Skip to main content
Journal of Epidemiology and Community Health logoLink to Journal of Epidemiology and Community Health
. 2003 Nov;57(11):857–863. doi: 10.1136/jech.57.11.857

The impact of community psychological responses on outbreak control for severe acute respiratory syndrome in Hong Kong

G Leung 1, T Lam 1, L Ho 1, S Ho 1, B Chan 1, I Wong 1, A Hedley 1
PMCID: PMC1732323  PMID: 14600110

Abstract

Objective: To examine the public's knowledge and perception of SARS and the extent to which various precautionary measures have been adopted.

Design: Cross sectional survey.

Setting: General population of Hong Kong at the height of the SARS outbreak (29 March to 6 April 2003).

Participants: 1115 ethnic Chinese adults.

Main results: Forty per cent did not recognise fomites as a possible mode of transmission whereas 55.1% believed that the infection could be transmitted airborne. A large proportion (30.1%) believed they were very or somewhat likely to contract SARS while only one quarter believed they were very likely to survive if they contracted the disease, benchmarked against an actual case fatality ratio of 2.8% at the time of the survey and 15%–20% according to current best estimates. Precautionary measures directed against person to person droplet spread were generally adopted by most while the prevention of transmission through fomites was not practised as frequently. Respondents with higher risk perceptions and a moderate level of anxiety were most likely to take comprehensive precautionary measures against the infection, as were older, female, more educated people as well as those with a positive contact history and SARS-like symptoms.

Conclusions: The findings demonstrate that the promotion of protective personal health practices to interrupt the self sustaining transmission of the SARS virus in the community must take into account background perceptions of risk and anxiety levels of the public at large. Continuing public education about preventive measures should be targeted at the identified groups with low current uptake of precautions.

Full Text

The Full Text of this article is available as a PDF (447.1 KB).

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Cheung Yuk Lung, Molassiotis Alexander, Chang Anne M. The effect of progressive muscle relaxation training on anxiety and quality of life after stoma surgery in colorectal cancer patients. Psychooncology. 2003 Apr-May;12(3):254–266. doi: 10.1002/pon.638. [DOI] [PubMed] [Google Scholar]
  2. Cohen R. E., Anderson D. L. Botulism: emotional impact on patient and family. J Psychosom Res. 1986;30(3):321–326. doi: 10.1016/0022-3999(86)90009-7. [DOI] [PubMed] [Google Scholar]
  3. Donnelly Christl A., Ghani Azra C., Leung Gabriel M., Hedley Anthony J., Fraser Christophe, Riley Steven, Abu-Raddad Laith J., Ho Lai-Ming, Thach Thuan-Quoc, Chau Patsy. Epidemiological determinants of spread of causal agent of severe acute respiratory syndrome in Hong Kong. Lancet. 2003 May 24;361(9371):1761–1766. doi: 10.1016/S0140-6736(03)13410-1. [DOI] [PMC free article] [PubMed] [Google Scholar]
  4. Griffin R. J., Dunwoody S., Zabala F. Public reliance on risk communication channels in the wake of a cryptosporidium outbreak. Risk Anal. 1998 Aug;18(4):367–375. doi: 10.1111/j.1539-6924.1998.tb00350.x. [DOI] [PubMed] [Google Scholar]
  5. McLeroy Kenneth R., Norton Barbara L., Kegler Michelle C., Burdine James N., Sumaya Ciro V. Community-based interventions. Am J Public Health. 2003 Apr;93(4):529–533. doi: 10.2105/ajph.93.4.529. [DOI] [PMC free article] [PubMed] [Google Scholar]
  6. Ramalingaswami V. Psychosocial effects of the 1994 plague outbreak in Surat, India. Mil Med. 2001 Dec;166(12 Suppl):29–30. [PubMed] [Google Scholar]
  7. Yung Paul Man Bun, Chui-Kam Szeto, French Peter, Chan Tony Moon Fai. A controlled trial of music and pre-operative anxiety in Chinese men undergoing transurethral resection of the prostate. J Adv Nurs. 2002 Aug;39(4):352–359. doi: 10.1046/j.1365-2648.2002.02296.x. [DOI] [PubMed] [Google Scholar]

Associated Data

This section collects any data citations, data availability statements, or supplementary materials included in this article.

Supplementary Materials

[Author Correction]

Articles from Journal of Epidemiology and Community Health are provided here courtesy of BMJ Publishing Group

RESOURCES