Avian Influenza Risk Perception among Poultry Workers, Nigeria

The Department of Production Animal 
Studies, Faculty of Veterinary Science, 
University of Pretoria and ARC-Onderstepoort 
Veterinary Institute provided funding 
for this research.

(south). We used pretested and previously evaluated structured interviews. Telephone interviews were used to confi rm data collected from ≈15% of respondents, and data were evaluated by using descriptive statistics. All responses were evaluated according to published guidelines of the World Organisation for Animal Health (OIE), US Centers for Disease Control and Prevention, World Health Organization, OIE/Food and Agriculture Organization of the United Nations (FAO) Network on Avian Infl uenza, and Food and Drug Administration of the United Nations, taken from the organizations' websites.
One hundred thirty-fi ve (68%) poultry farmer workers from 36 infected and 39 uninfected fl ocks responded to the interview. Farms evaluated had fl ocks of a few hundred (200-300) to >70,000 chickens. Eighty-nine percent of respondents were concerned about AI; 57% knew that AI has food safety implications. Eighteen percent were willing to eat chicken that had died or gotten sick from infection; 21% would eat chicken and eggs from infected farms. These surveyed workers stated that thorough cooking, frying, cleaning, and traditional cooking methods were suffi cient to kill the HPAI virus. 23% were not aware of risk associated with processing of HPAI-infected meat.
Although 61% reported knowing some risk factors for AI (e.g., close association with infected birds, home slaughtering, unprotected personnel, eating and processing of infected carcasses), only 56% correctly described some risk factors. Sixty percent reported having heard about the AI virus before the outbreak in Nigeria; 55% reported knowing the symptoms in affected birds. Of the 67% who had some knowledge of the symptoms, 56% were familiar with differential diagnoses. Ninety percent erroneously believed AI was fatal only to birds, although 58% believed it could affect humans.
After the fi rst wave of HPAI outbreaks in poultry in Nigeria (2006), 98% of respondents said they had gained some knowledge about AI, primarily through television but also through radio, newspapers, government, community public health messages, veterinarians, and the Internet or through journals and seminars. Although 21% of respondents had had their fl ocks tested for AI, they had diffi culty distinguishing between clinical assessment and laboratory tests. Seven farmers had themselves been tested for AI exposure. Seventy-six percent of farmers were willing to be tested, but only 67.9% were willing to have their fl ocks tested.
Respondents were more concerned about the effect of AI on fi nancial preservation of business interests than on public health risk. Knowledge about biosecurity and risk factors varied widely between urban/periurban (51 correct answers) and rural (25 cor-   (3,4) (Table). Our study showed that knowledge of food safety and risk factors and differentiation between HPAI and other poultry diseases is poor among the poultry farming communities of Nigeria. The belief by 90% of respondents that AI is lethal only in poultry further increases risk for human infection. The study also showed that farmers believe the news media (broadcast and print) are important in increasing public understanding of AI. Nearly all respondents agreed that poultry enterprise is profi table, albeit risky, and were not willing to abandon the business even in the event of an AI outbreak. Because the knowledge gap between the rural and urban communities further heightens the risk for human AI infection in Nigeria, public health messages about AI should target rural communities.
Previously, workers have indicated that socioeconomic factors prevent the rural and urban poor from accessing healthcare facilities (8). Lack of access to healthcare was evident in the response of workers who stated they would want to have themselves and their fl ocks tested if healthcare services were available and if government agencies would bear the cost of tests that may be unaffordable to most.
Since this survey, progress in disseminating knowledge of AI in Nigeria has been substantial. The country has established desk offi ces (state centers for coordination of surveillance activities in animals) to carry out regular surveillance for HPAI virus (H5N1), and farmers have tremendously improved their knowledge (9).

Mycobacterium avium subsp. hominissuis Infection in a Pet Parrot
To the Editor: Tuberculosis is a chronic wasting disease in domestic birds (especially hens) and free-ranging birds worldwide (1). Most mycobacterial infections in birds are caused by Mycobacterium avium subsp. avium (mainly domestic birds) or by M. genavense (especially pet birds). Nontuberculous (potentially pathogenic) mycobacteria (i.e., M. fortuitum, M. gordonae, and M. nonchromogenicum) occasionally have been isolated from necropsied pet birds (2). Because potentially pathogenic mycobacteria also are increasingly problematic in immunocompromised human patients, they merit special attention. M. avium subsp. hominissuis can infect humans, especially immunocompromised per-