Understanding, compliance and psychological impact of the SARS quarantine experience

Epidemiol Infect. 2008 Jul;136(7):997-1007. doi: 10.1017/S0950268807009156. Epub 2007 Jul 30.


This study examines a cohort of persons quarantined during the 2003 SARS outbreak in Canada and describes their understanding of, difficulties and compliance with, and the psychological impact of the quarantine experience. A mailed questionnaire was administered to 1912 eligible adults and included the Impact of Events Scale - Revised (IES-R) to assess symptoms of post-traumatic stress disorder (PTSD). Self-reported compliance with all required quarantine measures was low (15.8+/-2.3%), although significantly higher when the rationale for quarantine was understood (P=0.018). Health-care workers (HCW) experienced greater psychological distress, including symptoms of PTSD (P<0.001). Increasing perceived difficulty with compliance, HCW, longer quarantine and compliance with quarantine requirements were significant contributors to higher IES-R scores. The low compliance with quarantine requirements introduces concerns about the effectiveness of quarantine as a public health measure. Improvements in compliance and reduced psychological distress may be possible by minimizing duration, revising requirements, and providing enhanced education and support.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Canada / epidemiology
  • Cohort Studies
  • Comprehension
  • Disease Outbreaks*
  • Disease Transmission, Infectious / prevention & control*
  • Female
  • Health Personnel / psychology
  • Humans
  • Male
  • Middle Aged
  • Patient Acceptance of Health Care / statistics & numerical data*
  • Patient Compliance / statistics & numerical data*
  • Quarantine / psychology*
  • Severe Acute Respiratory Syndrome / epidemiology
  • Severe Acute Respiratory Syndrome / prevention & control*
  • Severe Acute Respiratory Syndrome / psychology*
  • Stress Disorders, Post-Traumatic / epidemiology
  • Surveys and Questionnaires