Epidemiology and Infection

Original Papers

Understanding, compliance and psychological impact of the SARS quarantine experience

D. L. REYNOLDSa1a2 c1, J. R. GARAYa1, S. L. DEAMONDa1, M. K. MORANa1a2, W. GOLDa3 and R. STYRAa3

a1 Sanofi Pasteur, Toronto, Ontario, Canada (formerly Durham Region Health Department, Whitby, Ontario, Canada)

a2 University of Toronto, Toronto, Ontario, Canada

a3 University Health Network, Toronto General Division, Toronto, Ontario, Canada


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.

(Accepted June 13 2007)

(Online publication July 30 2007)


c1 Author for correspondence: Dr D. L. Reynolds, Director, Clinical Development, Sanofi Pasteur, Connaught Campus, 1755 Steeles Avenue West, Toronto, ON, Canada M2R 3T4. (Email: donna.reynolds@sanofipasteur.com)