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Open Access Research article

Early responses to H7N9 in southern Mainland China

Robin Goodwin1* and Shaojing Sun2

Author Affiliations

1 School of Social Sciences, Brunel University, Uxbridge, London UB8 3PH, UK

2 School of Journalism, Fudan University, Shanghai, China

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BMC Infectious Diseases 2014, 14:8  doi:10.1186/1471-2334-14-8

Published: 7 January 2014

Abstract

Background

H7N9 posed potentially serious health challenges for Chinese society. The previous SARS outbreak in this country was accompanied by contradictory information, while worries about wide-spread influenza led to discrimination worldwide. Early understanding of public threat perceptions is therefore important for effective public health communication and intervention.

Methods

We interviewed 1011 respondents by phone two weeks after the first case. Questions examined risk awareness and media use, beliefs about the emergence of the threat and those most at risk, anxiety about infection and preventive and avoidant behaviours.

Results

Results demonstrate moderate levels of anxiety but relatively high levels of trust towards government officials. Threat emergence was associated with hygiene levels, temperature change, floating pigs in the Huangpu River and migration to the city. Anxiety predicted both recommended and non-recommended behavioural changes.

Conclusions

Comparatively high levels of trust in Chinese government advice about H7N9 contrast positively with previous pandemic communications in China. Anxiety helped drive both recommended and non-recommended behaviours, with potentially important economic and social implications. This included evidence of 'othering’ of those associated with the threat (e.g. migrants). Findings emphasise the need to manage public communications early during new influenza outbreaks.

Keywords:
H7N9; Pandemic influenza; Avian flu; Stigmatisation; Discrimination