Perceptions About Status and Modes of H5N1 Transmission and Associations with Immediate Behavioral Responses in the Hong Kong General Population

Objectives: Perceptions and associated behavioral responses to H5N1 avian influenza were investigated.

Methods: A random telephone survey interviewed 805 Hong Kong adults in November 2005.

Results: Of respondents, 37.9% believed that bird-to-human transmission had occurred somewhere in the last year (Hong Kong: 17.3%). Similar figures for human-to-human transmission were 16.8% (some locale) and 6.8% (Hong Kong). Many perceived bird-to-human H5N1 are transmittable via long-distance airborne transmission (35.8%), contaminated water sources (44%) and insect bites (48%). Corresponding figures for human-to-human H5N1 transmission were 47.9%, 47.3% and 48.9% respectively. In the last 3 months, 49.4% of the respondents exhibited one of the 4 studied behavioral responses; the variable was associated with unconfirmed beliefs that past-year human-to-human H5N1 transmission had occurred in Hong Kong (adjusted OR=2.08). Beliefs that human-to-human transmission had occurred somewhere were associated with the 4 individual behaviors studied (adjusted OR=1.58-4.24). Perceptions that human-to-human H5N1 should be transmittable via contaminated water sources was associated with avoidance of visiting hospitals and eating less poultry (adjusted OR=1.69 and 1.64). Belief about airborne transmission of human-to-human H5N1 was associated with perceived stress (adjusted OR=2.32).

Conclusions: Widespread unconfirmed beliefs about status of HN51 epidemic are associated with the general public's behavioral responses. Timely dissemination of up-to-date information is greatly warranted.