文章基本信息

标题：Pandemic Influenza and Community Preparedness
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作者：Helen Marshall ; Philip Ryan ; Don Roberton 等
期刊名称：American journal of public health
印刷版ISSN：0090-0036
出版年度：2009
卷号：99
期号：Suppl 2
页码：S365-S371
DOI：10.2105/AJPH.2008.153056
语种：English
出版社：American Public Health Association
摘要：Objectives . We aimed to examine community knowledge about and attitudes toward the threat of pandemic influenza and assess the community acceptability of strategies to reduce its effect. Methods . We conducted computer-aided telephone interviews in 2007 with a cross-sectional sample of rural and metropolitan residents of South Australia. Results . Of 1975 households interviewed, half (50.2%) had never heard of pandemic influenza or were unaware of its meaning. Only 10% of respondents were extremely concerned about the threat of pandemic influenza. Respondents identified children as the highest priority for vaccination, if supplies were limited; they ranked politicians and teachers as the lowest priority. Although only 61.7% of respondents agreed with a policy of home isolation, 98.2% agreed if it was part of a national strategy. Respondents considered television to be the best means of educating the community. Conclusion s. Community knowledge about pandemic influenza is poor despite widespread concern. Public education about pandemic influenza is essential if strategies to reduce the impact of the disease are to be effective. The latest outbreaks of avian influenza A(H5N1) and novel H1N1 influenza have heightened concerns that an influenza pandemic is imminent.^{1 – 4} In response, many governments have prepared protocols for rapid response and containment of infection to minimize the heavy burden of morbidity and mortality associated with previous pandemics. Although epidemic influenza kills thousands of people worldwide each year, the emergence of influenza viruses with novel surface antigens poses a greater threat with increased economic and social consequences. The occasional crossover of the highly pathogenic but poorly transmissible avian influenza virus H5N1 into humans has placed governments on high alert for an influenza pandemic. The United States began preparing pandemic influenza response plans in 1993 after the emergence of H5N1, closely followed by the European Union.^{5 , 6} A worldwide response to emerging diseases coalesced in the World Health Organization (WHO) Global Outbreak Alert and Response Network, established in 2000.⁷ Since then, a steady flow of WHO resource documents has encouraged the development of national pandemic influenza response plans and rapid action where outbreaks have occurred.⁸ Australia developed its own pandemic influenza management plan in 2005 in response to new cases of H5N1 in Asia; this was revised in 2006.⁹ Each state has developed a plan that is consistent with the national plan but includes additional details relating to local circumstances.¹⁰ The Australian federal government has invested more than AU $600 million in influenza pandemic preparedness,¹¹ including stockpiling antiviral drugs and personal protective equipment and developing a vaccine that is effective against H5N1. In 2006 a national pandemic influenza exercise, Exercise Cumpston, carried out at sites across Australia, highlighted several gaps in existing plans, including poor communication with the general public and a lack of information targeted to indigenous and culturally diverse groups. The Exercise Cumpston report led to an emphasis on improved communication, including government engagement in increasing public knowledge, with the aim of building a base level of awareness and understanding across the community and among primary care providers about the threat of an influenza pandemic.¹¹ Although many government and public health agencies have been involved in pandemic influenza planning, the wider population (including community and hospital health care workers) has generally not been included in decision-making on issues that will require community compliance. Public health control measures that are inadequately understood or supported by communities may fail to be implemented.¹² Poorly understood control measures caused confusion and fear during the SARS (severe acute respiratory syndrome) outbreak.¹³ Pandemic influenza planning in North America has included a US–Canada summit,¹⁴ the Public Engagement Pilot Project on Pandemic Influenza,¹⁵ and local initiatives such as the Baltimore program B'More Prepared,¹⁶ but citizen consultation and engagement have been limited. In New Zealand, consideration of ethical issues in pandemic influenza planning included elements of community consultation.¹⁷ Engagement of the community as active participants in pandemic flu preparedness is considered essential if a successful prevention program is to be established.^{17 , 18} We aimed to assess community knowledge regarding pandemic influenza preparedness and acceptance of government strategies to reduce the impact of pandemic influenza in South Australia.