SARS related preventive and risk behaviours practised by Hong Kong-mainland China cross border travellers during the outbreak of the SARS epidemic in Hong Kong

Objectives: To investigate patterns of behaviours and attitudes related to SARS prevention in the Hong Kong cross border traveller population. Settings: A survey was carried out at the Hong Kong-China cross border checkpoint in the middle of the epidemic. Participants: A total of 839 Hong Kong adult residents returning to Hong Kong from mainland China were surveyed. Main outcome measures: Practice of preventive measures and relevant behaviours and attitudes. Results: Around 40% of the respondents were using masks all or most of the time in public places or washing their hands frequently (>10 times per day) and about one third avoided visiting crowded places in mainland China. Such figures were however lower than those practised by the general public in Hong Kong. SARS related perceptions, such as perceived risk of transmission and efficacy, etc, were associated with mask use and not visiting crowded places, but not with hand washing, which was associated with duration of stay. Gender differences were also observed. Around 70% of the travellers would have delayed medical consultation for influenza-like illness in China; 12.7% would not wear masks during such episodes of illness. Furthermore, about 30% of the respondents used to wear masks in Hong Kong but not in mainland China. Conclusions: The findings have implications on cross border prevention of SARS. It seems that those travelling during the SARS epidemic were a "self selected'' group, and they were using less preventive measures. Special attention and intervention need to be provided to travellers to prevent a second wave cross border transmission of the disease.