Respiratory hygiene, cough etiquette key to decrease the transmission of respiratory illness

Dr Sangeeta Narang 


Respiratory hygiene and cough etiquette are terms used to describe infection prevention measures to decrease the transmission of respiratory illness (e.g., influenza and cold viruses). A respiratory infection is spread when a person who is infected with a virus coughs or sneezes. The droplets released from an ill person’s cough or sneeze can travel for several feet reaching the nose or mouth of others and causing illness. Viruses can spread easily from person to person through direct contact via touching or shaking hands. Droplets can also live for a short time on a variety of objects in the environment such as bed rails, door knobs, wheelchairs, or patient care equipment where they can be touched by another person.As   some individuals cough without having respiratory infections (e.g., persons with chronic obstructive lung disease), we do not always know who is infectious and who is not. Therefore, respiratory hygiene and cough etiquette are very important components to protecting yourself from illness and preventing others from becoming ill. Like hand hygiene, respiratory hygiene is part of the standard precautions that should be taken to prevent the spread of  air borne diseases.

 Respiratory hygiene and cough etiquette include a number of measures to prevent the spread of respiratory infections in the community :

  • Turn head away from others when coughing/sneezing
  • Cover the nose and mouth with  disposal tissues when coughing and sneezing. After tissues are used, discard immediately into the trash.
  • Cover your mouth & nose  with hollow of your elbow when tissue not available 
  • Use of a mask for a person who is coughing is necessary .

Basics of how to wear a mask:

  • Clean your hands before you put your mask on, as well as before and after you take it off, and after you touch it at any time.
  • Make sure it covers both your nose, mouth and chin. 
  • When you take off a mask, store it in a clean plastic bag, and every day either wash it if it’s a fabric mask, or dispose of a medical mask in a trash bin.
  • Don’t use masks with valves.
  • Droplets travel through the air for 3-6 feet,  so separating an ill person from others by more than 3 feet decreases risk of transmission.
  • If a patient is ill and shares a room, the use of curtains or screens between beds can limit dispersal of droplets.
  • Hand hygiene i.e wash your hands with soap and water after contact with respiratory secretions for minimum 40 seconds
  • People age 2 and older should wear masks in public settings and when around people who don’t live in their household.​
  • Tightly woven cloth fabric mask are good for use. They are washable.
  • Triple layer  medical mask to be discarded after 8 hours of use.
  • (The author is an Assistant Professor in the Department of Community Medicine, Faculty of Medicine and Health Sciences, SGT University, Gurugram)


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