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* Correspondence and reprint requests to Dr Greta Tam, Room 404, 4/F, School of Public Health and Primary Care, Prince of Wales Hospital, The Chinese University of Hong Kong, Hong Kong (e-mail: [email protected])
Influenza is estimated to infect 1 billion people annually worldwide. Five million cases will result in severe illness, causing 500,000 deaths. These figures are set to rise in the event of a pandemic. In developed countries, annual seasonal influenza epidemics already infect 20% of the population. 1
The first notified case of human A/H7N9 infection was reported in March 2013, catching global attention. Since then, at least 783 cases have been reported globally with cases rapidly progressing to severe pneumonia and a case fatality rate of 40%. 2 Of these, 760 cases were in Mainland China, with 16 in Hong Kong. Globally, there were cases in Taiwan (4), Canada (2), and Malaysia (1). 3 A/H7N9 is a particular cause for concern due to its high case fatality rate, lack of preexisting immunity among humans, and potential for human-to-human transmission, resulting in a pandemic. 4
Although vaccination is recognized as the first-line defense against seasonal influenza, 5 this cannot be applied to A/H7N9 prevention. Thus, individual preventive measures become all the more important for reducing transmission. However, due to an ongoing threat of avian influenza, such as A/H7N9, A/H5N6, and A/H5N1, the public may start to ignore the public health preparedness messaging and fail in following recommended preventive practices. This has been called pandemic-media-fatigue. 6 Relevant health promotion campaign strategies include correcting public misconceptions, communicating risks, and targeting messages to increase vigilance of neglected and poor preventive practices. Would a structured health promotion campaign aimed at relevant issues combat the public’s fatigue of a public health messaging about avian flu?
There is a need to review local epidemiology and assess how health promotion campaigns should be targeted, in terms of content and audience. A review of mass media materials can be used to assess existing services. In addition, a survey of public knowledge, attitude, and preventive practice toward A/H7N9 can provide information on how health promotion can be targeted to fill gaps in existing services. The public’s perceived need can be compared to experts’ views to discern discrepancies. In addition, a review...