***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: ABSTRACT Direct h and -to-h and contact is an important mechanism of transmission of rhinovirus infection . The rhinoviruses are inactivated at a low pH. A survey of organic acids in vitro revealed that these compounds have antirhinoviral activity that persists for at least 3 h after application to the skin . In additional studies of salicylic acid ( SA ) and pyroglutamic acid ( PGA ) , the h and s of volunteers were contaminated with rhinovirus at defined times after application of the acid , and then volunteers attempted to inoculate the nasal mucosa with one h and and quantitative viral cultures were done on the other h and . In one study , 3.5 % SA or 1 % SA with 3.5 % PGA was compared with controls 15 min after application to assess the efficacy of the inactivation of virus and prevention of infection . Virus was recovered from the h and s of 28 out of 31 ( 90 % ) of the volunteers in the control group compared to 4 out of 27 ( 15 % ) and 0 out of 27 in the groups administered 3.5 and 1 % SA , respectively ( P < 0.05 ) . Rhinovirus infection occurred in 10 out of 31 ( 32 % ) of the controls and 2 out of 27 ( 7 % ) of volunteers in both treatment groups ( P < 0.05 compared with control ) . In a second study , the efficacy of 4 % PGA was evaluated 15 min , 1 h , and 3 h after application . Significantly fewer volunteers had positive h and cultures at all time points compared with the control group , but the proportion that developed rhinovirus infection was not significantly reduced . These results suggest the feasibility of the prevention of rhinovirus transmission by h and treatments that are virucidal on contact and have activity that persists after application Elementary school-age children are particularly vulnerable to infections . While h and washing is the best method of preventing infections , many elementary schools are housed in buildings that have barriers to effective h and hygiene . The purpose of this study was to determine the effectiveness of an alcohol gel as an adjunct to h and washing in reducing absenteeism secondary to infectious illness .  Two-hundred and fifty-three elementary school children were r and omized by classroom into an experimental or control group . With a crossover design , all children participated in both groups , with a one-week washout period between phases . A 45-minute “ Germ Unit ” was taught to all children as they started the experimental phase and a st and ard unit on h and hygiene was taught as they started the control phase . Sixty-nine children were absent due to illness while in the control group . Thirty-nine children became ill while in the experimental group . Alcohol gel as an adjunct to h and washing was shown to be effective in reducing absenteeism due to infectious illness by 43 % BACKGROUND Influenza causes lower respiratory tract complications ( LRTCs ) , particularly bronchitis and pneumonia , in both otherwise healthy adults and those with underlying conditions . The aim of this study was to assess the effect of oseltamivir treatment on the incidence of LRTCs leading to antibiotic treatment and hospitalizations following influenza illness . METHODS We analyzed prospect ively collected data on LRTCs and antibiotic use from 3564 subjects ( age range , 13 - 97 years ) with influenzalike illness enrolled in 10 placebo-controlled , double-blind trials of oseltamivir treatment .  RESULTS In adults and adolescents with a proven influenza illness , oseltamivir treatment reduced overall antibiotic use for any reason by 26.7 % ( 14.0 % vs 19.1 % with placebo ; P<.001 ) and the incidence of influenza-related LRTCs result ing in antibiotic therapy by 55 % ( 4.6 % vs 10.3 % with placebo ; P<.001 ) . In those subjects considered at increased risk of complications , 74 ( 18.5 % ) of 401 placebo recipients developed an LRTC leading to antibiotic use compared with 45 ( 12.2 % ) of 368 oseltamivir recipients ( 34.0 % reduction ; P = .02 ) . Hospitalization for any cause occurred in 18 ( 1.7 % ) of 1063 placebo recipients compared with 9 ( 0.7 % ) of 1350 oseltamivir-treated patients ( 59 % reduction ; P = .02 ) . In contrast , among subjects with an influenzalike illness but without a confirmed influenza infection , the incidence of LRTCs ( 6.7 % vs 5.3 % ) , overall antibiotic use ( 19.7 % vs 19.3 % ) , or hospitalizations ( 1.7 % vs 1.9 % ) was similar between placebo and oseltamivir recipients , respectively . CONCLUSION Oseltamivir treatment of influenza illness reduces LRTCs , antibiotic use , and hospitalization in both healthy and " at-risk " adults The objective of this study was to assess the effectiveness of a hygiene program in reducing the incidence of respiratory and diarrheal diseases in toddlers attending day care centers . A r and omized field trial was conducted in 52 day care centers in Quebec , Canada , between September 1 , 1996 and November 30 , 1997 . Absences for any reasons and the daily occurrence of colds and /or diarrhea in toddlers were recorded on calendars by the educators . The number of fecal coliforms on children 's h and s and on educators ' h and s was measured during three unannounced visits . Overall , 1,729 children were followed in 47 day care centers for a total of 153,643 child-days . The incidence rate of diarrhea was considerably reduced by the effect of monitoring ( IRR = 0.73 , 95 % CI = 0.54,0.97 ) , and the intervention reduced the incidence rate of upper respiratory tract infections ( IRR = 0.80 , 95 % CI = 0.68,0.93 ) . Monitoring alone also had an important effect in reducing the level of bacterial contamination on children 's and educators ' h and s. The results indicate that both an intervention program and monitoring alone play a role in reducing infections in children attending day care centers BACKGROUND Gargling to wash the throat is commonly performed in Japan , and people believe that such hygienic routine , especially with gargle medicine , prevents upper respiratory tract infections ( URTIs ) . Its effectiveness , however , has not been established by clinical trials . DESIGN R and omized controlled trial carried out in 2002 - 2003 winter season and analyzed in 2003 and 2004 . PARTICIPANTS Healthy volunteers ( 387 ) aged 18 to 65 years . INTERVENTION Participants were r and omly assigned to water gargling , povidone-iodine gargling , and usual care ( control ) . Subjects in the two gargling groups were requested to gargle with water or diluted povidone-iodine at least three times a day . Participants were followed for 60 days . MAIN OUTCOME MEASURES The primary outcome measure was first URTI incidence . Severity of URTI symptoms among incident cases was also evaluated . Both outcomes were assessed with a self-administered symptom record . Analyses were performed on an intention-to-treat basis . RESULTS A total of 130 participants contracted URTIs .  The incidence rate of first URTI was 0.26 episodes/30 person-days among control subjects . The rate decreased to 0.17 episodes/30 person-days in the water gargling group , and 0.24 episodes/30 person-days in the povidone-iodine gargling group . Respective incidence rate ratios against controls were 0.64 ( 95 % confidence interval [CI]=0.41 - 0.99 ) and 0.89 ( 95 % CI=0.60 - 1.33 ) . A Cox regression ( proportional hazard model ) revealed the efficacy of water gargling ( hazard ratio=0.60 , 95 % CI=0.39 - 0.95 ) . Even when a URTI occurred , water gargling tended to attenuate bronchial symptoms ( p=0.055 ) . CONCLUSIONS Simple water gargling was effective to prevent URTIs among healthy people . This virtually cost-free modality would appreciably benefit the general population BACKGROUND More than 3.5 million children aged less than 5 years die from diarrhoea and acute lower respiratory-tract infection every year . We undertook a r and omised controlled trial to assess the effect of h and washing promotion with soap on the incidence of  acute respiratory infection , impetigo , and diarrhoea .  METHODS In adjoining squatter settlements in Karachi , Pakistan , we r and omly assigned 25 neighbourhoods to h and washing promotion ; 11 neighbourhoods ( 306 households ) were r and omised as controls . In neighbourhoods with h and washing promotion , 300 households each were assigned to antibacterial soap containing 1.2 % triclocarban and to plain soap . Fieldworkers visited households weekly for 1 year to encourage h and washing by residents in soap households and to record symptoms in all households . Primary study outcomes were diarrhoea , impetigo , and acute respiratory-tract infections ( ie , the number of new episodes of illness per person-weeks at risk ) . Pneumonia was defined according to the WHO clinical case definition . Analysis was by intention to treat . FINDINGS Children younger than 5 years in households that received plain soap and h and washing promotion had a 50 % lower incidence of pneumonia than controls ( 95 % CI ( -65 % to -34 % ) . Also compared with controls , children younger than 15 years in households with plain soap had a 53 % lower incidence of diarrhoea ( -65 % to -41 % ) and a 34 % lower incidence of impetigo ( -52 % to -16 % ) . Incidence of disease did not differ significantly between households given plain soap compared with those given antibacterial soap . INTERPRETATION H and washing with soap prevents the two clinical syndromes that cause the largest number of childhood deaths globally-namely , diarrhoea and acute lower respiratory infections .  H and washing with daily bathing also prevents impetigo BACKGROUND Control of infection within the long-term care facility is a daunting problem . Elderly patients are at high risk for contracting infection because of reduced innate immunity , malnutrition , and the presence of chronic medical conditions . This small study tested the effect of developing and implementing a comprehensive preventive infection control program in the long-term care setting and examined the result ant incidence of infections . METHODS Eight private , freest and ing , long-term care facilities in urban and suburban setting s were selected for the study . The 4 test sites had a total of 443 beds ; there were 447 beds in 4 matched control sites . Data on infection rates were accrued in both preintervention and intervention years . The control homes maintained their existing infection control policies and procedures . The test homes were provided with an infection control educational program and replaced all currently used germicidal products with single-br and ed products for a 12-month period . A criteria -based st and ardized infection control surveillance system was used to monitor and report infections in all facilities . RESULTS In the preintervention year , the test sites experienced 743 infections ( incidence density rate , 6.33 ) and the control homes experienced 614 infections ( incidence density rate , 3.39 ) . In the intervention year , the test homes reported 621 infections , a decrease of 122 infections ( incidence density rate , 4.15 ) ; in the control homes , the number of infections increased slightly , to 626 ( incidence density rate , 3.15 ) . The greatest reduction in infections in the test homes was in upper respiratory infections ( P = .06 ) . CONCLUSIONS This study provides additional evidence that a comprehensive infection control program that includes h and washing and environmental cleaning and disinfecting may help reduce infections among the elderly residing in long-term care setting OBJECTIVE To evaluate the efficacy and safety of oseltamivir phosphate as treatment for naturally acquired influenza infection . METHODS This study was conducted as a double-blind , r and omized , placebo-controlled , multicenter trial during the influenza epidemic season from January to April 2001 at 7 centers in China . A total of 478 adults without other medical history , aged 18 to 65 years , were enrolled into the study . All subjects demonstrated febrile respiratory illness of no more than 36 hours ' duration with a temperature of 37.8 degrees C or more plus at least two of the following symptoms : coryza/nasal congestion , sore throat , cough , myalgia/muscles aches and pain , fatigue , headache or chills/sweats . Individuals were r and omized into either the oseltamivir phosphate or placebo group with identical-looking capsules . Either oral oseltamivir phosphate , 75 mg twice daily , or placebo was administered to the subjects for 5 days . RESULTS A total of 451 individuals were analyzed for efficacy as the intent-to-treat population ( ITT ) ( 216 oseltamivir and 235 placebo ) and 273 individuals were identified as influenza-infected through laboratory test , who were then defined as 
    Output:
    
The highest quality cluster r and omised trials suggested that spread of respiratory viruses can be prevented by hygienic measures in younger children and within households .
Evidence that the more uncomfortable and expensive N95 masks were superior to simple surgical masks was limited , but they caused skin irritation .
Evidence was limited for social distancing being effective , especially if related to risk of exposure — that is , the higher the risk the longer the distancing period .
Conclusion Routine long term implementation of some of the measures to interrupt or reduce the spread of respiratory viruses might be difficult .
However , many simple and low cost interventions reduce the transmission of epidemic respiratory viruses .