Preventive and protective measures reducing influenza transmission in general practice: a systematic review

BACKGROUND: Seasonal influenza and influenza-like illnesses are widespread, with an impact on GP consultations. GPs apply many preventive and protective measures to prevent seasonal influenza transmission, with no clear evidence of their effectiveness in this setting. AIM: To review the effectiveness of preventive and protective measures to reduce the transmission of seasonal influenza and influenza-like illnesses in GP practices. DESIGN & SETTING: A systematic review was conducted of the literature in Medline, Embase, and the Cochrane Central Register databases published between January 1960 and April 2014, later extended to January 2018. METHOD: Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) criteria were used. Controlled trials and experimental studies were included. Study quality was assessed according to the Cochrane risk of bias tool. RESULTS: Out of 5727 articles screened, only two studies were finally retained: one study about the seasonal influenza vaccination of GPs to prevent transmission from patients or staff, and one about surface disinfection. The first study was a controlled trial, which showed limited evidence for seasonal influenza infection reduction among GPs through vaccination. The second, an experimental study, performed a virus screening on toys in the waiting area before and after disinfection. No study on protection measures was found that assessed the impact on influenza transmission in general practices. CONCLUSION: The evidence is scarce on interventions that reduce influenza transmission in GP practices.