Personal preventive measures among patients with different symptoms of influenza-like illness

Abstract

Introduction Influenza viruses affect 5–15% of the population annually and cause a broad spectrum of disease severity. Handwashing and wearing face masks are common preventive measures against transmission in the community. Our study investigated how different influenza-related symptoms would affect personal preventive measures. Methods We conducted a longitudinal study with 4 rounds of telephone interviews. We collected data on symptom profile and the corresponding personal preventive measures. We used generalized estimating equations to assess the effect of different influenza-like illness (ILI) symptoms on preventive measures taken. Results We interviewed 3249 participants contributing to 8722 responses. ILI-related symptoms were reported in 3592 responses and 22.2% of these respondents have taken preventive measures. Of these, 49.9% and 53.9% increased frequency of handwashing and wore mask, respectively. Among subjects having one ILI symptom only, a small proportion adopted personal preventive measures, ranging from 3.7%–2.7%, 2.4%–25.2% for more handwashing and wearing mask. Subjects with more than one symptoms were more likely to take preventive measures. In the multivariable analysis, we found that younger subjects (aged 0–15y) with ILI washed their hands more frequently (adjusted odds ratio, aOR = 2.4, 95% CI: 1.6–3.6), but were less likely to wear masks (aOR = 0.2, 95% CI: 0.1–0.5). Subjects having fever increased their frequency of handwashing (aOR = 3.3, 95% CI: 2.1–5.2) and wore mask (aOR = 6.8, 95% CI: 3.7–12.5). Runny nose had similar effect on personal preventive measures, with aOR = 3.5 (95% CI: 2.6–2.7) and 4.9 (95% CI: 3.5–6.8) for handwashing and wearing mask, respectively, while aOR = 2.6 (95% CI: 1.9–3.6) and 4.7 (95% CI: 3.2–6.9) for cough. Discussion Preventive measures taken by subjects with ILI were in line with public health recommendations that emphasize on cough etiquette for persons with respiratory symptoms, however fever is also a major symptom enhancing personal preventive measures. This suggests that personal preventive measures taken may also depend on personal discomfort. Further understanding of the factors affecting preventive measures may help to refine public health messages during influenza season to targeted population.