gms | German Medical Science

GMS Hygiene and Infection Control

Deutsche Gesellschaft für Krankenhaushygiene (DGKH)

ISSN 2196-5226

Level of respiratory protection against influenza virus

Letter to the Editor

Search Medline for

  • corresponding author Beuy Joob - Sanitation 1 Medical Academic Center, Bangkok, Thailand
  • Viroj Wiwanitkit - Hainan Medical University, Haikou, China; Faculty of Medicine, University of Nis, Serbia

GMS Hyg Infect Control 2013;8(2):Doc14

doi: 10.3205/dgkh000214, urn:nbn:de:0183-dgkh0002148

Published: November 6, 2013

© 2013 Joob et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution License ( You are free: to Share – to copy, distribute and transmit the work, provided the original author and source are credited.


Sir, the recent report on influenza is very interesting [1]. Heuer et al. reported that “The three tested filters retained the virus input, indicating that their use in the breathing systems of intubated and mechanically ventilated patients can reduce the risk of spreading the virus to the breathing system and the ambient air." [1] In fact, the management of the intubation in the era of influenza outbreak is a topic to be discussed. The protective tool to clear out the spreading of influenza virus is very important. It should be noted that regular replacement of the used filter has to be done because the contaminated filters can be the source for viral spreading [2]. In addition to the filters, the practitioners have to use self-protective device. Simonds et al. noted that “health-care workers providing non-invasive ventilation (NIV) and chest physiotherapy, working within 1 m of an infected patient should have a higher level of respiratory protection" [3].


Competing interests

The authors declare that they have no competing interests.


Heuer JF, Crozier TA, Howard G, Quintel M. Can breathing circuit filters help prevent the spread of influenza A (H1N1) virus from intubated patients? GMS Hyg Infect Control. 2013 Apr 29;8(1):Doc09. DOI: 10.3205/dgkh000209 External link
Kranabetter R, Leier M, Kammermeier D, Krodel U. HME-Filter versus patientenbezogener Wechsel der Beatmungsschlauchsysteme von Narkosegeraten: Eine Kosten-Nutzen-Analyse [HME filter versus patient-related replacement of tubes from the ventilation circuit for anaesthesia: a cost-benefit analysis]. Anaesthesist. 2006 May;55(5):561-7.
Simonds AK, Hanak A, Chatwin M, Morrell M, Hall A, Parker KH, Siggers JH, Dickinson RJ. Evaluation of droplet dispersion during non-invasive ventilation, oxygen therapy, nebuliser treatment and chest physiotherapy in clinical practice: implications for management of pandemic influenza and other airborne infections. Health Technol Assess. 2010 Oct;14(46):131-72. DOI: 10.3310/hta14460-02 External link