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06-10-2009 | Infectious disease | Article

Europeans may underestimate swine flu threat


Free abstract

MedWire News: People in Europe are less concerned about swine flu (Influenza A H1N1) than their Asian counterparts, survey results suggest.

Lead researcher Robin Goodwin (Brunel University, Uxbridge, UK) and team explain that the outbreak of pandemic swine flu in early 2009 posed a major challenge to health services around the world.

“Previous pandemics have led to stockpiling of goods, the victimization of particular population groups, and the cancellation of travel and the boycotting of particular foods (eg, pork),” the researchers write in the journal BMC Infectious diseases.

They add: “Understanding such attitudes and levels of knowledge may have important public health implications for information campaigns aimed at encouraging appropriate precautions against infection, while comprehending risk perceptions can help identify those groups most likely to be at risk of stereotyping and prejudice during a pandemic.”

The team surveyed 148 members of the general public from six countries in Europe and 180 in Malaysia about their initial behavioral and attitudinal responses to swine flu during the 6-day period after the World Health Organization increased their pandemic alert to level 5 on 29 April 2009.

The researchers found that 42% of Malaysian respondents were “very concerned” about becoming infected with swine flu, and 48% said that they had reduced their use of public transport due to fears of infection. In contrast, just 5% of European respondents were very concerned about swine flu infection and only 22% said they would reduce their use of public transport.

Furthermore, 41% of Malaysians planned to purchase products such as face masks to protect themselves from swine flu infection compared with just 15% of Europeans.

Five particular groups were identified as being at particularly high risk for swine flu by the participants, including individuals with weakened immunity, the elderly, pig farmers, the homeless, and prostitutes or highly sexually active individuals. Malaysians were more likely to believe that pig farmers, homosexuals, and prostitutes were at greater risk than other people, while Europeans were more likely to believe that the elderly and those with weakened immunity were at particularly high risk.

Further information collected only among European respondents revealed that 64% significantly underestimated mortality rates due to seasonal flu, and 26% believed seasonal flu vaccination offered protection against swine flu.

Goodwin and team conclude: “Our findings suggest culture and individual anxiety are important predictors of behavioral responses to pandemic influenza, with higher levels of anxiety about swine flu in Malaysia compared to Europe, and with greater levels of behavioral change in Malaysia.

They add that the belief among mainly Malaysian respondents that prostitutes, homosexuals, and other “out groups” are at particularly high risk for swine flu “may have important implications for the equitable treatment of socially marginalized groups, particularly as the pandemic continues to accelerate worldwide.”

MedWire ( is an independent clinical news service provided by Current Medicine Group, a trading division of Springer Healthcare Limited. © Springer Healthcare Ltd; 2009

By Mark Cowen

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