Perceptions about status and modes of H5N1 transmission and associations with immediate behavioral responses in the Hong Kong general population

Perceptions and associated behavioral responses to H5N1 avian influenza were investigated. A random telephone survey interviewed 805 Hong Kong adults in November 2005. 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). 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.