Risk factors and effectiveness of preventive measures against influenza in the community

Influenza and Other Respiratory Viruses

Jesús Castilla⁴  Pere Godoy²  Ángela Domínguez²  Vicente Martín²  Miguel Delgado-Rodríguez²  Iván Martínez-Baz⁴  Maretva Baricot²  Nuria Soldevila²  José M. Mayoral²  Jenaro Astray²  José M. Quintana²  Rafael Cantón²  Ady Castro⁵  Fernando González-Candelas²  Jordi Alonso²  Marc Saez²  Sonia Tamames³  Tomás Pumarola¹ 

[1] Red Española de Investigación en Patología Infecciosa, Spain.;CIBER Epidemiología y Salud Pública (CIBERESP), Spain;Dirección General de Salud Pública e Investigación, Desarrollo e Innovación, Junta de Castilla y León, Valladolid, Spain;Instituto de Salud Pública de Navarra, Pamplona, Spain;CIBER Enfermedades Respiratorias, Spain

关键词: Epidemiology;    infection control;    influenza;    public health;    transmission;    vaccine;   

DOI  :  10.1111/j.1750-2659.2012.00361.x

来源: Wiley

【 摘 要 】

Abstract

Please cite this paper as: Castilla et al. (2013) Risk factors and effectiveness of preventive measures against influenza in the community. Influenza and Other Respiratory Viruses 7(2) 177–183.

Background  The role of different risk exposures and preventive measures against influenza has not been well established.

Objective  The aim of this study was to evaluate risk factors and measures to prevent influenza infection in the community.

Methods  We conducted a multicenter case–control study. Cases were 481 outpatients aged 18 years or older with laboratory-confirmed influenza A(H1N1)09 in the 2009–2010 season in Spain. A control was selected for each case from outpatients from the same area matched by age and date of consultation. Information on risk situations, preventive measures and other variables was obtained by interview and review of the medical record.

Results  In the multivariate conditional logistic regression analysis, the risk of a diagnosis of influenza increased with the number of cohabitants (compared with <3 cohabitants, three cohabitants had an OR = 1·80, 95% CI 1·12–2·89, and ≥5 cohabitants had an OR = 2·66, 95% CI 1·31–5·41) and for health care workers (OR = 2·94, 95% CI 1·53–5·66). The use of metropolitan public transport was associated with a lower frequency of a diagnosis of influenza (OR = 0·45, 95% CI 0·30–0·68) but not the use of taxis or long-distance transport. The influenza A(H1N1)09 vaccine had a protective effect (OR = 0·13, 95% CI 0·04–0·48), unlike hand washing after touching contaminated surfaces or the use of alcohol-based hand sanitizers.

Conclusion  The home environment appears to play an important role in the spread of influenza in adults, but not the use of public transport. Health care workers have a higher risk of contracting influenza. Vaccination was the most effective preventive measure.

【 授权许可】

Unknown   
© 2012 Blackwell Publishing Ltd