Objective To investigate the prevalence and risk factors of influenza-like illness (ILI) among college students in Guangzhou city during the influenza epidemic season from 2017 to 2018, and to provide evidences for influenza prevention and control.

Methods We conducted a survey among 2 112 students selected using proportional random sampling from 12 universities in a college town in Guangzhou city during an influenza epidemic season (from December 2016 to January 2017). A self-designed questionnaire was used to collect influenza-related behaviors, living habits and knowledge among the students. Influenza virus nucleic acid was detected for pharyngeal swab specimens sampled among some of students with fever. Univariate analysis and multivariate logistic regression analysis were performed to assess risk factors for influenza incident.

Results Of all students surveyed, totally 707 (33.47%) ILI incidents were identified. Among the 175 throat swab specimens collected from the students will ILI symptoms, 113 were positive for influenza virus nucleic acid. Multivariate logistic regression analysis revealed following significant factors correlated with ILI incidence: washing hands more than 4 times per day (odds ratio OR = 0.66, 95% confidence interval 95% CI: 0.50 – 0.88), contacting recently with a classmate having a fever or other ILI symptoms (OR = 3.49, 95% CI: 2.83 – 4.31), with a low influenza-related knowledge (OR = 1.03, 95% CI: 1.01 – 1.28), and ever having a fever during previous one year (OR = 8.16, 95% CI: 5.81 – 11.47).

Conclusion There was a high prevalence of influenza among college students in Guangzhou city during the epidemic season from 2017 to 2018 and targeted health intervention on influenza prevention should be promoted among the students.