Effectiveness of hand hygiene and provision of information in preventing influenza cases requiring hospitalization

Prev Med. 2012 Jun;54(6):434-9. doi: 10.1016/j.ypmed.2012.04.009. Epub 2012 Apr 23.


Background: The objective of the study was to investigate the effectiveness of non-pharmacological interventions in preventing cases of influenza requiring hospitalization.

Methods: We performed a multicenter case-control study in 36 hospitals, in 2010 in Spain. Hospitalized influenza cases confirmed by reverse-transcription polymerase chain reaction and three matched controls (two hospital and one community control) per case were selected. The use of non-pharmacological measures seven days before the onset of symptoms (frequency of hand washing, use of alcohol-based hand sanitizers and handwashing after touching contaminated surfaces) was collected.

Results: We studied 813 cases hospitalized for influenza and 2274 controls. The frequency of hand washing 5-10 times (adjusted odds ratio [aOR]=0.65) and >10 times (aOR=0.59) and handwashing after contact with contaminated surfaces (aOR=0.65) were protective factors and were dose-responsive (p<0.001). Alcohol-based hand sanitizers were associated with marginal benefits (aOR=0.82).

Conclusions: Frequent handwashing should be recommended to prevent influenza cases requiring hospitalization.

Publication types

  • Multicenter Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Administration, Cutaneous
  • Adolescent
  • Adult
  • Anti-Infective Agents, Local / administration & dosage*
  • Case-Control Studies
  • Child
  • Child, Preschool
  • Disinfectants / administration & dosage
  • Female
  • Hand Disinfection / methods*
  • Health Promotion / methods*
  • Health Promotion / standards
  • Hospitalization / statistics & numerical data*
  • Hospitalization / trends
  • Humans
  • Infant
  • Infant, Newborn
  • Infection Control / methods*
  • Influenza A Virus, H1N1 Subtype / isolation & purification*
  • Influenza, Human / prevention & control*
  • Male
  • Middle Aged
  • Reverse Transcriptase Polymerase Chain Reaction
  • Risk Factors
  • Social Class
  • Spain


  • Anti-Infective Agents, Local
  • Disinfectants