• Mingbin Liu, Jianming Ou, Lijie Zhang, Xiaona Shen, Rongtao Hong, Huilai Ma, Bao-Ping Zhu, and Robert E Fontaine.
• 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.
• Medicine (Baltimore). 2016 Mar 1; 95 (11): e3046.

AbstractPrevious 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.

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