Preventable and non-preventable risk factors for influenza transmission and hygiene behavior in German influenza households, pandemic season (H1N1) 2009/2010
Article first published online: 16 JUL 2012
© 2012 Blackwell Publishing Ltd
Influenza and Other Respiratory Viruses
Volume 7, Issue 3, pages 418–425, May 2013
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How to Cite
Remschmidt, C., Stöcker, P., an der Heiden, M., Suess, T., Luchtenberg, M., Schink, S. B., Schweiger, B., Haas, W. and Buchholz, U. (2013), Preventable and non-preventable risk factors for influenza transmission and hygiene behavior in German influenza households, pandemic season (H1N1) 2009/2010. Influenza and Other Respiratory Viruses, 7: 418–425. doi: 10.1111/j.1750-2659.2012.00407.x
- Issue published online: 17 APR 2013
- Article first published online: 16 JUL 2012
- Accepted 7 June 2012. Published Online 16 July 2012.
- Behavioral risk factors;
- household transmission;
- hygiene behavior;
- pandemic influenza
Background To date, little is known about the role of behavioral risk factors for influenza transmission as well as hygiene behavior in the household setting during the influenza pandemic (H1N1) 2009. In a household-based study conducted during 2008/2009, we identified several behavioral risk factors for influenza transmission; 30% of index patients and 30% of household contacts reported increased hand cleaning frequency in the week after symptom onset of the index patient. We conducted another household-based study during the pandemic season 2009/2010.
Methods We identified index patients with laboratory confirmed influenza infection and interviewed household members after illness day 8 of the index patient. Outcome was influenza-like illness (ILI) in a household contact.
Results We included 108 households. Overall secondary attack rate was 10·1% (27/267) and decreased with increasing age. Apart from being in close daily proximity with the index patient for at least 9 hours, no other behavioral risk factor was associated with secondary ILI. Of all index patients and household contacts, 49% and 55%, respectively, cleaned their hands more often in the week after symptom onset of the index patient (in comparison with 2008/2009 P-value for both <0·01).
Conclusions While the study was hampered by its relatively limited size, data suggest that a significantly larger proportion of influenza households practiced good hand hygiene compared to the last pre-pandemic season. This may have led to a different risk factor profile and a delay of the time threshold necessary for transmission among household members with close contact.