In the Oct 24th edition of Lancet, van Weel looks at the importance of managing infection in home and everyday life – and the importance of handwashing.
He says “Influenza has a strong potential to transfer from individual to individual, and encounters in everyday life play an important part in its diffusion in the population. Wherever people meet—at work, in shops, on public transport—there is the risk of transmission, suggesting that the community is the context in which protection against further spread has to be orchestrated. Vaccination, personal hygiene (including handwashing), and measures against crowding are recommended measures”.
He reviews the recent study by Paul Little and colleagues looking at the effects of an internet-based handwashing promotion intervention in 16,000+ UK households. They found a “small but tangible” protective effect. After 16 weeks, 51% individuals reported one or more episodes of respiratory-tract infections in the intervention group compared with 59% in the control group. Importantly, this reduction was accompanied by lower demand for professional care (11%) vs 10%); and fewer antibiotic prescriptions (617 vs 535).
Their use of the internet to reach households is innovative – with the family and household as a key focus, and empowerment of people to care for their own health as a core objective. The engagement of individuals and the population meant that the study was not only able to recruit substantial participation, representative of the primary care population, but also to retain their commitment to self-care over time.
Protection of individuals (particularly those at highest risk), prevention of further spread in the community, and early identification of individuals in need of intensive treatment are key to management of outbreaks. Additionally, processes that can be managed by communities and individuals themselves do not add to the burden of professional health care—a particular issue during influenza pandemics. Equally, the small effects on individual risk of infection and decreased demand on primary care services could add up to substantial benefit. Influenza is only one of the many infectious diseases that can affect populations.
Van Weel concludes ”An exciting way forward to support communities in coping better with various infectious diseases might therefore be in promotion of the intervention through a community participation approach”.