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Improving flu prevention posters and reducing the risk of infection during outbreaks

To the Editor: As winter, and the flu season, approaches, I would like to propose some changes to flu prevention posters circulated by New South Wales Health. After living in the United States for some time, I grew accustomed to seeing numerous posters around Boston highlighting the risks of flu and how to prevent it spreading, especially during the pandemic (H1N1) 2009 influenza outbreak. This preventive measure is important, and this was emphasised at my daughter’s childcare centre where all the children and staff were encouraged to learn techniques of stopping the spread of flu and good hygiene.

One aspect of this that stands out in my mind (mostly because of my daughter and her constant demonstration of what she was taught at child care) is the practice of coughing or sneezing into your sleeve rather than your hands as an alternative to sneezing into tissues if these were not available (and given the fact that individuals are not usually prepared enough to have a tissue ready to use for a quick reflex cough or sneeze). This practice was recommended by the Centers for Disease Control and Prevention in the US,1 and is shown in the poster from the Minnesota Department of Health (Box 1). However, during the flu season in 2010 in NSW, I was surprised…

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