006 and 0.002, respectively). Other demographic variables, including age and race, were associated with protective behaviors in response to ILI. Travelers also identified diverse information requirements which would influence their behavior in response to entry screening, including characteristics of the pandemic, severity of illness, and screening operations. Conclusions. Demographic characteristics and perceived severity of illness are important factors

that may influence the protective behaviors of travelers overseas. Our results indicate that educational material and advice directed to international travelers could be differentially tailored to traveler subpopulations. In April 2009, the 2009 pandemic influenza A (2009 H1N1) virus was identified in North America.1 In the following weeks, travelers departing from Mexico transported the virus to destinations throughout the world.2 Sotrastaurin The World Health Organization raised the worldwide pandemic alert level to Phase VI on June 11, 2009, signifying that a global pandemic was in progress.3 In early 2010, 2009 H1N1 continued to be the predominant influenza virus in circulation globally.4 Khan and colleagues have noted the importance of air travel in the spread BKM120 cost of 2009 H1N1.2 Studies of travelers returning to Hong Kong and

Taiwan conducted during the 2003 severe acute respiratory syndrome (SARS) epidemic assessed preventive and risk behaviors. These studies provided useful information about travelers’ journey home during an outbreak, as well as influences on travelers’ decisions whether to seek care or delay travel.5,6 Other studies have attempted to evaluate the effectiveness of screening protocols employed during the SARS crisis.7,8 One study in 2009 examined how air travelers departing Progesterone from Swiss airports would respond to a hypothetical respiratory disease pandemic.9 Few studies have explored the knowledge, attitudes, and practices (KAP) of international air travelers with respect to exposure to pandemic influenza while abroad. Apart from broader assessments of willingness

to take travel-related health risks,10,11 studies have primarily addressed KAP regarding the introduction of pandemic influenza into countries and communities.12–14 Other research has focused on KAP toward H5N1 avian influenza.15,16 These results may not be generalizable to air travelers, who play a significant role in the spread of novel strains of influenza viruses.17–20 To better inform future research and preparedness efforts, we assessed travelers’ attitudes toward health screening for pandemic influenza at US ports of entry (POE) and their potential overseas behaviors in response to a hypothetical influenza pandemic. This study was conducted prior to the advent of the 2009 H1N1 influenza pandemic.