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

Jesús Castilla, Pere Godoy, Ángela Domínguez, Vicente Martín, Miguel Delgado-Rodríguez, Iván Martínez-Baz, Maretva Baricot, Nuria Soldevila, José M. Mayoral, Jenaro Astray, José M. Quintana, Rafael Cantón, Ady Castro, Fernando González-Candelas, Jordi Alonso, Marc Saez, Sonia Tamames, Tomás Pumarola, E. Azor, J. CarrilloR. Moyano, J. A. Navarro, M. Vázquez, F. Zafra, M. A. Bueno, M. L. Gómez, M. Mariscal, B. Martínez, J. P. Quesada, M. Sillero, M. Carnero, J. Fernández-Crehuet, J. del Diego Salas, V. Fuentes, V. Gallardo, E. Pérez, R. López, J. R. Maldonado, A. Morillo, J. M. Navarro, M. Pérez, S. Oña, M. J. Pérez, M. C. Ubago, M. Zarzuela, J. Blanquer, M. Morales, D. Carriedo, F. Díez, I. Fernández, S. Fernández, M. P. Sanz, J. J. Castrodeza, A. Pérez, R. Ortiz de Lejarazu, J. Ortiz, A. Pueyo, J. L. Viejo, P. Redondo, A. Molina, A. Agustí, A. Torres, A. Trilla, A. Vilella, F. Barbé, L. Blanch, G. Navarro, X. Bonfill, J. López-Contreras, V. Pomar, M. T. Puig, E. Borràs, V. Martínez, N. Torner, C. Bravo, F. Moraga, F. Calafell, J. Caylà, C. Tortajada, I. Garcia, J. Ruiz, J. J. García, O. Garín, J. Gea, J. P. Horcajada, N. Hayes, A. Rosell, C. A. Álvarez, M. Enríquez, F. Pozo, F. Baquero, J. C. Galán, A. Robustillo, M. Valdeón, E. Córdoba, F. Dominguez, J. García, R. Génova, Elisa Gil, S. Jiménez, M. A. Lopaz, J. López, F. Martín, M. L. Martínez, M. Ordobá s, E. Rodriguez, S. Sánchez, C. Valdés, J. R. Paño, M. Romero, A. Martinez, L. Martínez, V. Martínez-Artola, M. Ruiz, P. Fanlo, F. Gil, M. E. Ursua, M. Sota, M. T. Virto, J. Gamboa, F. Pérez-Afonso, U. Aguirre, A. Caspelastegui, P. P. España, S. García, J. M. Antoñana, I. Astigarraga, J. I. Pijoan, I. Pocheville, M. Santiago, J. I. Villate, J. Arístegui, A. Escobar, M. I. Garrote, A. Bilbao, C. Garaizar, G. Cilla, J. Korta, E. Pérez Trallero, C. Sarasqueta, F. Esteban, C. Salado, J. L. Lobo, J. Alustizac

Research output: Contribution to journalArticlepeer-review


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 18years 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.

Original languageEnglish (US)
Pages (from-to)177-183
Number of pages7
JournalInfluenza and other Respiratory Viruses
Issue number2
StatePublished - Mar 2013
Externally publishedYes


  • Epidemiology
  • Infection control
  • Influenza
  • Public health
  • Transmission
  • Vaccine

ASJC Scopus subject areas

  • Epidemiology
  • Pulmonary and Respiratory Medicine
  • Public Health, Environmental and Occupational Health
  • Infectious Diseases


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