Objective To explore risk factors of human infections with avian influenza H7N9 in Fujian province and to provide evidences for developing and adjusting related control strategies.

Methods We collected the data on 75 pathogenically confirmed human avian influenza H7N9 infection cases with census registration of Fujian province from November 2014 to October 2017. Residence (housing estate or village) and age (± 3 years) group-matched controls (n = 300) were also selected simultaneously. Multivariate logistic regression was performed to analyze potential risk and protective factors for human H7N9 avian influenza infection.

Results There were no significant differences in gender and body mass index (BMI) index between the cases and the controls. Univariate analysis resulted in 36 factors associated with human avian influenza infection. Stepwise multivariate logistic regression revealed following factors for human avian influenza H7N9 infection: pulmonary disease (odds ratio OR = 4.95), diabetes (OR = 4.46), exposure to live poultry market (OR = 3.66), exposure to poultry epilation sites (OR = 5.78), contact with poultry cage (OR = 5.77), and exposure to wildfowl feces; the regression analysis also demonstrated that regular hand-washing (OR = 0.07) may reduce the risk of the infection. The concordance rate for the prediction of regression equation on training samples was 89.40%, indication a fair goodness of fit of the model (C = 0.90).

Conclusion Among residents in Fujian province, pulmonary disease, diabetes, exposure to live poultry market, exposure to poultry epilation sites, contact with poultry cage, and exposure to wildfowl feces are the risk factors for human infections with avian influenza H7N9 and regular hand-washing may be a protective factor.