To the Editor: The US Depart-ment of Labor recommends air-puri-fying respirators (e.g., N95, N99, orN100) as part of a comprehensive res-piratory protection program for work-ers directly involved with avianinfluenza–infected birds or patients(1). N95 respirators have 2 advan-tages over simple cloth or surgicalmasks; they are >95% efficient at fil-tering 0.3-μm particles (smaller thanthe 5-μm size of large droplets—cre-ated during talking, coughing, andsneezing—which usually transmitinfluenza) and are fit tested to ensurethat infectious droplets and particlesdo not leak around the mask (2–4).Even if N95 filtration is unnecessaryfor avian influenza, N95 fit offersadvantages over a loose-fitting surgi-cal mask by eliminating leakagearound the mask. The World Health Organizationrecommends protective equipmentincluding masks (if they not available,a cloth to cover the mouth is recom-mended) for persons who must handledead or ill chickens in regions affect-ed by H5N1 (5). Quality commercialmasks are not always accessible, butanecdotal evidence has showed thathandmade masks of cotton gauzewere protective in military barracksand in healthcare workers during theManchurian epidemic (6,7). A simple,locally made, washable mask may bea solution if commercial masks arenot available. We describe the testresults of 1 handmade, reusable, cot-ton mask
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