Epidemiology and Infection

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Epidemiology and Infection (2010), 138:449-456 Cambridge University Press
Copyright © Cambridge University Press 2010

Review Article

Face masks to prevent transmission of influenza virus: a systematic review

B. J. COWLINGa1 c1, Y. ZHOUa1, D. K. M. IPa1, G. M. LEUNGa1 and A. E. AIELLOa2

a1 School of Public Health, The University of Hong Kong, Hong Kong Special Administrative Region, China
a2 Department of Epidemiology, Center for Social Epidemiology & Population Health, School of Public Health, University of Michigan, Ann Arbor, MI, USA
Article author query
cowling bj [PubMed]  [Google Scholar]
zhou y [PubMed]  [Google Scholar]
ip dkm [PubMed]  [Google Scholar]
leung gm [PubMed]  [Google Scholar]
aiello ae [PubMed]  [Google Scholar]


Influenza viruses circulate around the world every year. From time to time new strains emerge and cause global pandemics. Many national and international health agencies recommended the use of face masks during the 2009 influenza A (H1N1) pandemic. We reviewed the English-language literature on this subject to inform public health preparedness. There is some evidence to support the wearing of masks or respirators during illness to protect others, and public health emphasis on mask wearing during illness may help to reduce influenza virus transmission. There are fewer data to support the use of masks or respirators to prevent becoming infected. Further studies in controlled settings and studies of natural infections in healthcare and community settings are required to better define the effectiveness of face masks and respirators in preventing influenza virus transmission.

(Accepted December 16 2009)

(Online publication January 22 2010)

Key Words:Infectious disease control; infectious disease epidemiology; influenza; public health


c1 Author for correspondence: Dr B. J. Cowling, School of Public Health, The University of Hong Kong, Units 624-7, Cyberport 3, Pokfulam, Hong Kong. (Email: bcowling@hku.hk)