Dr. Christopher Smith, Virologist at Cambridge University and the author of The Naked Scientists Science Radio Show Podcast

Here is some footage of the advertising to get people vaccinated in 1976:

youtube >>

As we know, the 1976 scare was just that, the epidemic never came. However, it raises an interesting question about vaccination in 2009. Should health officials go ahead and call the public to vaccinate? If they do, the upcoming seasonal flu in the autumn will possibly require a second vaccination. While it may be possible to manufacture enough vaccine for one flu round, it probably is not possible to manufacture enough vaccine to cover both the Swine Flu and the normal, upcoming flu season ahead of us. And health officials do not want to try to concoct vaccines which are untested and which may result in the catastrophy of 1976.

In Other News:

Facebook is weighing in with its own Swine Flu discussion. See the photos here: http://www.facebook.com/album.php?aid=106392&id=20531316728

* Several countries are beginning to debate where and when schools may be closed down to halt a possible spread of Swine Flu. Since infection can happen between 1 and 5 days before any symptoms show up, it is a hard choice to make.

* Schweinegerippe in Deutschland bestätigt aber Erste Zweifel an Gefährlichkeit der Schweinegrippe: http://www.spiegel.de/

* CAIRO (AP) — Egypt began slaughtering the roughly 300,000 pigs in the country Wednesday as a precautionary measure against the spread of swine flu even though no cases have been reported here yet, the Health Ministry said.

* Virus’s Arrival Is Reported on Four Continents: http://online.wsj.com/article/SB124090884691363061.html

* Lingo Watch: From Swine Flu to H1N1 Virus (so as not to disrupt the sale of pork)

http://www.cdc.gov/swineflu/
Swine Flu website last updated April 28, 2009 6:00 AM ET … An investigation and response effort surrounding the outbreak of swine flu is ongoing. …

http://www.npr.org/templates/story/story.php?storyId=103506962
Swine flu, a highly contagious respiratory disease in pigs, can infect humans who have close contact with the animals or a contaminated …

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http://www.who.int/csr/disease/swineflu/en/index.html
WHO is coordinating the global response to human cases of swine influenza A (H1N1) and monitoring the corresponding threat of an influenza …

http://www.pandemicflu.gov/
One-stop access to US Government avian and pandemic flu information. … Flu terms defined — Seasonal flu, swine flu, avian flu, and pandemic flu are not …

http://www.spiegel.de/fotostrecke/fotostrecke-41899.html
Photo Gallery: Fighting a Swine Flu Pandemic. 04/27/2009. Return to Homepage. 1 of 16. REUTERS. Virologists expect that the swine flu will soon reach …

http://www.bloomberg.com/apps/news?pid=20601087&sid=aWcd0Nbgc_R4&refer=home
The seasonal flu vaccine doesn’t appear effective against swine flu, … No decision has been made to order a vaccine against swine flu, …

http://www.youtube.com/watch?v=rT2HWdPFqMg
Harry Smith spoke with a Texas family who contracted Swine flu but are recovering without difficulty. Dr. Jennifer Ashton outlined the …

http://twitter.com/cdcemergency
Tracking Swine flu on Twitter

http://coldflu.about.com/
A series of blog entries from About.com related to Swine Influenza

http://www.medicinenet.com/pneumonia/article.htm
Learn pneumonia symptoms, causes, treatment, signs, diagnosis and types: viral and bacterial (Pneumocystis carinii, Klebsiella, Mycoplasma, …

http://kidshealth.org/parent/infections/lung/pneumonia.html
Kids Health: When this happens, symptoms of pneumonia begin after 2 or 3 days of a cold … Symptoms of pneumonia vary, depending on the age of the child and the cause …

http://news.bbc.co.uk/2/hi/europe/8020552.stm
BBC News, links, QandA, video, audio and more on Swine Flu

http://www.ecdc.europa.eu/Default.aspx
European Centre for disease prevention and control

http://www.google.org/flutrends/
Explore flu trends across the U.S. via Google

http://healthguide.howstuffworks.com/influenza-vaccine-dictionary.htm
How Stuff Works: Vaccine – influenza; Immunization – influenza; Flu shot; Flu vaccine …

http://bodyandhealth.canada.com/
Body and Health Canada: Pneumonia rarely causes serious complications for healthy people under 65 …

http://www.xodigo.com/h5n1/pandemic.htm
The history of influenza Pandemics in the last century and what we can learn from them …

http://www.xodigo.com/h5n1/links.htm
Health Links: Links to International health and information web sites …

http://www.xodigo.com/h5n1/facemask.htm
Face Masks: which ones work and which ones to avoid …

“We are very, very concerned,” World Health Organization spokesman Thomas Abraham said. “We have what appears to be a novel virus and it has spread from human to human,”

At this time, CDC (Centers for Disease Control and Prevention) recommends the use of oseltamivir or zanamivir for the treatment of infection with swine influenza viruses. The H1N1 viruses are resistant to amantadine and rimantadine but not to oseltamivir or zanamivir. It is not anticipated that the seasonal influenza vaccine will provide protection against the swine flu H1N1 viruses.

There are everyday actions people can take to stay healthy against Swine Flu.

* Cover your nose and mouth with a tissue when you cough or sneeze. Throw the tissue in the trash after you use it.
* Wash your hands often with soap and water, especially after you cough or sneeze. Alcohol-based hands cleaners are also effective.
* Avoid touching your eyes, nose or mouth. Germs spread that way.

Try to avoid close contact with sick people.

* Influenza is thought to spread mainly person-to-person through coughing or sneezing of infected people.
* If you get sick, it is recommended that you stay home from work or school and limit contact with others to keep from infecting them.

To survive swine flu or any influenza, a strong immune system is a must. Smoking, drinking, drug abuse and lack of sleep weaken your immune system. Eat right, get plenty of exercise and rest properly. Abuses of any kind are going to weaken your bodies natural defense mechanisms.

Symptoms of Swine flu are similar to normal influenza and include breathing problems, fever, fatigue, vomiting and diarrhoea. You should consult a doctor if you suspect you have the flu. And as you might know, most countries have been stock-piling anti-flu virals for some time now. It is expected (certainly hoped) that Tamiflu and Relenza will be able to fight against A (H1N1).

A new trainer’s manual aims to provide health journalists with adequate tools to report on threats of bird flu.

Put together by Internews and funded by UNICEF, the manual is to help trainers design and conduct media workshops on avian influenza. The manual also includes the basic resources that media need when trying to promote awareness and discussion about the virus.

The manual was a result of a series of three-day journalists’ training workshops in Vietnam, Laos, Mongolia, Indonesia and Thailand. The training was part of the “Equipping Journalists for Accurate Reporting on Avian Influenza and the H5N1 Virus in Southeast Asia” project conducted by Internews.

The training manual (PDF format): http://tinyurl.com/33ukzs. (1.7 Megabytes)

Source: International Journalist’s Network: http://www.ijnet.org/Director.aspx?P=Article&ID=306552&LID=1

—

The online course offered by the Centers for Disease Control and Prevention and the Council of State and Territorial Epidemiologists provides a standardized curriculum for local and state health system first responders concerning how to identify and control human infections and illness associated with the H5N1 strain of bird flu.

The training focuses on human health issues during an avian influenza investigation. Through lectures, reference materials and case studies, the course provides mechanisms to facilitate discussion and planning among people who may be called upon to respond to an avian influenza outbreak in the United States.

… Public-health officials around the world consider H5N1 to be the greatest current pandemic influenza threat.

The course is available at http://www.cste.org/influenza/avian.asp.
Copyright © 2007 by United Press International