Changing Perception of Avian Influenza Risk, Hong Kong, 2006–2010

To the Editor: Since 1997, routine surveillance has demonstrated periodic reemergence of infl uenza A (H5N1) viruses (avian infl uenza) in retail markets in Hong Kong, People's Republic of China (1,2), leading to stepped implementation (progressively implementing more measures over time) of measures to reduce human exposure to infl uenza subtype H5N1. From 2006 through November 2008, progressive importation and farm restrictions and curtailed retail capacity cut Hong's live poultry supply in half, from 40,000 to <20,000 chickens daily (3,4). To determine whether the decline in the Hong Kong live poultry supply was paralleled by declines in avian infl uenza risk perceptions and protective hygiene behavior, we conducted a telephone survey. During December 2005–March 2006, we recruited 1,760 adults >17 years of age. We randomly called households and then interviewed 1 adult (randomly selected by Kish grid) within each household (5,6). Ordering by age and starting from the oldest eligible member in the household, 1 selected member was then invited to participate in the survey. Of 1,613 (92%) respondents consenting to follow-up survey, 680 (42%) were resurveyed during July– August 2010. The same items were used in both surveys to measure avian infl uenza risk perceptions, personal live poultry exposures, and hygiene practices. Overall, 461 (68%) respondents completed the initial (2006) and follow-up (2010) surveys. Compared with respondents lost to follow-up, these 461 respondents were more likely to be female, slightly older, and married; they were comparable with the general population (7), except more respondents were older (data not shown). Respondents perceived that their likelihood of contracting avian infl uenza was the same in 2010 as in 2006, but they reported worrying less about contracting avian infl uenza and risks from buying live poultry in 2010 than in 2006 (Table). When categorized into " unchanged, " " increasing, " and " declining " in 2010 relative to 2006, these groups were comparable demographically, except younger respondents more often perceived declining likelihood of contracting avian infl uenza (odds ratio [OR] 2.30, 95% confi dence interval [CI] 1.25–4.24 for those 18–34 years of age); declining worry about contracting avian infl uenza years of age), and declining risk from buying live poultry (OR 2.31, 95% CI 1.33–4.01 for those 35–54 years of age); respondents who had completed secondary education were more likely to report declining worry about contracting avian infl uenza (OR 1.90, 95% CI 1.09–3.31).