title: Live Bird Exposure among the General Public, Guangzhou, China, May 2013.
abstract: BACKGROUND
  A novel avian-origin influenza A(H7N9) caused a major outbreak in Mainland China in early 2013. Exposure to live poultry was believed to be the major route of infection. There are limited data on how the general public changes their practices regarding live poultry exposure in response to the early outbreak of this novel influenza and the frequency of population exposure to live poultry in different areas of China.
  
  
  METHODS
  This study investigated population exposures to live birds from various sources during the outbreak of H7N9 in Guangzhou city, China in 2013 and compared them with those observed during the 2006 influenza A(H5N1) outbreak. Adults were telephone-interviewed using two-stage sampling, stratified by three residential areas of Guangzhou: urban areas and two semi-rural areas in one of which (Zengcheng) A(H7N9) virus was detected in a chicken from wet markets. Logistic regression models were built to describe practices protecting against avian influenza, weighted by age and gender, and then compare these practices across residential areas in 2013 with those from a comparable 2006 survey.
  
  
  RESULTS
  Of 1196 respondents, 45% visited wet markets at least daily and 22.0% reported buying live birds from wet markets at least weekly in April-May, 2013, after the H7N9 epidemic was officially declared in late March 2013. Of those buying live birds, 32.3% reported touching birds when buying and 13.7% would slaughter the poultry at home. Although only 10.1% of the respondents reported raising backyard birds, 92.1% of those who did so had physical contact with the birds they raised. Zengcheng respondents were less likely to report buying live birds from wet markets, but more likely to buy from other sources when compared to urban respondents. Compared with the 2006 survey, the prevalence of buying live birds from wet markets, touching when buying and slaughtering birds at home had substantially declined in the 2013 survey.
  
  
  CONCLUSIONS
  Although population exposures to live poultry were substantially fewer in 2013 compared to 2006, wet markets and backyard poultry remained the two major sources of live bird exposures for the public in Guangzhou in 2013. Zengcheng residents seemed to have reduced buying live birds from wet markets but not from other sources in response to the detection of H7N9 virus in wet markets.
authors.affiliation: School of Public Health, the University of Hong Kong, Hong Kong, People's Republic of China.
authors.forename: Qiuyan
authors.initials: Q
authors.lastname: Liao
authors.affiliation: Guangzhou Center for Disease Control and Prevention, Guangzhou, People's Republic of China.
authors.forename: Jun
authors.initials: J
authors.lastname: Yuan
authors.affiliation: School of Public Health, the University of Hong Kong, Hong Kong, People's Republic of China.
authors.forename: Eric H Y
authors.initials: EH
authors.lastname: Lau
authors.affiliation: Panyu Center for Disease Control and Prevention, Guangzhou, People's Republic of China.
authors.forename: Guang Yan
authors.initials: GY
authors.lastname: Chen
authors.affiliation: Guangzhou Center for Disease Control and Prevention, Guangzhou, People's Republic of China.
authors.forename: Zhi Cong
authors.initials: ZC
authors.lastname: Yang
authors.affiliation: Guangzhou Center for Disease Control and Prevention, Guangzhou, People's Republic of China.
authors.forename: Xiao Wei
authors.initials: XW
authors.lastname: Ma
authors.affiliation: Guangzhou Center for Disease Control and Prevention, Guangzhou, People's Republic of China.
authors.forename: Jian Dong
authors.initials: JD
authors.lastname: Chen
authors.affiliation: Guangzhou Center for Disease Control and Prevention, Guangzhou, People's Republic of China.
authors.forename: Yan Hui
authors.initials: YH
authors.lastname: Liu
authors.affiliation: Guangzhou Center for Disease Control and Prevention, Guangzhou, People's Republic of China.
authors.forename: Chang
authors.initials: C
authors.lastname: Wang
authors.affiliation: The Eighth People's Hospital of Guangzhou, Guangzhou, People's Republic of China.
authors.forename: Xiao Ping
authors.initials: XP
authors.lastname: Tang
authors.affiliation: Guangzhou Center for Disease Control and Prevention, Guangzhou, People's Republic of China.
authors.forename: Yu Fei
authors.initials: YF
authors.lastname: Liu
authors.affiliation: The Eighth People's Hospital of Guangzhou, Guangzhou, People's Republic of China.
authors.forename: Li
authors.initials: L
authors.lastname: Zhuo
authors.affiliation: School of Public Health, the University of Hong Kong, Hong Kong, People's Republic of China.
authors.forename: Gabriel M
authors.initials: GM
authors.lastname: Leung
authors.affiliation: Guangdong Center for Disease Control and Prevention, Guangzhou, People's Republic of China.
authors.forename: Wei
authors.initials: W
authors.lastname: Zhang
authors.affiliation: School of Public Health, the University of Hong Kong, Hong Kong, People's Republic of China.
authors.forename: Benjamin J
authors.initials: BJ
authors.lastname: Cowling
authors.affiliation: Guangzhou Center for Disease Control and Prevention, Guangzhou, People's Republic of China.
authors.forename: Ming
authors.initials: M
authors.lastname: Wang
authors.affiliation: School of Public Health, the University of Hong Kong, Hong Kong, People's Republic of China.
authors.forename: Richard
authors.initials: R
authors.lastname: Fielding
mesh_terms: D000328:Adult; D000818:Animals; D002681:China; D004781:Environmental Exposure / Q000009:adverse effects / Q000032:analysis*; D006801:Humans; D064766:Influenza A Virus, H7N9 Subtype / Q000502:physiology; D011200:Poultry / Q000821:virology*; D012309:Risk-Taking; D011795:Surveys and Questionnaires