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Modeling respiratory illnesses with change point: A lesson from the SARS epidemic in Hong Kong


  • Wong, Heung
  • Shao, Quanxi
  • Ip, Wai-cheung


It is generally agreed that respiratory disease is closely related to ambient air quality and weather conditions. Besides, hygiene related factors such as the public health measures by the government and possible personal awareness in the community can also affect the spread of infectious respiratory diseases. However, there is no quantitative support for this conclusion, because of lack of quality data. The severe acute respiratory syndrome (or SARS) outbreak in 2003 triggered strict public health measures and personal awareness in the prevention of infectious respiratory diseases, providing us an opportunity to quantify the impact of hygiene related factors in the spread of the disease. In this paper, we model the number of the respiratory illnesses by a semiparametric model which models the environmental and weather impacts using a multiple index model and the impact of other public health measures and possible personal awareness using a growth curve with jump. Using data from Hong Kong, we found that public health measures contributed to about 39% of reduction in the number of respiratory illnesses during the SARS period. However, the impact of hygienically related factors eventually fades as time passes. The results provide indirect quantitative support to the usefulness of governmental campaigns to arouse the awareness of the public in staying away from transmission of respiratory diseases during the full outbreak of the disease. The results also show the fast fading of alertness of Hong Kong people towards the epidemic. Furthermore, our model also offers a way to model the impacts of environmental factors on respiratory diseases, when the data contains the effect of human intervention, by introducing the change point and growth curve to remove such an effect.

Suggested Citation

  • Wong, Heung & Shao, Quanxi & Ip, Wai-cheung, 2013. "Modeling respiratory illnesses with change point: A lesson from the SARS epidemic in Hong Kong," Computational Statistics & Data Analysis, Elsevier, vol. 57(1), pages 589-599.
  • Handle: RePEc:eee:csdana:v:57:y:2013:i:1:p:589-599
    DOI: 10.1016/j.csda.2012.07.029

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    References listed on IDEAS

    1. Yingcun Xia & Howell Tong & W. K. Li & Li-Xing Zhu, 2002. "An adaptive estimation of dimension reduction space," Journal of the Royal Statistical Society Series B, Royal Statistical Society, vol. 64(3), pages 363-410.
    2. Ståle Navrud, 2001. "Valuing Health Impacts from Air Pollution in Europe," Environmental & Resource Economics, Springer;European Association of Environmental and Resource Economists, vol. 20(4), pages 305-329, December.
    3. Francesca Dominici & Jonathan M. Samet & Scott L. Zeger, 2000. "Combining evidence on air pollution and daily mortality from the 20 largest US cities: a hierarchical modelling strategy," Journal of the Royal Statistical Society Series A, Royal Statistical Society, vol. 163(3), pages 263-302.
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    Cited by:

    1. McKinley, Trevelyan J. & Ross, Joshua V. & Deardon, Rob & Cook, Alex R., 2014. "Simulation-based Bayesian inference for epidemic models," Computational Statistics & Data Analysis, Elsevier, vol. 71(C), pages 434-447.


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