Van et al. BMC Public Health 2010, 10:130 http://www.biomedcentral.com/1471-2458/10/130 R E S E A R C H A R T I C L E Open Access University life and pandemic influenza: Attitudes and intended behaviour of staff and students towards pandemic (H1N1) 2009 Debbie Van1, Mary-Louise McLaws2, Jacinta Crimmins3, C Raina MacIntyre2,4, Holly Seale2* Abstract Background: In a pandemic young adults are more likely to be infected, increasing the potential for Universities to be explosive disease outbreak centres. Outbreak management is essential to reduce the impact in both the institution and the surrounding community. Through the use of an online survey, we aimed to measure the perceptions and responses of staff and students towards pandemic (H1N1) 2009 at a major university in Sydney, Australia. Methods: The survey was available online from 29 June to 30 September 2009. The sample included academic staff, general staff and students of the University. Results: A total of 2882 surveys were completed. Nearly all respondents (99.6%, 2870/2882) were aware of the Australian pandemic situation and 64.2% (1851/2882) reported either “no anxiety” or “disinterest.” Asian-born respondents were significantly (p < 0.001) more likely to believe that the pandemic was serious compared to respondents from other regions. 75.9% (2188/2882) of respondents had not made any lifestyle changes as a result of the pandemic. Most respondents had not adopted any specific behaviour change, and only 20.8% (600/2882) had adopted the simplest health behaviour, i.e. hand hygiene. Adoption of a specific behaviour change was linked to anxiety and Asian origin. Students were more likely to attend the university if unwell compared with staff members. Positive responses from students strongly indicate the potential for expanding online teaching and learning resources for continuing education in disaster settings. Willingness to receive the pandemic vaccine was associated with seasonal influenza vaccination uptake over the previous 3 years. Conclusions: Responses to a pandemic are subject to change in its pre-, early and mid-outbreak stages. Lessons for these institutions in preparation for a second wave and future disease outbreaks include the need to promote positive public health behaviours amongst young people and students. Background In April 2009, severe cases of pneumonia preceded by influenza-like illness were noted to occur in Mexico and then North America. A novel influenza A (H1N1) virus was identified as the cause and it rapidly evolved into a pandemic. Cases of the strain were first identified in Australia in early May and soon appeared across the country [1]. As of February 12 2010, there have been 37,000 confirmed cases and 191 deaths in Australia. While this pandemic has been moderate or milder than * Correspondence: h.seale@unsw.edu.au 2School of Public Health and Community Medicine, Faculty of Medicine, The University of New South Wales, Australia previous pandemics such as the Spanish flu of 1918- 1919, similarities can be drawn between the two in regards to the median age of cases. In Australia, the median age of confirmed cases is 21 years [2] Universities therefore have the potential to become explosive, centrifugal outbreak centres due to their large young adult population, high levels of close social con- tact and permeable boundaries. During a pandemic or disease outbreak, the proportion affected may exceed the seasonal norm of one-third of the student popula- tion [3]. As sites of transmission, they may have a nega- tive impact on the larger communities in which they are embedded. Additionally, student behaviour is often divergent from non-student adult populations [4]. © 2010 Van et al; licensee BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.