The characteristics of household transmission of pandemic H1N1 2009 virus infection (pH1N1) have recently been reported in several studies. In these studies, however, the development of secondary attacks among household contacts was infrequently confirmed by laboratory testing. Antiviral prophylaxis targeting household transmission was occasionally performed and did affect transmission. Therefore, we investigated risk factors for pH1N1 household transmission among household members who had confirmatory tests for pH1N1 and had not received antiviral prophylaxis. American Journal of Infection Control. 2010;38:e43-5