A student walks past a hand sanitizer dispensing station at Simon Fraser University in Surrey, B.C.DARRYL DYCK
Does hand-washing prevent the spread of influenza? Is the surgical mask enough to protect health-care workers from getting sick? Will flu vaccines be safe?
For Canadians already puzzled by the abrupt changes to the country's fall vaccination campaigns, new reports are adding to the confusion.
While scientific discourse is ongoing, new studies surrounding influenza are being thrust into the public spotlight at a time when citizens are trying to make sense of the country's various vaccination campaigns.
The latest papers, both released Thursday, came from the Canadian Medical Association Journal and Journal of the American Medical Association.
The CMAJ article questioned the value of good hand hygiene practices in preventing the spread of influenza, referencing a government-commissioned report from 2007 that said hand washing was based on practical, rather than evidence-based considerations.
The message runs counter to that of the Public Health Agency of Canada, which has relentlessly preached frequent hand washing to prevent the spread of the pandemic H1N1 virus, even in a high-profile advertising campaign.
Meanwhile, a study by a McMaster University researcher released online by the Journal of the American Medical Association found that surgical masks appear to protect health-care workers from catching the flu as well as N95 respirators. Mark Loeb, an infectious diseases expert at McMaster, and colleagues randomly assigned 446 nurses from eight Ontario hospitals to wear either surgical masks or fitted N95s last flu season. An N95 fits more tightly around the mouth and nose than an ordinary surgical mask.
About 23.6 per cent of the nurses who wore surgical masks got sick, compared to 22.9 per cent of the nurses wearing the N95s, which meant both masks were just as effective.
The results run contrary to research released last month that found N95s were better in protecting health-care workers.
Donald Low, chief microbiologist at Toronto's Mount Sinai Hospital, called the timing of the papers "unfortunate."
"But I think you have to share this information," he said.
Dr. Low chaired the 2007 panel on influenza and personal protective respiratory equipment. He said that while scientific evidence may be lacking on influenza viruses and how they spread, hand hygiene remains good practice.
CMAJ editor-in-chief Paul Hébert defended the article on hand washing, saying it is meant to encourage debate in the scientific community.
The Public Health Agency of Canada Thursday stood by its advice. "The hand hygiene recommendations for routine practice are based on scientific evidence and expert opinion. There is substantial evidence to support hand hygiene as a basic premise of infection prevention and control measures," the agency said in an e-mail.
The new studies come as Canadians are struggling to make sense of provincial and territorial vaccination programs that have changed, mainly because of an unpublished Canadian study that suggested people who got a seasonal flu shot last year were twice as likely to contract the H1N1 virus compared with unvaccinated people.
Most provinces and territories have either scaled back or suspended plans to deliver seasonal flu vaccine this month. Alberta said yesterday that it would offer the seasonal flu vaccine this month to high-risk groups only, including the elderly, and then roll out the H1N1 vaccine campaign in November.
Caroline Alphonso