This document provides interim guidance on the use of masks in communities that have

　　reported community-level outbreaks caused by the new Influenza A(H1N1) virus. It will be

　　revised as more data become available.

　　此文件是对已经报告有新的甲型(H1N1)流感爆发的社区中使用口罩的问题提供一个临时性的指南。随着更多数据的获得，本指南将会不断更新。

　　Background

　　背景

　　At present, evidence suggests that the main route of human-to-human transmission of the new Influenza A (H1N1) virus is via respiratory droplets, which are expelled by speaking, sneezing or coughing.

　　在目前的状况下，有证据显示，新的甲型(H1N1)流感人与人之间的主要传播途径是通过飞沫传播，即通过说话、打喷嚏或咳嗽过程中产生的呼吸飞沫传播。

　　Any person who is in close contact (approximately 1 metre) with someone who has influenza-like symptoms (fever, sneezing, coughing, running nose, chills, muscle ache etc) is at risk of being exposed to potentially infective respiratory droplets.

　　任何与流感样症状(发烧、打喷嚏、咳嗽、流鼻涕、寒战、肌肉疼痛等)病人有近距离(大约1米)接触的人士，都有传染性呼吸道飞沫的潜在暴露风险。

　　In health-care settings, studies evaluating measures to reduce the spread of respiratory viruses suggest that the use of masks could reduce the transmission of influenza.2 Advice on the use of masks in health-care settings is accompanied by information on additional measures that may have impact on its effectiveness, such as training on correct use, regular supplies and proper disposal facilities. In the community, however, the benefits of wearing masks has not been established, especially in open areas, as opposed to enclosed spaces while in close contact with a person with influenza-like symptoms.

　　在医疗设施中，经过对降低呼吸道病毒传播措施的评价性研究，得出可使用口罩来降低流感传播的建议2。对医疗设施内人员使用口罩的建议，还包括其他一些信息，即应采取措施，提高口罩使用的有效性，如提供正确使用方法的培训，定期补给更换和废弃口罩等。然而，对于公众而言，使用口罩的益处并未被证实，尤其是在开放的环境中，因为这和在相对封闭的环境中与流感样症状人员近距离接触是不同的。

　　Nonetheless, many individuals may wish to wear masks in the home or community setting, particularly if they are in close contact with a person with influenza-like symptoms, for example while providing care to family members. Furthermore, using a mask can enable an individual with influenza-like symptoms to cover their mouth and nose to help contain respiratory droplets, a measure that is part of cough etiquette.

　　尽管如此，很多人会希望在家或在公共场所内使用口罩，尤其是当他们与一个有流感样症状的人近距离接触的时候，如照顾家庭成员。此外，对有流感样症状的个体而言，使用口罩可以遮盖其口鼻部，帮助拦截呼吸道飞沫，可作为咳嗽礼仪的一个做法。

　　Using a mask incorrectly however, may actually increase the risk of transmission, rather than reduce it. If masks are to be used, this measure should be combined with other general measures to help prevent the human-to-human transmission of influenza, training on the correct use of masks and consideration of cultural and personal values.

　　但错误使用口罩的确会增加传染的风险，而不是降低风险。如果要使用口罩，应同时采取其他常规措施，帮助预防人与人之间的流感传播，培训如何正确使用口罩，并考虑到文化的差异，以及每个人价值观的不同。

　　General advice

　　通用性建议

　　It is important to remember that in the community setting the following general measures may be more important than wearing a mask in preventing the spread of influenza.

　　重要的是要牢记，在公共环境中，以下通用性措施往往会比使用口罩能有效地避免流感的传播。

　　For individuals who are well:

　　对健康的人的建议：

　　Maintain distance of at least 1 metre from any individual with influenza-like symptoms, and:

　　与任何有流感样症状的人至少保持1米的距离，并且：

　　• refrain from touching mouth and nose;

　　• 尽量不要触摸嘴和鼻子;

　　• perform hand hygiene frequently, by washing with soap and water or using an alcohol-based handrub 3 , especially if touching the mouth and nose and surfaces that are potentially contaminated;

　　• 勤洗手，用肥皂和清水洗手，或用含酒精的洗手液3清洁双手，尤其是接触口鼻，和接触可能受到污染的表面后;

　　• reduce as much as possible the time spent in close contact with people who might be ill;

　　• 尽量减少与可能生病的人的接触时间;

　　• reduce as much as possible the time spent in crowded settings;

　　• 尽量减少在人群聚集的公共场所内停留;

　　• improve airflow in your living space by opening windows as much as possible.

　　• 尽可能开窗换气，提高居室的空气流通。

　　For individuals with influenza-like symptoms:

　　对有流感样症状的人员的建议：

　　• stay at home if you feel unwell and follow the local public health recommendations;

　　• 如果感觉不适，尽量呆在家中，遵守当地公共卫生的建议;

　　• keep distance from well individuals as much as possible (at least 1 metre);

　　• 尽量与健康人保持距离(至少1米);

　　• cover your mouth and nose when coughing or sneezing, with tissues or other suitable

　　materials, to contain respiratory secretions. Dispose of the material immediately after use

　　or wash it. Clean hands immediately after contact with respiratory secretions!

　　• 咳嗽或打喷嚏时遮盖口鼻，用纸巾或其它合适的材料，包裹呼吸道分泌物，使用后立即废弃，或立即清洗，如果手接触到呼吸道分泌物后应立刻洗手!

　　• improve airflow in your living space by opening windows as much as possible.

　　• 尽可能开窗，改善居室通风。

　　If masks are worn, proper use and disposal is essential to ensure they are potentially effective and to avoid any increase in risk of transmission associated with the incorrect use of masks.

　　如果使用了口罩，正确使用和及时废弃口罩，是确保其发挥有效作用，避免错误使用而增加传染风险的关键。

　　The following information on correct use of masks derives from the practices in health-care settings4:

　　以下有关正确使用口罩的信息来自医疗机构的实践4：

　　• place mask carefully to cover mouth and nose and tie securely to minimise any gaps

　　between the face and the mask

　　• 小心地将口罩遮住口和鼻，并牢牢系紧，尽量减小面部与口罩之间的缝隙;

　　• while in use, avoid touching the mask

　　• 使用中避免触摸口罩;

　　• whenever you touch a used mask, for example when removing or washing, clean

　　hands by washing with soap and water or using an alcohol-based handrub

　　• 只要你触摸了一个使用过的口罩，如在摘口罩或在洗口罩后，用肥皂和清水洗手，或用含酒精的洗手液清洁双手。

　　• replace masks with a new clean, dry mask as soon as they become damp/humid

　　• 一旦口罩变得潮湿，立即更换使用新的、干燥的口罩;

　　• do not re-use single-use masks

　　• 不要重复使用一次性口罩;

　　• discard single-use masks after each use and dispose of them immediately upon removing.

　　• 对一次性口罩，每次使用完后立即摘除废弃。

　　Although some alternative barriers to standard medical masks are frequently used (e.g. cloth mask, scarf, paper masks, rags tied over the nose and mouth), there is insufficient information available on their effectiveness. If such alternative barriers are used, they should only be used once or, in the case of cloth masks, should be cleaned thoroughly between each use (i.e. wash with normal household detergent at normal temperature). They should be removed immediately after caring for the ill. Hands should be washed immediately after removal of the mask.

　　虽然标准的医用口罩经常会被一些隔离材料所替代(如：布口罩、围巾、纸口罩、缠在口鼻处的布等)，没有充分的数据证明其有效性。如果使用这类替代性隔离材料，应只用一次，假如使用的是布口罩，应在每次使用后彻底清洗(如在常温下使用家用洗涤剂清洗)。口罩在每次用于照顾病人后应立即摘除。摘除口罩后应立即洗手。

　　1 The term “mask” is used here to include home-made or improvised masks, dust masks and surgical masks (sometimes called “medical masks”). Masks have several designs. They are often single use and labelled as either surgical, dental, medical procedure, isolation, dust or laser masks. Masks frequently used outside health-care settings may also be made out of cloth, or paper or similar material. Masks, names and standards differ among countries.

　　注1：本文中提到的“口罩”包括自制的或临时制作的口罩、防尘口罩和外科口罩(有时也称为“医用口罩”)。口罩有很多设计，通常是一次性使用的产品，标记有外科用、牙医用、治疗用、隔离用、防尘用或激光手术用等。在医疗机构以外被经常使用的口罩也会用布、纸或其它类似材料制作。不同国家的口罩、称呼和标准都不相同。

　　2 Jefferson T, Foxlee R, Del Mar C et al. Physical interventions to interrupt or reduce the spread of respiratory viruses: systematic review . BMJ 2008; 336;77-80

　　3 In settings where alcohol-based hand rubs are available and the safety concerns (such as fire hazards and accidental ingestion) are adequately addressed, their proper use (rubbing hands for 20–30 seconds) could be promoted as a means of disinfection.

　　注3：在提供含酒精的洗手液的设施中，洗手液的安全使用(如火灾和意外食用)需得到重视，而且应推广正确的使用方法(揉搓双手20-30秒)以作为一种消毒措施。

　　4 Infection prevention and control of epidemic- and pandemic-prone acute respiratory diseases in health care WHO Interim Guidelines (Jul 2007) available at http://www.who.int/csr/resources/publications/WHO_CD_EPR_2007_6/en/index.html.