Get access

The Effect of Mask Use on the Spread of Influenza During a Pandemic

Authors

  • Nicole C. J. Brienen,

    Corresponding author
    1. National Institute for Public Health and the Environment (RIVM), Bilthoven, Netherlands.
      Address correspondence to Nicole Brienen, National Institute for Public Health and the Environment (RIVM), Epidemiology and Surveillance/Postvak 75, Postbus 1, 3720 BA Bilthoven, Netherlands; nbrienen@gmail.com.
    Search for more papers by this author
  • Aura Timen,

    1. National Institute for Public Health and the Environment (RIVM), Bilthoven, Netherlands.
    Search for more papers by this author
  • Jacco Wallinga,

    1. National Institute for Public Health and the Environment (RIVM), Bilthoven, Netherlands.
    2. Julius Center for Health Services and Primary Care, University Medical Center, Utrecht, Netherlands.
    Search for more papers by this author
  • Jim E. Van Steenbergen,

    1. National Institute for Public Health and the Environment (RIVM), Bilthoven, Netherlands.
    Search for more papers by this author
  • Peter F. M. Teunis

    1. National Institute for Public Health and the Environment (RIVM), Bilthoven, Netherlands.
    2. Hubert Department of Global Health, Rollins School of Public Health, Emory University, Atlanta, GA, USA.
    Search for more papers by this author

Address correspondence to Nicole Brienen, National Institute for Public Health and the Environment (RIVM), Epidemiology and Surveillance/Postvak 75, Postbus 1, 3720 BA Bilthoven, Netherlands; nbrienen@gmail.com.

Abstract

Face masks have traditionally been used in general infection control, but their efficacy at the population level in preventing transmission of influenza viruses has not been studied in detail. Data from published clinical studies indicate that the infectivity of influenza A virus is probably very high, so that transmission of infection may involve low doses of virus. At low doses, the relation between dose and the probability of infection is approximately linear, so that the reduction in infection risk is proportional to the reduction in exposure due to particle retention of the mask. A population transmission model was set up to explore the impact of population-wide mask use, allowing estimation of the effects of mask efficacy and coverage (fraction of the population wearing masks) on the basic reproduction number and the infection attack rate. We conclude that population-wide use of face masks could make an important contribution in delaying an influenza pandemic. Mask use also reduces the reproduction number, possibly even to levels sufficient for containing an influenza outbreak.

Get access to the full text of this article

Ancillary