CO25 | KNOWLEDGE, AND PRACTICES REGARDING THE HEPATITIS A VIRUS OUTBREAK IN CAMPANIA, ITALY: PRELIMINARY RESULTS FROM A CROSS-SECTIONAL SURVEY

Maria Francesca Peruzy¹, Claire Julie Akwongo¹, Giorgio Smaldone^2|3, Maurizio della Rotonda^2|3, Marco Esposito^2|3, Aniello Anastasio^1|3, Nicoletta Murru¹ | ¹Dep. Of veterinary medicine and A.P., University of Naples Federico II, Italy; ²Operational Unit for Prevention and Veterinary Public Health, Naples, Italy; ³Regional Reference Centre for the Health Safety of Fishery Products, Naples, Italy.

Aim. The purpose was to assess knowledge, and practices regarding the recent hepatitis A virus (HAV) outbreak in the Campania Region (Italy), with the aim of identifying knowledge gaps, risk perception, and preventive behaviors among the adult population.

Methods. A cross-sectional online survey was conducted among adults aged ≥18 years, primarily residing in the Campania Region. The questionnaire collected socio-demographic characteristics and included specific sections exploring participants’ general knowledge of HAV and its transmission and prevention, awareness of the recent outbreak, perceived reliability of information sources, risk perception, and preventive practices. Particular attention was given to food-related behaviours, including changes in dietary habits and avoidance of specific foods following the outbreak.

Results. A total of 147 participants completed the survey; 69.4% were female and 84.4% resided in Campania. Most respondents had a university degree or higher education. Overall awareness of HAV was high, with 93.2% reporting that they knew about the disease and 94.6% having heard of it before the recent outbreak. Most participants correctly identified HAV as a viral infection (72.1%), recognized the liver as the primary affected organ (86.4%), and acknowledged vaccination as the main preventive measure (78.9%). Knowledge of food hygiene was generally satisfactory, with over 90% recognizing the importance of washing fruit and vegetables and cooking food to reduce infection risk. However, important misconceptions emerged. Only 55.1% knew that infected individuals can transmit the virus before symptom onset, while uncertainty remained regarding virus survival after freezing, chronicity of the disease, and lifelong immunity after infection. Awareness of the outbreak was high (91.2%), although participants reported only moderate confidence in the information received and moderate perceived personal risk. Overall, 55.8% of respondents reported modifying their dietary habits, and 59.9% temporarily avoided specific foods following the outbreak. While avoidance of raw shellfish was expected and consistent with the known transmission route of HAV, many participants also avoided foods not considered relevant to HAV transmission, including cooked fish, cooked meat, and dairy products. These findings suggest that the outbreak influenced food choices beyond evidence-based recommendations, reflecting risk overestimation and possible misunderstandings of preventive measures.

Conclusions. The survey highlights a generally good level of awareness regarding HAV and its prevention. Nevertheless, substantial knowledge gaps persist regarding transmission dynamics and the natural history of the disease. Despite satisfactory overall knowledge, the outbreak prompted many respondents to adopt precautionary dietary behaviors extending beyond scientifically supported recommendations. These findings underline the importance of strengthening risk communication to improve public understanding, prevent unnecessary dietary restrictions, and promote evidence-based food safety practices during future outbreaks.