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. 2003 Jul 9;362(9378):170. doi: 10.1016/S0140-6736(03)13874-3

SARS transmission: language and droplet production

Sakae Inouye a
PMCID: PMC7135525  PMID: 12867123

Sir

Severe acute respiratory syndrome (SARS) is transmitted via droplets spread by infected individuals. Droplets are generated when patients cough and, to a lesser extent, when they talk during the early stages of disease. I believe that the efficiency of transmission of SARS by talking might be affected by the language spoken.

As of mid June, 2003, the number of probable cases of SARS in Japan remained zero, whereas there were more than 70 cases diagnosed in the USA.1 There were about 3·1 million Japanese travellers to mainland China, Hong Kong, and Taiwan in 2000,2 and about 2·3 million US citizens visited these areas in 2001.3 With such large numbers of visitors from Japan and USA, why have no Japanese visitors contracted the virus? Here, I propose a hypothesis.

The Chinese language has an aspiration/non-aspiration pronunciation system: the consonants p, t, k, q, ch, and c, when placed in front of vowels, are pronounced with a strong breath, by contrast with b, d, g, j, zh, and z. In English, but not in Japanese, p, t, and k are pronounced with a similar accompanying exhalation of breath. Furthermore, the p sound is not used as frequently in Japanese as in English. Aspiration could produce droplets.

A Chinese attendant in a souvenir shop probably speaks to American tourists in English, and to Japanese tourists in Japanese. If the shop assistant is in the early stages of SARS and has no cough, I believe American tourists would, hence, be exposed to the infectious droplets to a greater extent than would Japanese tourists.

Acknowledgments

I thank Professors S Yabuki, Yokohama City University, and T Kohno, Otsuma Women's University, for discussions on cultural and linguistic aspects of Chinese and American people.

References


Articles from Lancet (London, England) are provided here courtesy of Elsevier

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