![](media/image1.png){width="7.151388888888889in"
height="1.1395833333333334in"}

EMBARGOED UNTIL 12 NOON Contact: CDC Press Office

Thursday, May 3, 2007 (404) 639-3286

### HHS ISSUES INTERIM GUIDANCE FOR THE USE OF FACEMASKS AND RESPIRATORS IN PUBLIC SETTINGS DURING AN INFLUENZA PANDEMIC

### Facemasks and Respirators Could Provide Added Value When Used in Combination with Other Preventive Measures

The Department of Health and Human Services' (HHS) Centers for Disease
Control and Prevention (CDC) today released interim advice to the public
about the use of facemasks and respirators in certain public
(non-occupational) settings during an influenza pandemic. There is very
little research about the value of masks to protect people in public
settings. These interim recommendations are based on the best judgment
of public health experts who relied in part on information about the
protective value of masks in healthcare facilities.

The guidance stresses that during an influenza pandemic a combination of
actions will be needed, including hand washing, minimizing the
likelihood of exposure by distancing people who are infected or likely
to be infected with influenza away from others and treating them with
antiviral medications, having people who are caring for ill family
members voluntarily stay home, and encouraging people to avoid crowded
places and large gatherings. When used in conjunction with such
preventive steps, masks and respirators may help prevent some spread of
influenza.

"Pandemic influenza remains a very real threat. We continue to look for
ways to protect people and reduce the spread of disease," Secretary Mike
Leavitt said. "The guidance issued today is a good step forward in the
broader, multifaceted federal effort to prepare the nation for an
influenza pandemic."

"During an influenza pandemic, we know that no single action will
provide complete protection," said Dr. Julie Gerberding, CDC director.
"We also know that many people may choose to use masks for an extra
margin of protection even if there is no proof of their effectiveness.
If people are not able to avoid crowded places, large gatherings or are
caring for people who are ill, using a facemask or a respirator
correctly and consistently could help protect people and reduce the
spread of pandemic influenza."

Gerberding noted that while studies are underway in an effort to learn
more about whether masks and respirators can provide protection from
influenza and how people would use such things, the CDC guidance was
designed to be a "best estimate" based on what is currently known. It is
designed to help guide people's decisions regarding the use of masks.

In the guidance recommends that:

\- More -

\- 2 -

**People should consider wearing a facemask during an influenza pandemic
if ...**

-   They are sick with the flu and think they might have close contact
    with other people (within about 6 feet).

-   They live with someone who has the flu symptoms (and therefore might
    be in the early stages of infection) or will be spending time in a
    crowded public place and thus may be in close contact with infected
    people. During a pandemic, people should limit the amount of time
    they spend in crowded places and consider wearing a facemask while
    they are there.

-   They are well and do not expect to be in close contact with a sick
    person but need to be in a crowded place. Again, people should limit
    the amount of time they spend in crowded places and wear a facemask
    while they are there.

**People should consider wearing a respirator during an influenza
pandemic if...**

-   They are well and will be, or expect to be, in close contact (within
    about 6 feet) with people who are known or thought to be sick with
    pandemic flu. People should limit the amount of time they are in
    close contact with these people and wear a respirator during this
    time. These recommendations apply if people are taking care of a
    sick person at home (and if a respirator is unavailable, use of a
    mask should be considered).

Dr. Michael Bell, associate director for infection control at CDC's
Division of Healthcare Quality Promotion, noted that facemasks and
respirators have different qualities and offer different types and
levels of protection. According to Bell, the primary factor that should
be considered by a well person before deciding to whether to wear a
facemask or a respirator for personal protection during a pandemic is
whether close contact is expected with someone who has pandemic
influenza.

"Facemasks are not designed to protect people from breathing in very
small particles, such as viruses," said Bell. "Rather, facemasks help
stop potentially infectious droplets from being spread by the person
wearing them. They also keep splashes or sprays from coughs and sneezes
from reaching the mouth and nose of the person wearing the facemask.
Respirators are designed to protect people from breathing in very small
particles, which might contain viruses. Thus, if you're caring for
someone who is ill with pandemic flu, proper use of a well-fitted
respirator may be a reasonable choice."

Bell stressed that neither a facemask nor a respirator will provide
complete protection from a virus. To reduce the chances of becoming
infected during a pandemic, people will need to practice a combination
of simple actions, including: washing hands often with soap and water,
staying away from other people when they are ill, and avoiding crowds
and gatherings as much as possible.

**Pandemic Influenza**

A flu pandemic is a global outbreak caused by a new flu virus that
spreads around the world. The virus will spread easily from person to
person, mostly by close contact (within about 6 feet) with individuals
who are infected, and mostly through coughing and sneezing. Because the
virus will be new to people, everyone will be at risk of getting it.
Much of the transmission will most likely occur in non-healthcare
settings, such as schools, public gatherings, mass transit, and
households. The severity of the infection from an influenza virus in a
pandemic is not knowable in advance. Severity could range from a level
comparable to seasonal influenza to the level that occurred in the
pandemic of 1918.

\- More -

\- 3 -

**What is a facemask?**

Facemasks are loose-fitting, disposable masks that cover the nose and
mouth. These include products labeled as surgical, dental, medical
procedure, isolation, and laser masks.

Facemasks help stop droplets from being spread by the person wearing
them. They also keep splashes or sprays from reaching the mouth and nose
of the person wearing the facemask. They are not designed to protect the
person wearing it against breathing in very small particles. Facemasks
should be used once and then thrown away in the trash.

**What is a respirator?**

A respirator (e.g., an N95 or higher filtering facepiece respirator
approved by the National Institute for Occupational Safety and Health)
is designed to protect people from breathing in very small particles,
which might contain viruses. Most of the time, N95 respirators are used
in construction and other jobs that involve dust and small particles.
Healthcare workers, such as nurses and doctors, also use respirators
when taking care of patients with diseases that can be spread through
the air.

"N95" means the filter on the respirator screens out 95 percent of the
particles (0.3 microns and larger) that could pass through (and higher
numbers mean a higher percentage of particles are screened). The filter
and the tightness of fit together determine overall effectiveness of a
respirator. To be most effective, these types of respirators need to fit
tightly to the face so that the air is breathed through the filter
material. "Fit testing" is the usual method for assuring proper fit in
workplaces where respirators are used. Respirators are not designed to
form a tight fit on people with small faces (e.g., children) or facial
hair. Men who have beards need to shave before using. N95 and higher
respirators are less comfortable to wear than facemasks because they are
more difficult to breathe through. If people have a heart or lung
disease or other health condition, they may have trouble breathing
through respirators and should talk with their doctor before using a
respirator.

Like surgical masks, most N95 respirators should be worn only once and
then thrown away in the trash. Reusable respirators are available, but
special precautions need to be followed when using them. For more
information about respirators, see NIOSH Safety and Health Topic:
Respirators
([www.cdc.gov/niosh/npptl/topics/respirators/](http://www.cdc.gov/niosh/npptl/topics/respirators/)).

For more information on the proper use and removal of masks and
respirators, or to learn more about these (including pictures) and other
issues relating to pandemic influenza,
<http://www.pandemicflu.gov/vaccine/mask.html>.

This guidance is now part of other community preventive measures
available at
[www.pandemicflu.gov/plan/community/commitigation.html](http://www.pandemicflu.gov/plan/community/commitigation.html).

Members of the public with questions about masks, respirators and
pandemic influenza can also call the CDC information line,
1-800-CDC-INFO.

\###

Note: All HHS press releases, fact sheets and other press materials are
available at [*http://www.hhs.gov/news*](http://www.hhs.gov/news).