{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,4]],"date-time":"2026-06-04T12:50:07Z","timestamp":1780577407927,"version":"3.54.1"},"reference-count":16,"publisher":"Oxford University Press (OUP)","issue":"10","license":[{"start":{"date-parts":[[2024,10,14]],"date-time":"2024-10-14T00:00:00Z","timestamp":1728864000000},"content-version":"vor","delay-in-days":17,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100011912","name":"Washington University School of Medicine","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100011912","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2024,9,27]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>Respiratory viral infections are common and are a major cause of morbidity and mortality. We evaluated the impact of universal masking implemented during the coronavirus disease 2019 (COVID-19) pandemic on other healthcare-associated respiratory viral infections (HA-RIs) in an academic medical center.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>A retrospective cohort study was performed among all inpatients aged \u226518 years admitted between 1 May 2019 and 30 June 2022. Universal masking was implemented in May 2020 at our hospital and state-level mask mandates had been lifted by May 2021. We evaluated and compared the HA-RI rates, adjusted for monthly community-onset viral infections, during the premasking period, universal masking period, and post\u2013community mandate period.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>We identified 3015 patients (median age, 58 years; 48.0% males) with a positive respiratory viral test within 14 days prior to, or during, their hospitalization; 441 (14.6%) patients had an HA-RI. Rhinovirus\/enterovirus (51.0%), parainfluenza virus (14.3%), coronaviruses (229E, OC43, HKU1, and NL63; 13.2%) and influenza (10.0%) were the predominant HA-RI viruses detected. The monthly HA-RI rate decreased 34.9% (95% confidence interval, 8.8%\u201351.8%) after the implementation of universal masking (0.71 premasking period vs 0.19 universal masking period vs 0.35 infections per 1000 patient-days in the post\u2013community mandate period) while accounting for a drop in the community-onset respiratory viral infections using a structural time-series model analysis (P &amp;lt; .001), with no significant change in HA-RI rates with the relaxation of community masking mandate.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>Implementation of universal masking at our hospital was associated with a significantly reduced incidence of HA-RIs.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/ofid\/ofae617","type":"journal-article","created":{"date-parts":[[2024,10,14]],"date-time":"2024-10-14T11:55:59Z","timestamp":1728906959000},"source":"Crossref","is-referenced-by-count":2,"title":["Effect of Universal Masking on Non\u2013Severe Acute Respiratory Syndrome Coronavirus 2 Healthcare-Associated Respiratory Viral Infections"],"prefix":"10.1093","volume":"11","author":[{"given":"Satish","family":"Munigala","sequence":"first","affiliation":[{"name":"Division of Infectious Diseases, Department of Medicine, Washington University School of Medicine , St Louis, Missouri ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6106-2799","authenticated-orcid":false,"given":"Patrick R","family":"Ching","sequence":"additional","affiliation":[{"name":"Division of Infectious Diseases, Department of Medicine, Washington University School of Medicine , St Louis, Missouri ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Helen","family":"Wood","sequence":"additional","affiliation":[{"name":"Department of Hospital Epidemiology and Infection Prevention, Barnes-Jewish Hospital , St Louis, Missouri ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"R J","family":"Waken","sequence":"additional","affiliation":[{"name":"Division of Biostatistics, Washington University School of Medicine , St Louis, Missouri ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Josephine","family":"Fox","sequence":"additional","affiliation":[{"name":"Department of Hospital Epidemiology and Infection Prevention, Barnes-Jewish Hospital , St Louis, Missouri ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Heather","family":"Gasama","sequence":"additional","affiliation":[{"name":"Department of Hospital Epidemiology and Infection Prevention, Barnes-Jewish Hospital , St Louis, Missouri ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Robert","family":"Russell","sequence":"additional","affiliation":[{"name":"Department of Hospital Epidemiology and Infection Prevention, Barnes-Jewish Hospital , St Louis, Missouri ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2166-7552","authenticated-orcid":false,"given":"Melanie L","family":"Yarbrough","sequence":"additional","affiliation":[{"name":"Department of Pathology and Immunology, Washington University School of Medicine , St Louis, Missouri ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David K","family":"Warren","sequence":"additional","affiliation":[{"name":"Division of Infectious Diseases, Department of Medicine, Washington University School of Medicine , St Louis, Missouri ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2024,10,14]]},"reference":[{"key":"2024102920241179300_ofae617-B1","doi-asserted-by":"crossref","first-page":"100986","DOI":"10.1016\/j.eclinm.2021.100986","article-title":"Global burden of upper respiratory infections in 204 countries and territories, from 1990 to 2019","volume":"37","author":"Jin","year":"2021","journal-title":"EClinicalMedicine"},{"key":"2024102920241179300_ofae617-B2","doi-asserted-by":"crossref","first-page":"ofx006","DOI":"10.1093\/ofid\/ofx006","article-title":"Hospital-acquired respiratory viral infections: incidence, morbidity, and mortality in pediatric and adult patients","volume":"4","author":"Chow","year":"2017","journal-title":"Open Forum Infect Dis"},{"key":"2024102920241179300_ofae617-B3","doi-asserted-by":"crossref","first-page":"81","DOI":"10.1016\/0196-4399(94)90059-0","article-title":"Nosocomial viral respiratory infections","volume":"16","author":"Turner","year":"1994","journal-title":"Clin Microbiol Newsl"},{"key":"2024102920241179300_ofae617-B4","doi-asserted-by":"crossref","first-page":"999","DOI":"10.1093\/cid\/ciw451","article-title":"Universal mask usage for reduction of respiratory viral infections after stem cell transplant: a prospective trial","volume":"63","author":"Sung","year":"2016","journal-title":"Clin Infect Dis"},{"key":"2024102920241179300_ofae617-B5","doi-asserted-by":"crossref","first-page":"965","DOI":"10.1111\/tid.12608","article-title":"Masks for prevention of respiratory viruses on the BMT unit: results of a quality initiative","volume":"18","author":"Sokol","year":"2016","journal-title":"Transpl Infect Dis"},{"key":"2024102920241179300_ofae617-B6","doi-asserted-by":"crossref","first-page":"1466","DOI":"10.1017\/ice.2020.313","article-title":"Universal masking is an effective strategy to flatten the severe acute respiratory coronavirus virus 2 (SARS-CoV-2) healthcare worker epidemiologic curve","volume":"41","author":"Seidelman","year":"2020","journal-title":"Infect Control Hosp Epidemiol"},{"key":"2024102920241179300_ofae617-B7","doi-asserted-by":"crossref","first-page":"703","DOI":"10.1001\/jama.2020.12897","article-title":"Association between universal masking in a health care system and SARS-CoV-2 positivity among health care workers","volume":"324","author":"Wang","year":"2020","journal-title":"JAMA"},{"key":"2024102920241179300_ofae617-B8","doi-asserted-by":"crossref","first-page":"218","DOI":"10.1017\/ice.2020.425","article-title":"Absence of nosocomial influenza and respiratory syncytial virus infection in the coronavirus disease 2019 (COVID-19) era: implication of universal masking in hospitals","volume":"42","author":"Wong","year":"2021","journal-title":"Infect Control Hosp Epidemiol"},{"key":"2024102920241179300_ofae617-B9","author":"Siegel"},{"key":"2024102920241179300_ofae617-B10","article-title":"Public health orders","author":"St Louis County Department of Public Health","year":"2022"},{"key":"2024102920241179300_ofae617-B11","doi-asserted-by":"crossref","first-page":"542","DOI":"10.7326\/M20-3213","article-title":"Masks for prevention of respiratory virus infections, including SARS-CoV-2, in health care and community settings: a living rapid review","volume":"173","author":"Chou","year":"2020","journal-title":"Ann Intern Med"},{"key":"2024102920241179300_ofae617-B12","doi-asserted-by":"crossref","first-page":"469","DOI":"10.1016\/j.ajic.2020.10.019","article-title":"Unintended consequences of infection prevention and control measures during COVID-19 pandemic","volume":"49","author":"Wee","year":"2021","journal-title":"Am J Infect Control"},{"key":"2024102920241179300_ofae617-B13","doi-asserted-by":"crossref","first-page":"1022","DOI":"10.1017\/ice.2022.137","article-title":"The impact of a comprehensive coronavirus disease 2019 (COVID-19) infection prevention bundle on non-COVID-19 hospital-acquired respiratory viral infection (HA-RVI) rates","volume":"44","author":"Seidelman","year":"2023","journal-title":"Infect Control Hosp Epidemiol"},{"key":"2024102920241179300_ofae617-B14","doi-asserted-by":"crossref","first-page":"e078918","DOI":"10.1136\/bmj-2023-078918","article-title":"Personal protective effect of wearing surgical face masks in public spaces on self-reported respiratory symptoms in adults: pragmatic randomised superiority trial","volume":"386","author":"Solberg","year":"2024","journal-title":"BMJ"},{"key":"2024102920241179300_ofae617-B15","doi-asserted-by":"crossref","first-page":"e0012423","DOI":"10.1128\/cmr.00124-23","article-title":"Masks and respirators for prevention of respiratory infections: a state of the science review","volume":"37","author":"Greenhalgh","year":"2024","journal-title":"Clin Microbiol Rev"},{"key":"2024102920241179300_ofae617-B16","article-title":"2024 National Healthcare Safety Network (NHSN) patient safety component manual. Chapter 2. Identifying healthcare-associated infections","author":"Centers for Disease Control and Prevention","year":"2024"}],"container-title":["Open Forum Infectious Diseases"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/academic.oup.com\/ofid\/advance-article-pdf\/doi\/10.1093\/ofid\/ofae617\/59746675\/ofae617.pdf","content-type":"application\/pdf","content-version":"am","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/ofid\/advance-article-pdf\/doi\/10.1093\/ofid\/ofae617\/60198437\/ofae617.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/ofid\/advance-article-pdf\/doi\/10.1093\/ofid\/ofae617\/60198437\/ofae617.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,10,29]],"date-time":"2024-10-29T20:25:36Z","timestamp":1730233536000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/ofid\/article\/doi\/10.1093\/ofid\/ofae617\/7821072"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,9,27]]},"references-count":16,"journal-issue":{"issue":"10","published-print":{"date-parts":[[2024,9,27]]}},"URL":"https:\/\/doi.org\/10.1093\/ofid\/ofae617","relation":{},"ISSN":["2328-8957"],"issn-type":[{"value":"2328-8957","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2024,10]]},"published":{"date-parts":[[2024,9,27]]},"article-number":"ofae617"}}