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 mm). 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 Gefluelpest eingesetzten Personals. 2005.
* Deutsches Institut für Normung e.V., Berlin, Operationsmasken “ Anforderungen und Präverfahren, 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.

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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

Here is the excerpt:

TORONTO–(BUSINESS WIRE)–Pandemic 101 today announces the launch of new programs for the business and the home. The Pandemic 101 website (www.pandemic101.com) provides valuable resources for pandemic preparedness information, as well as corporate and family pandemic preparedness products.

“We have all seen the news and heard stories from across the globe on how pandemics like the Avian Bird Flu have affected people in regions where outbreaks have occurred,” states Scott Ashley, President and Founder of Pandemic 101. “We hope that our resources and products will get people thinking of the damaging effects a pandemic in North America could have on individuals and corporations and how important it is for everyone to be prepared.”

…

Pandemic 101 offers family solutions which come in 1, 2, or 4 person kits. Each kit contains:

* An 80 page family preparedness guide,
* An Infectious disease and pandemic flu training DVD,
* Free access to training videos and information at the Pandemic 101 library,
* Personal protective products including gloves, masks and sanitizers,
* A voucher for Tamiflu, which can be processed through an online pharmacy.

Pandemic101â„¢ also provides organizations with turnkey operational processes, plans, medical directives, infectious control guidelines, pandemic table top exercises, on-line training, infection control products, medical directors and access to antiviral medications. Our program is designed to enable business organizations to be prepared.

More information can be found at www.pandemic101.com or by contacting 1-888-FLU-PREP in North America, or internationally at +1 (519) 488-5122.

“The vaccine could be used in the event the current H5N1 avian virus were to develop the capability to efficiently spread from human to human, resulting in the rapid spread of the disease across the globe. Should such an influenza pandemic emerge, the vaccine may provide early limited protection in the months before a vaccine tailored to the pandemic strain of the virus could be developed and produced.”

“The threat of an influenza pandemic is, at present, one of the most significant public health issues our nation and world faces,” said Andrew C. von Eschenbach, M.D., Commissioner of Food and Drugs. “The approval of this vaccine is an important step forward in our protection against a pandemic.”

“The vaccine was obtained from a human strain and is intended for immunizing people 18 through 64 years of age who could be at increased risk of exposure to the H5N1 influenza virus contained in the vaccine. H5N1 influenza vaccine immunization consists of two intramuscular injections, given approximately one month apart. The manufacturer, sanofi pasteur Inc., will not sell the vaccine commercially. Instead, the vaccine has been purchased by the federal government for inclusion within the National Stockpile for distribution by public health officials if needed. The vaccine will be manufactured at sanofi pasteur’s Swiftwater, Pa., facility.”

“A clinical study was conducted to collect safety information and information on recipient’s immune responses and to determine the appropriate vaccine dose. A total of 103 healthy adults received a 90 microgram dose of the vaccine by injection followed by another 90 microgram dose 28 days later. In addition, there were approximately 300 healthy adults who received the vaccine at doses lower than 90 micrograms and a total of 48 who received a placebo injection.”

“The vaccine was generally well tolerated, with the most common side effects reported as pain at the injection site, headache, general ill feeling and muscle pain. The study showed that 45 percent of individuals who received the 90 microgram, two-dose regimen developed antibodies at a level that is expected to reduce the risk of getting influenza. Although the level of antibodies seen in the remaining individuals did not reach that level, current scientific information on other influenza vaccines suggests that less than optimal antibody levels may still have the potential to help reduce disease severity and influenza-related hospitalizations and deaths. Additional information on this H5N1 influenza vaccine is being collected on safety and effectiveness in other age groups and will be available to FDA in the near future.”

“With the support of FDA, the U.S. National Institutes of Health and other government agencies, sanofi pasteur and other manufacturers are working to develop a next generation of influenza vaccines for enhanced immune responses at lower doses, using technologies intended to boost the immune response. Meanwhile, the approval and availability of this vaccine will enhance national readiness and the nation’s ability to protect those at increased risk of exposure.”

According to researches, hands are the most common mode of disease transmission, and one of the common ways people catch the flu is by rubbing their noses after their hands have been contaminated with the flu virus.

So most people wash their hands before eating, right? Wrong, surveys suggest at the most sixty percent of people take the time to do this simple yet effective step, and of course not everyone has access to either soap or clean water.

Still, the influenza virus and the H5N1 Avian flu variation can remain on surfaces for several hours and get into the body through hand contact to the mouth, nose or eyes. For those who can, hand washing and personal hygiene are a simple but very effective help to stop the spread of what is turning out to be a very deadly disease.

In Vietnam where a current outbreak of Bird Flu has authorities nervous, experts are campaigning for hand washing. “Frequent hand washing with soap may help us reduce the risk of bird flu,” one such advert says. Proper hand washing takes us only 15-20 seconds. Because a bar of soap costs relatively little, it’s a small amount for prevention preferable to spending a larger amount on doctors.

More details of this and other personal hygiene tips are on our site, www.xodigo.com/epidemics/prevention/, but the bottom line is, washing your hands with soap frequently helps prevent bird flu transmission.

The link is: Find a flu shot . com

Trust that helps.

There are a number of steps you can take to protect yourself. Here are a few:

1) Get a flu shot: in general, anyone who wants to reduce their chances of getting the flu can get vaccinated.

However, certain people should get vaccinated each year. They are either people who are at high risk of having serious flu complications or people who live with or care for those at high risk for serious complications.

For the current flu season, the CDC recommendations have added on children ages 24 to 59 months, which also extends to household contacts of the children, and their caregivers outside the home.

The CDC also suggests you take the following steps to help ward off the flu:

2) Avoid close contact with people who are infected.

3) Wash your hands often to help protect you from germs. Studies suggest that flu viruses can live on surfaces for two to eight hours.

4) Avoid touching your eyes, nose or mouth. Germs are often spread when a person touches something that is contaminated with germs and then touches his or her eyes, nose, or mouth.

5) Ask your doctor about antiviral drugs, which are not a substitute for the flu shot, but they do add another level of protection.

6) If possible, stay home from work, school and errands when you are sick, so you’ll be less likely to pass on the virus.

7) Ask your doctor about Pneumonia shots: NOTE – You need a flu shot every year while your pneumonia shot is generally good for a lifetime.

Details are given about quarantines and border closures although stressing that defence against bird flu is difficult. But the principle goal of the US “implementation plan” is, “the capacity for every American to have a vaccine in the case of a pandemic, no matter what the virus is”, according to the Health and Human Services Secretary Michael Leavitt. The plan also stresses more methods to develop vaccines. The government already has ordered $162.5 million worth of vaccine against Asian bird flu.

Specifically, the US implementation plan costs $ 7.1 billion including:

* $1.2 billion for the government to buy enough doses of the vaccine against the current strain of bird flu to protect 20 million Americans; the administration wants to have sufficient vaccine for front-line emergency personnel and at-risk populations, including military personnel.

* $1 billion to stockpile more anti-viral drugs that lessen the severity of the flu symptoms.

* $2.8 billion to speed the development of vaccines as new strains emerge, a process that now takes months. The goal is to have the manufacturing capability by 2010 to brew enough vaccine for every American within six months’ of a pandemic’s start.

* $583 million for states and local governments to prepare emergency plans to respond to an outbreak.

President George W. Bush announced the initial plan in November, 2005. Congress approved about half that amount but is likely to approve the rest soon. “At this moment there is no pandemic influenza in the United States or the world, but if history is our guide there’s reason to be concerned,” Bush said. “In the last century, our country and the world have been hit by three influenza pandemics, and viruses from birds contributed to all of them.”

“The 1918 pandemic was followed by pandemics in 1957 and 1968, which killed tens of thousands of Americans and millions across the world,” continued Bush. “If a pandemic strikes, our country must have a surge capacity in place that will allow us to bring a new vaccine online quickly and manufacture enough to immunize every American against the pandemic strain,” Bush said.

The H5N1 avian bird flu virus has infect 205 people and killed 113 of them in nine countries, according to the World Health Organization.

With a few mutations it could become easily transmitted from person to person and spark a pandemic. And experts say H5N1 looks closer to doing this than any other new flu virus seen in the past 30 years.

Sources :: Health and Human Services (HHS) ; Reuters

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