Perceptions related to human avian influenza and their associations with anticipated psychological and behavioral responses at the onset of outbreak in the Hong Kong Chinese general population

BACKGROUND: Anticipated psychological responses and perceptions of risk have not been examined prior to the outbreak of an epidemic. METHODS: Using a cross-sectional, telephone survey, 805 Chinese adults in Hong Kong were interviewed anonymously in November, 2005 to examine beliefs related to H5N1 avian influenza and anticipated responses. RESULTS: Of respondents, 71.4% and 52.4%, respectively, believed that bird-to-human or human-to-human H5N1 transmission would occur in the next year. In the event of a bird-to-human or human-to-human outbreak in Hong Kong, many anticipated high fatality rates (70.5% and 74.4%, respectively), permanent physical damage (52.0% and 54.9%, respectively), inadequate vaccines (50.0% and 64.4%, respectively), insufficient medicine supplies (43.7% and 54.5%, respectively), inadequate hospital infection control (35.1% and 43.3%, respectively), high susceptibility of family members contracting H5N1 (13.9% and 24.3%, respectively), and impact on oneself/family worse than those of severe acute respiratory syndrome (21.2 and 25.0%, respectively). Most anticipated at least 1 of the 7 studied stress-related responses (e.g., panic) or the adoption of at least 1 of the 5 studied preventive behavioral measures (e.g., avoiding going out). CONCLUSION: Panic and interruption of daily routines may occur in the event of a human avian influenza outbreak. Dissemination of accurate, timely information would reduce unnecessary distress and unwanted behaviors.