Volume 198 - Issue 6
Improving flu prevention posters and reducing the risk of infection during outbreaks
Author: Guy D Eslick
Med J Aust 2013; 198 (6): 313. || doi: 10.5694/mja12.10884
Published online: 1 April 2013
Published online: 1 April 2013
Public health posters about flu transmission prevention need to reflect current best practice: cough or sneeze into your sleeve rather than your hands if tissues are not available.
To the Editor: As winter, and the flu season, approaches, I would like to propose some changes to flu prevention posters circulated by New South Wales Health. After living in the United States for some time, I grew accustomed to seeing numerous posters around Boston highlighting the risks of flu and how to prevent it spreading, especially during the pandemic (H1N1) 2009 influenza outbreak. This preventive measure is important, and this was emphasised at my daughter’s childcare centre where all the children and staff were encouraged to learn techniques of stopping the spread of flu and good hygiene.
One aspect of this that stands out in my mind (mostly because of my daughter and her constant demonstration of what she was taught at child care) is the practice of coughing or sneezing into your sleeve rather than your hands as an alternative to sneezing into tissues if these were not available (and given the fact that individuals are not usually prepared enough to have a tissue ready to use for a quick reflex cough or sneeze). This practice was recommended by the Centers for Disease Control and Prevention in the US,1 and is shown in the poster from the Minnesota Department of Health (Box 1). However, during the flu season in 2010 in NSW, I was surprised to see similar posters on buses and trains showing coughing into hands as an acceptable method of flu transmission prevention. Box 2 shows a recent poster from NSW Health that carries this message.
I believe that this should be amended in future messages concerning flu transmission prevention by NSW Health or any other Australian health organisation. I am sure that coughing or sneezing into hands assists in the spread of flu, either through direct contact or by contact with fomites. This risk would be reduced substantially if individuals were educated and informed that coughing or sneezing into their sleeve is a preferred method of preventing flu transmission.
1 Flu transmission prevention poster from the Minnesota Department of Health,2 which recommends sneezing into the sleeve if a tissue is not available
2 Flu transmission prevention poster from NSW Health in 2012,3 which suggests that coughing or sneezing into hands is acceptable
Competing interests
No relevant disclosures.
References
- Centers for Disease Control and Prevention. Seasonal influenza (flu). http://www.cdc.gov/flu/protect/covercough.htm (accessed Feb 2013).
- Minnesota Department of Health. Cover your cough [poster]. http://www.health.state.mn.us/divs/idepc/dtopics/infectioncontrol/cover/index.html (accessed Feb 2013).
- NSW Health. The spread of flu is up to you [poster]. http://www0.health.nsw.gov.au/resources/publichealth/infectious/influenza/winter_illness_a3_2012_pdf.asp (accessed Feb 2013).