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Volume 20, Number 8—August 2014
Research

Human Exposure to Live Poultry and Psychological and Behavioral Responses to Influenza A(H7N9), China

Liping Wang1, Benjamin J. Cowling1, Peng Wu1, Jianxing Yu1, Fu Li, Lingjia Zeng, Joseph T. Wu, Zhongjie Li, Gabriel M. Leung, and Hongjie YuComments to Author 
Author affiliations: Division of Infectious Disease, Key Laboratory of Surveillance and Early-warning on Infectious Disease, Chinese Center for Disease Control and Prevention, Beijing, China (L. Wang, J. Yu, F. Li, L. Zeng, Z. Li, H. Yu); Division of Epidemiology and Biostatistics, School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong Special Administrative Region, China (B.J. Cowling, P. Wu, J.T. Wu, G.M. Leung)

Main Article

Table 3

Risk perception related to influenza A(H7N9) among participants recruited for surveys in urban areas, by area, China, 2013*

Characteristic Chengdu, n = 500 Guangzhou, n = 500 Shanghai, n = 500 Shenyang, n = 504 Wuhan, n = 500 p value†
Mean STAI scores (95% CI)
1.89 (1.85–1.94)
1.80 (1.75–1.84)
1.82 (1.78–1.86)
1.73 (1.69–1.77)
1.74 (1.71–1.78)
<0.001
Self-perceived susceptibility to influenza A(H7N9)‡ <0.001
High 13 (2.6) 9 (1.8) 14 (2.8) 1 (0.2) 5 (1.0)
Even 61 (12.2) 98 (19.6) 61 (12.2) 54 (10.7) 90 (18.0)
Low
426 (85.2)
393 (78.6)
425 (85.0)
449 (89.1)
405 (81.0)

Perceived susceptibility to influenza A(H7N9) compared with others§ 0.431
High 5 (1.0) 5 (1.0) 9 (1.8) 4 (0.8) 7 (1.4)
Even 40 (8.0) 52 (10.4) 39 (7.8) 32 (6.3) 50 (10.0)
Low
455 (91.0)
443 (88.6)
452 (90.4)
468 (92.9)
443 (88.6)

ILI symptoms induced worry¶ <0.001
More 105 (21.0) 151 (30.2) 140 (28.0) 113 (22.4) 107 (21.4)
Same as usual 197 (39.4) 198 (39.6) 192 (38.4) 165 (32.7) 233 (46.6)
Less
198 (39.6)
151 (30.2)
168 (33.6)
226 (44.8)
160 (32.0)

Infection with influenza A(H7N9) in next week# 0.004
Worry 64 (12.8) 68 (13.6) 68 (13.6) 49 (9.7) 53 (10.6)
Think about it but no worry 77 (15.4) 57 (11.4) 104 (20.8) 92 (18.3) 78 (15.6)
Never think about it
359 (71.8)
375 (75.0)
328 (65.6)
363 (72.0)
369 (73.8)

Relative severity of influenza A(H7N9) compared with**
Seasonal influenza 313 (62.6) 319 (63.8) 290 (58.0) 361 (71.6) 312 (62.4) <0.001
Avian influenza A(H5N1) 159 (31.8) 163 (32.6) 170 (34.0) 203 (40.3) 156 (31.2) 0.028
SARS
52 (10.4)
57 (11.4)
54 (10.8)
45 (8.9)
51 (10.2)
0.779
Distance, km†† 804 383 601 233

*Values are no. (%) persons except as indicated. STAI, State Trait Anxiety Inventory; ILI, influenza-like illness; SARS, severe acute respiratory syndrome.
†Differences between groups was examined with the Kruskal Wallis Test (assuming nonhomogeneous variances).
‡Respondents who answered certain/very likely/likely to the question “How likely do you think it is that you will contract H7N9 avian flu over the next 1 month?” were categorized as “High”; those who answered never/very unlikely/unlikely were categorized as “Low.”
§Respondents who answered certain/much more /more to the question “What do you think is your chance of getting infected with H7N9 avian flu over the next 1 month compared to other people outside your family of a similar age?” were categorized as “High”; those who answered not at all/much less/less were categorized as “Low.”
¶Respondents who answered extremely concerned/concerned much more than normal/concerned more than normal to the question “If you were to develop ILI symptoms tomorrow, would you be…?” were categorized as “More”; those who answered not at all concerned/much less concerned than normal/ concerned less than normal were categorized as “Less.”
#Respondents who answered worried about it all the time/worried a lot/worried a bit to the question “Did you worry about H7N9 in the past week?“ were categorized as “Worry.”
**Respondents who answered much higher/a little higher regarding the severity of influenza A(H7N9) compared with seasonal influenza, avian influenza A(H5N1), and SARS.
††Distance between the survey location and the nearest area in which influenza A(H7N9) case(s) were reported.

Main Article

1These authors contributed equally to this article.

Page created: July 18, 2014
Page updated: July 18, 2014
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The conclusions, findings, and opinions expressed by authors contributing to this journal do not necessarily reflect the official position of the U.S. Department of Health and Human Services, the Public Health Service, the Centers for Disease Control and Prevention, or the authors' affiliated institutions. Use of trade names is for identification only and does not imply endorsement by any of the groups named above.
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