There were three recognized influenza pandemics in the 20th century, and historical experience suggests that another influenza pandemic is all but inevitable. Although 'colds' and seasonal influenza are clinically very different diseases from pandemic influenza, they share common transmission pathways and the community-level interventions needed to reduce both seasonal flu, common viral URIs and pandemic influenza are likely to be similar. In addition, the circulating influenza viruses causing seasonal flu are physically identical to pandemic influenza viruses, and therefore should be a good model for testing interventions before a pandemic emerges. Little research has been conducted to identify influenza prevention strategies at the household level. Hence, specific aims of this project are to compare the impact of two household-level interventions (an alcohol-based hand sanitizer with or without face masks) on six outcomes: incidence and types or strains of virologically confirmed influenza occurring in study households; rates of symptoms of influenza and viral URIs; basic reproduction number (R0), i.e. number of secondary cases generated by a single infected person in a fully susceptible household; antibiotic use practices for symptoms of influenza and other viral URIs; household member knowledge of prevention and treatment strategies for pandemic influenza and viral URIs; and rates of influenza vaccination among household members. 450 households in northern Manhattan (primarily recently immigrated Hispanics) will be randomized to three groups: control (receiving only a pamphlet on influenza prevention), alcohol hand sanitizer, and sanitizer plus face masks. Symptoms of influenza will be monitored daily for 15 months using ecological momentary assessment technology. Virologic cultures will be obtained from persons with flu symptoms (fever >100 degrees F., sore throat and/or cough). Antibiotic use practices, knowledge, and vaccination rates will be assessed by survey using pilot-tested, psychometrically sound instruments. For this cluster randomization design with randomized intervention on the household level, outcomes will be measured at the individual and household level using generalized linear mixed model for counts response with a Poisson distribution and other appropriate multivariate techniques to control for confounding.
| Cohen, Bevin; Ferng, Yu-hui; Wong-McLoughlin, Jennifer et al. (2012) Predictors of flu vaccination among urban Hispanic children and adults. J Epidemiol Community Health 66:204-9 |
| Landers, Timothy F; Ferng, Yu-Hui; McLoughlin, Jennifer Wong et al. (2010) Antibiotic identification, use, and self-medication for respiratory illnesses among urban Latinos. J Am Acad Nurse Pract 22:488-95 |
| Larson, Elaine L; Ferng, Yu-hui; Wong-McLoughlin, Jennifer et al. (2010) Impact of non-pharmaceutical interventions on URIs and influenza in crowded, urban households. Public Health Rep 125:178-91 |
| Ford, Timothy E; Colwell, Rita R; Rose, Joan B et al. (2009) Using satellite images of environmental changes to predict infectious disease outbreaks. Emerg Infect Dis 15:1341-6 |
| Larson, Elaine L; Ferng, Yu-Hui; Wong-McLoughlin, Jennifer et al. (2009) Retention and protocol adherence of Hispanic volunteers in a longitudinal trial. Am J Health Behav 33:435-44 |
| Larson, Elaine L; Ferng, Yu-Hui; McLoughlin, Jennifer Wong et al. (2009) Effect of intensive education on knowledge, attitudes, and practices regarding upper respiratory infections among urban Latinos. Nurs Res 58:150-7 |
| Larson, Elaine L; Wong-McLoughlin, Jennifer; Ferng, Yu-Hui (2009) Preferences among immigrant Hispanic women for written educational materials regarding upper respiratory infections. J Community Health 34:202-9 |
| Morse, Stephen S (2007) Pandemic influenza: studying the lessons of history. Proc Natl Acad Sci U S A 104:7313-4 |
| Morse, Stephen S (2007) Global preparedness for public health emergencies. J Public Health Policy 28:196-200 |
| Morse, Stephen S (2007) The US pandemic influenza implementation plan at six months. Nat Med 13:681-4 |
