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Can a Mask Protect You from SARS?

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>

> April 29, 2003 -- The images of mask-covered men, women, and children

> have

> been linked with SARS (severe acute respiratory syndrome) since the

> outbreak

> began. Sales of the paper masks have soared in areas hardest hit by SARS

> as

> people try to protect themselves from an unknown enemy. But how much

> protection can a simple mask offer from SARS?

>

> Despite their popularity in Asia, experts say standard surgical masks --

> the

> inexpensive square masks that tie behind your head -- are probably more

> effective in preventing people with SARS from spreading the disease

> than

> protecting healthy people from becoming infected.

>

> CDC director Julie Gerberding, MD, says surgical masks are useful in

> filtering out relatively large particles of moist materials that you

> cough

> up or sneeze, which reduces the likelihood of passing SARS to another

> person.

>

> " That's the reason why we recommend that those masks be used for

> patients

> with SARS because it contains their secretions and prevents them from

> being

> disseminated in the environment, " says Gerberding.

>

> Infectious disease expert Jon Temte, MD, PhD, of the University of

> Wisconsin

> says the pictures of people in Beijing and Hong Kong wearing surgical

> masks

> remind him of the influenza pandemic of 1918.

>

> " I remember looking at old photos from the 1918 influenza pandemic and

> seeing people wearing masks everywhere, " says Temte. " But that was

> never

> shown to be effective for preventing the spread of influenza. "

>

> Temte says it's really to early to know whether masks are an effective

> way

> to protect against SARS. Researchers simply don't know enough about the

> virus and how it spreads.

>

> " On the flip side, there is probably not a whole lot of harm in it, "

> Temte

> tells WebMD. " Any sort of barrier will reduce likelihood of droplet

> transmission. "

>

> Health officials at the World Health Organization and CDC believe SARS

> is

> spread primarily by close contact with droplets from an infected person.

>

>

> " So if we're looking at a viral transfer on the basis of coughing up

> small

> droplets, when that droplet travels the distance between the person and

> the

> unlucky recipient and lands on fertile ground, you have transmission, "

> says

> Temte.

>

> Wearing a mask may protect people from inhaling these droplets and

> becoming

> infected, but the masks usually don't fit snugly and can allow droplets

> to

> enter the mouth or nose from the edges of the mask.

>

> Although droplet transmission through close, personal contact with an

> infected individual is believed to be the primary mode of transmission

> of

> SARS, health officials have not ruled out the possibility that tiny

> particles of the SARS coronavirus may also spread the disease through

> the

> air. If such transmission is possible, some of these tiny virus

> particles

> may pass through a simple surgical mask or enter through an air gap.

>

> Surgical masks also provide no protection for the eyes, and some types

> of

> virus particles can enter the body through the eyes as well as the mouth

> and

> nose.

>

> In addition, some types of coronaviruses are known to survive on objects

> for

> several hours, which means it's possible that person with SARS person

> could

> sneeze and infect an object like a door knob that is later touched by

> someone who then rubs their eyes, nose, or mouth and becomes infected

> in

> that manner.

>

> For protecting people from SARS infection, the CDC recommends that

> healthcare providers who care for SARS patients wear a much more

> efficient

> mask known as an N95 respirator. This type of mask is certified by the

> National Institute of Occupational Safety and Health (NIOSH) as being

> effective at filtering out at least 95% of airborne particles of a

> particular size.

>

> There are also N99 and N100 masks that are even more efficient, but N95

> masks are considered the standard for preventing infection from most

> known

> viruses.

>

> But for these masks to work, they must be properly fitted to make sure

> there

> are no gaps between the mask and the skin. The mask is made of a

> thicker

> material than regular surgical masks and, when properly fitted, does

> not

> allow air to flow outside the mask.

>

> Gerberding says N95 masks are only recommended for healthcare workers

> caring

> for SARS patients because they are at greatest risk of becoming

> infected. In

> fact, the majority of initial SARS cases were among doctors, nurses,

> and

> medical students who cared for the first round of SARS patients and did

> not

> wear such protection. Since infection control measures such as wearing

> N95

> masks were implemented, the rate of SARS spread to healthcare workers

> has

> been drastically reduced.

>

> " We don't recommend N95 masks for the general public. We don't recommend

> N95

> masks for patients, " says Gerberding. " We are recommending surgical

> masks

> for patients if they're well enough to wear one, and we're using those

> N95

> masks in the healthcare environment in hospitals where we've got sick

> patients most likely to be aerosolizing relatively high concentrations

> of

> infectious material. "

>

> To reduce the risk of SARS transmission in the general public, the CDC

> recommends following good hygiene practices, such as frequent hand

> washing

> and use of alcohol-based rubs, and avoiding areas where SARS is known

> to

> have been spread.

>

> _____

>

> SOURCES: CDC telebriefing, April 22. World Health Organization. Jon

> Temte,

> MD, PhD, associate professor at the University of Wisconsin in the

> department of family medicine.

>

>

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