Universal Mask Usage for Reduction of Respiratory Viral Infections After Stem Cell Transplant: A Prospective Trial.
BACKGROUND
Respiratory viral infections (RVIs) are frequent complications of hematopoietic stem cell transplant (HSCT). Surgical masks are a simple and inexpensive intervention that may reduce nosocomial spread.


METHODS
In this prospective single-center study, we instituted a universal surgical mask policy requiring all individuals with direct contact with HSCT patients to wear a surgical mask, regardless of symptoms or season. The primary endpoint was the incidence of RVIs in the mask period (2010-2014) compared with the premask period (2003-2009).


RESULTS
RVIs decreased from 10.3% (95/920 patients) in the premask period to 4.4% (40/911) in the mask period (P < .001). Significant decreases occurred after both allogeneic (64/378 [16.9%] to 24/289 [8.3%], P = .001) and autologous (31/542 [5.7%] to 16/622 [2.6%], P = .007) transplants. After adjusting for multiple covariates including season and year in a segmented longitudinal analysis, the decrease in RVIs remained significant, with risk of RVI of 0.4 in patients in the mask group compared with the premask group (0.19-0.85, P = .02). In contrast, no decrease was observed during this same period in an adjacent hematologic malignancy unit, which followed the same infection control practices except for the mask policy. The majority of this decrease was in parainfluenza virus 3 (PIV3) (8.3% to 2.2%, P < .001).


CONCLUSIONS
Requiring all individuals with direct patient contact to wear a surgical mask is associated with a reduction in RVIs, particularly PIV3, during the most vulnerable period following HSCT.
['Sung|Anthony D|AD|', 'Sung|Julia A M|JAM|', 'Thomas|Samantha|S|', 'Hyslop|Terry|T|', 'Gasparetto|Cristina|C|', 'Long|Gwynn|G|', 'Rizzieri|David|D|', 'Sullivan|Keith M|KM|', 'Corbet|Kelly|K|', 'Broadwater|Gloria|G|', 'Chao|Nelson J|NJ|', 'Horwitz|Mitchell E|ME|']
D000293:Adolescent D000328:Adult D000368:Aged D000369:Aged, 80 and over D015986:Confounding Factors, Epidemiologic D005260:Female D019337:Hematologic Neoplasms D018380:Hematopoietic Stem Cell Transplantation D006801:Humans D016867:Immunocompromised Host D015994:Incidence D017053:Infection Control D008297:Male D008397:Masks D008875:Middle Aged D012141:Respiratory Tract Infections D012621:Seasons D055815:Young Adult
infection hematopoietic stem cell transplant surgical mask parainfluenza virus prevention