title: Protective Effect of Hand-Washing and Good Hygienic Habits Against Seasonal Influenza: A Case-Control Study.
abstract: Previous observational studies have reported protective effects of hand-washing in reducing upper respiratory infections, little is known about the associations between hand-washing and good hygienic habits and seasonal influenza infection. We conducted a case-control study to test whether the risk of influenza transmission associated with self-reported hand-washing and unhealthy hygienic habits among residents in Fujian Province, southeastern China.Laboratory confirmed seasonal influenza cases were consecutively included in the study as case-patients (n = 100). For each case, we selected 1 control person matched for age and city of residence. Telephone interview was used to collect information on hand-washing and hygienic habits. The associations were analyzed using conditional logistic regression. Compared with the poorest hand-washing score of 0 to 3, odds ratios of influenza infection decreased progressively from 0.26 to 0.029 as hand-washing score increased from 4 to the maximum of 9 (P < 0.001). Compared with the poorest hygienic habit score of 0 to 2, odds ratios of influenza infection decreased from 0.10 to 0.015 with improving score of hygienic habits (P < 0.001). Independent protective factors against influenza infection included good hygienic habits, higher hand-washing score, providing soap or hand cleaner beside the hand-washing basin, and receiving influenza vaccine. Regular hand-washing and good hygienic habits were associated with a reduced risk of influenza infection. These findings support the general recommendation for nonpharmaceutical interventions against influenza.
authors.affiliation: From the Department of Infectious Diseases (ML), Nanchang Center for Disease Control and Prevention, Nanchang; Chinese Field Epidemiology Training Program (ML, LZ, HM), Chinese Center for Disease Control and Prevention, Beijing; Office of Public Health Preparedness and Response (JO, XS, RH), Fujian Center for Disease Control and Prevention, Fuzhou, China; and Centers for Disease Control and Prevention (B-PZ, REF), Atlanta, GA.
authors.forename: Mingbin
authors.initials: M
authors.lastname: Liu
authors.forename: Jianming
authors.initials: J
authors.lastname: Ou
authors.forename: Lijie
authors.initials: L
authors.lastname: Zhang
authors.forename: Xiaona
authors.initials: X
authors.lastname: Shen
authors.forename: Rongtao
authors.initials: R
authors.lastname: Hong
authors.forename: Huilai
authors.initials: H
authors.lastname: Ma
authors.forename: Bao-Ping
authors.initials: BP
authors.lastname: Zhu
authors.forename: Robert E
authors.initials: RE
authors.lastname: Fontaine
mesh_terms: D016022:Case-Control Studies; D002947:Cities; D006235:Hand Disinfection; D006801:Humans; D006920:Hygiene; D007252:Influenza Vaccines; D007251:Influenza, Human / Q000517:prevention & control* / Q000635:transmission; D012307:Risk Factors
chemical_list: D007252:Influenza Vaccines