title: Effectiveness of hand hygiene and provision of information in preventing influenza cases requiring hospitalization.
abstract: BACKGROUND
  The objective of the study was to investigate the effectiveness of non-pharmacological interventions in preventing cases of influenza requiring hospitalization.
  
  
  METHODS
  We performed a multicenter case-control study in 36 hospitals, in 2010 in Spain. Hospitalized influenza cases confirmed by reverse-transcription polymerase chain reaction and three matched controls (two hospital and one community control) per case were selected. The use of non-pharmacological measures seven days before the onset of symptoms (frequency of hand washing, use of alcohol-based hand sanitizers and handwashing after touching contaminated surfaces) was collected.
  
  
  RESULTS
  We studied 813 cases hospitalized for influenza and 2274 controls. The frequency of hand washing 5-10 times (adjusted odds ratio [aOR]=0.65) and >10 times (aOR=0.59) and handwashing after contact with contaminated surfaces (aOR=0.65) were protective factors and were dose-responsive (p<0.001). Alcohol-based hand sanitizers were associated with marginal benefits (aOR=0.82).
  
  
  CONCLUSIONS
  Frequent handwashing should be recommended to prevent influenza cases requiring hospitalization.
authors.affiliation: Departament de Salut, Generalitat of Catalonia, Spain. Pere.godoy@gencat.cat
authors.forename: Pere
authors.initials: P
authors.lastname: Godoy
authors.forename: Jesús
authors.initials: J
authors.lastname: Castilla
authors.forename: Miguel
authors.initials: M
authors.lastname: Delgado-Rodríguez
authors.forename: Vicente
authors.initials: V
authors.lastname: Martín
authors.forename: Núria
authors.initials: N
authors.lastname: Soldevila
authors.forename: Jordi
authors.initials: J
authors.lastname: Alonso
authors.forename: Jenaro
authors.initials: J
authors.lastname: Astray
authors.forename: Maretva
authors.initials: M
authors.lastname: Baricot
authors.forename: Rafael
authors.initials: R
authors.lastname: Cantón
authors.forename: Ady
authors.initials: A
authors.lastname: Castro
authors.forename: Fernando
authors.initials: F
authors.lastname: González-Candelas
authors.forename: José María
authors.initials: JM
authors.lastname: Mayoral
authors.forename: José María
authors.initials: JM
authors.lastname: Quintana
authors.forename: Tomás
authors.initials: T
authors.lastname: Pumarola
authors.forename: Sonia
authors.initials: S
authors.lastname: Tamames
authors.forename: Angela
authors.initials: A
authors.lastname: Domínguez
mesh_terms: D000279:Administration, Cutaneous; D000293:Adolescent; D000328:Adult; D000891:Anti-Infective Agents, Local / Q000008:administration & dosage*; D016022:Case-Control Studies; D002648:Child; D002675:Child, Preschool; D004202:Disinfectants / Q000008:administration & dosage; D005260:Female; D006235:Hand Disinfection / Q000379:methods*; D006293:Health Promotion / Q000379:methods* / Q000592:standards; D006760:Hospitalization / Q000706:statistics & numerical data* / Q000639:trends; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D017053:Infection Control / Q000379:methods*; D053118:Influenza A Virus, H1N1 Subtype / Q000302:isolation & purification*; D007251:Influenza, Human / Q000517:prevention & control*; D008297:Male; D008875:Middle Aged; D020133:Reverse Transcriptase Polymerase Chain Reaction; D012307:Risk Factors; D012923:Social Class; D013030:Spain
chemical_list: D000891:Anti-Infective Agents, Local; D004202:Disinfectants