Kaleidoscoping public understanding of science on hygiene, health and plague: a survey in the aftermath of a plague epidemic in India

Abstract

In September 1994 a plague epidemic hit a number of cities in India. Though the spread of the disease was controlled within a short period of about one month, its influences on various channels of information, on the functioning of government departments (especially health and sanitation), on the scientific community and on people's scientific information level were remarkable. This paper analyzes the responses of 1127 individuals interviewed in December 1994. The data indicates high levels of informedness about health, hygiene and plague, with little reference to extra-scientific explanations of the causes of the epidemic. Respondents expressed a high degree of confidence in the modern system of medicine. From this analysis we also infer that the public could not be described as 'superstitious', 'unscientific' or 'unhygienic': only when denied access to information and civic amenities did they show extra-scientific thinking or 'unhygienic' behaviour.

How to Reduce the Impact of “Low-Risk Patients” Following a Bioterrorist Incident: Lessons from SARS, Anthrax, and Pneumonic Plague

“…In this article, we review the incidence and impact of low-risk patients in 3 previous infectious disease incidents: the anthrax attacks in the U.S. during 2001, the outbreak of severe acute respiratory syndrome (SARS) in 2002 and 2003, and the outbreak of pneumonic plague in Surat, India, in 1994. These outbreaks were chosen because they represent a genuine bioterrorist attack (anthrax); 6 a natural outbreak of a potential bioterrorism agent, which at the time was widely rumored to be a deliberate release (pneumonic plague); 7 and a major outbreak of a novel emerging pathogen that required some hospitals to activate their bioterrorism protocols in order to cope with the incident (SARS). 8 Data relating to these incidents are used to characterize likely low-risk patient behaviors and to suggest possible strategies for dealing with them.…”

Perceptions and Reactions with Regard to Pneumonic Plague

“…However, interventions such as isolating case-patients, identifying contacts, and providing prophylactic antimicrobial drugs may halt the spread of an outbreak ( 3 , 4 ). The success of such interventions relies on public cooperation, which should not be taken for granted ( 5 ). Indeed, various commentators have suggested that future plague outbreaks could result in widespread panic ( 2 ), mass public fear and civil disruption ( 1 ), and rioting ( 6 ).…”

A framework for capturing the interactions between laypersons’ understanding of disease, information gathering behaviors, and actions taken during an epidemic

“…For instance, the occurrence describes peo-pleÕs reactions during a different time period (not living in our current culture) and these texts might be biased towards the view of the author. Another method of understanding lay reaction is through questionnaires/ surveys following a real-life episode [24] or a simulation of an outbreak [25,26]. These questionnaires use pre-defined categories leading to large amounts of data on select variables of interest (e.g., whether or not people believe they would follow quarantine restrictions).…”

“…Informally learned remedies and cultural beliefs sometimes play a major role in determining lay interpretations of epidemic events. For instance, Raza et al [24] examined lay understanding of the plague with persons belonging to the economically weaker sections of society in Delhi and Gurgaon India. In identifying the factors that influence the public understanding of science, they found significant amount of lay understanding based on ''extra-scientific belief systems'' (e.g., sins committed by people contributed to the outbreak), which were prevalent in the context of the plague epidemic.…”