Background: The growing numbers of H1N1 "swine influenza" cases should prompt national health systems to achieve dual preparedness: preparedness of clinicians to recognize and treat cases of human H1N1 flu, and national preparedness for an influenza pandemic. This is similar to recent contingency planning for an avian flu pandemic.

Objectives: To evaluate hospital personnel's knowledge on avian flu (zoonotic, sporadic, pandemic), comparing among nurses, residents and faculty, and between those who attended lectures or other educational modalities targeted at avian flu and those who did not.

Methods: A 14 item multiple choice questionnaire was designed to test crucial points regarding preparedness for human avian flu. The directors of 26 general hospitals were instructed by the Ministry of Health to improve knowledge of and preparedness for different avian flu scenarios, and to expect an official inspection. As part of this inspection, we distributed the questionnaires to nurses, residents and senior physicians.

Results: Altogether, 589 questionnaires were collected from the 26 hospitals. Examinees who participated in training modules (course, lecture or any training provided by the hospital) did somewhat better (scoring 78 points out of 100) than those who did not attend the training (70 points) (P < 0.05). Differences in nurses’ knowledge were even more striking: 66 points for the non-attendants compared to 79 for nurses who attended the lecture (P < 0.05).  Residents had significantly lower scores compared to nurses or senior physicians: 70 compared to 77 and 78 respectively (P < 0.05).