We evaluated effectiveness of personal protective measures against severe acute respiratory disease coronavirus 2 (SARS-CoV-2) infection. Our case-control study included 211 cases of coronavirus disease (COVID-19) and 839 controls in Thailand. Cases were defined as asymptomatic contacts of COVID-19 patients who later tested positive for SARS-CoV-2; controls were asymptomatic contacts who never tested positive. Wearing masks all the time during contact was independently associated with lower risk for SARS-CoV-2 infection compared with not wearing masks; wearing a mask sometimes during contact did not lower infection risk. We found the type of mask worn was not independently associated with infection and that contacts who always wore masks were more likely to practice social distancing. Maintaining > 1 m distance from a person with COVID-19, having close contact for < 15 minutes, and frequent handwashing were independently associated with lower risk for infection. Our findings support consistent wearing of masks, handwashing, and social distancing to protect against COVID-19.

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Background. Effectiveness of personal protective measure against COVID-19 infection is largely unknown. Methods. We conducted a retrospective case-control study, using a cohort of contact tracing records in Thailand. A total of 1,050 asymptomatic contacts of COVID-19 patients between 1 and 31 March 2020 were retrospectively interviewed by phone about their protective measures against COVID-19 infection. Cases were defined as asymptomatic contacts who were diagnosed with COVID-19 by 21 April 2020. Multilevel mixed-effect logistic regression models were used Findings. Overall, 211 (20%) were diagnosed with COVID-19 by 21 Apr 2020 (case group) while 839 (80%) were not (control group). Fourteen percent of cases (29/210) and 24% of controls (198/823) reported wearing either non-medical or medical masks all the time during the contact period. Wearing masks all the time (adjusted odds ratio [aOR] 0.23; 95%CI 0.09-0.60) was independently associated with lower risk of COVID-19 infection compared to not wearing masks, while wearing masks sometimes (aOR 0.87; 95%CI 0.41-1.84) was not. Shortest distance of contact >1 meter (aOR 0.15; 95%CI 0.04-0.63), duration of close contact ≤15 minutes (aOR 0.24; 95%CI 0.07-0.90) and washing hands often (aOR 0.33; 95%CI 0.13-0.87) were significantly associated with lower risk of infection. Sharing a cigarette (aOR 3.47; 95%CI 1.09-11.02) was associated with higher risk of infection. Those who wore masks all the time were more likely to wash hands and practice social distancing. We estimated that if everyone wore a mask all the time, washed hands often, did not share a dish, cup or cigarette, maintained distances >1 meter and spent ≤15 minutes with close contacts, cases would have been reduced by 84%. Interpretation. Our findings support consistently wearing masks, washing hands, and social distancing in public to protect against COVID-19 infections. Combining measures could substantially reduce infections in Thailand.

| 111 wileyonlinelibrary.com/journal/jch 1 | BACKG ROU N D Cardiovascular diseases (CVD) are responsible for 18 million deaths annually-a third of all deaths worldwide. 1 Over three-quarters of CVD morbidity occurs in low-income and middle-income countries (LMICs), where it is more likely to strike prematurely (under the age of 70). 2 CVD is largely preventable through population-wide approaches to reduce harmful behaviors such as smoking, physical inactivity, high dietary intake of salt and trans-fatty acids, and patient-centered approaches to address CVD risk factors such as hypertension, diabetes, and hyperlipidemia. 1-3 Recognizing the rising significance of CVD globally, all 194 WHO member states have established 2020 targets of reducing the risk of premature CVD death by 25%, reducing the prevalence of high blood pressure by 25%, and increasing drug treatment for the prevention of CVD by 50%. 2 The Global Hearts Initiative (GHI) provides a comprehensive set of strategies for improving cardiovascular health globally. A principal GHI component is HEARTS, a technical package of strategies Abstract

On 4 Sep 2017, the Bureau of Epidemiology received a notification from Tak Provincial Health Office on an outbreak of hand, foot and mouth disease (HFMD) at a nursery following one death at the provincial hospital. An investigation was carried out to confirm the diagnosis and identify source of infection. Active case finding was performed in the nursery, index case’s house and community. Medical records were reviewed, and children, teachers and household members of the index case were interviewed. Confirmed cases were defined as children or teachers in the nursery, household members and neighbors of the index case who was found to have enterovirus from fresh stool or nasopharyngeal/throat swab by polymerase chain reaction. Total 30 cases were identified, including nine confirmed, one probable (index case) and 20 suspected cases. The overall attack rate was 51.7% and case fatality proportion was 3.3%. There were 26% of enterovirus 71, 13% of coxsackie B4 identified from fresh stool samples of symptomatic cases. Neither samples from asymptomatic close contact or nasopharyngeal/throat swab was positive. No residual chlorine in the supplied water at the nursery was detected. We recommended hand washing with soap, wash the toys more than once a week, chlorinate the water to more than 0.5 ppm and increase awareness of enterovirus infection to early detect the outbreak.