Hand Sanitizers in Schools Can Help Prevent the Flu

A hand and respiratory hygiene program that includes frequent use of alcohol-based hand sanitizer helps reduce illness caused by influenza A and missed school days in elementary school children, according to research published in the November issue of The Pediatric Infectious Disease Journal.

“Respiratory hygiene education and the regular use of hand sanitizer can be an important adjunct to influenza vaccination programs to reduce the number of influenza A infections among children,” the authors wrote.

In the study, which was led by Samuel Stebbins, MD, PhD, of the University of Pittsburgh and colleagues, 5 elementary schools in Pittsburgh were assigned to receive training as part of the “cough etiquette and hand hygiene” program, and 5 schools received no special training.

In the program, called “WHACK the Flu,” children were taught to:

• (W)ash or sanitize your hands often.
• (H)ome is where you stay when you are sick.
• (A)void touching your eyes, nose, and mouth.
• (C)over your coughs and sneezes.
• (K)eep your distance from sick people.

During the school year, children who developed a flu-like illness were tested to determine if they had influenza, and whether the cause was influenza A or B virus. Of the 279 tests performed in children with flu-like illness, 104 confirmed cases of influenza were identified.

The program was deemed successful in getting children to use hand sanitizer regularly, with average use estimated at 2.4 times per day. Schools assigned to “WHACK the Flu” demonstrated a 52% reduction in the rate of confirmed illness caused by influenza A. However, there was no significant difference in the overall rate of laboratory-confirmed influenza, or in the rate of illness caused by influenza B.

Along with the decrease in influenza A, there was a 26% reduction in total school absences. The hygiene program was also linked to possible improvements in other school attendance measures, including a lower rate of absences during flu season.

School-age children are an important source of influenza transmission and were heavily affected by the 2009-10 influenza A H1N1 pandemic. Previous reports have suggested that using hand sanitizer—alone or with other hygiene measures—can reduce absences and some causes of infectious diseases. Although the “WHACK the Flu” program didn’t lower the overall influenza rate, it did achieve approximately a one-half reduction in influenza A and a one-fourth reduction in school absences.

The results show that a hygiene education program including hand sanitizer “can be implemented successfully on a large scale within urban schools to reduce absenteeism and the incidence of influenza A,” the authors wrote. They believe the study supports current recommendations for respiratory hygiene—including hand sanitizer—during any type of flu outbreak, and as part of an overall influenza prevention strategy in schools.