Responses to the outbreak of novel influenza A (H1N1) in Japan: Risk communication and shimaguni konjo


  • Jun Shigemura, MD
  • Koichi Nakamoto, MD, PhD
  • Robert J. Ursano, MD



influenza, pandemic, risk communication, public fear, cultural competence


In Japan, national outbreak of novel influenza A (H1N1) triggered serious social disruption. The public perceived overwhelming fear and their behaviors were severely affected. Countless events were put off, with massive economic losses due to activity cancellations. The heightened fear may have been a mixture of risk communication consequences, geographic characteristics (island nation), and culture-bound fear related to shimaguni konjo, or “island mentality”; according to a Japanese cultural norm, the “outside” is considered “impure” and is often covered-up, criticized, and avoided. These consequences shed light on cultural effects on collective behaviors, along with the importance of risk communication strategies.

Author Biographies

Jun Shigemura, MD

Department of Psychiatry, National Defense Medical College, Tokorozawa, Saitama, Japan.

Koichi Nakamoto, MD, PhD

Medical Attaché, Embassy of Japan Tanzania, Ministry of Foreign Affairs of Japan, Dar es Salaam, Tanzania.

Robert J. Ursano, MD

Department of Psychiatry, Center for the Studies of Traumatic Stress, Uniformed Services University of the Health Sciences, Bethesda, Maryland, USA.


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The Yomiuri Shimbun: Mask shortages. May 21, 2009: 35 (morning edition).

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How to Cite

Shigemura, MD, J., K. Nakamoto, MD, PhD, and R. J. Ursano, MD. “Responses to the Outbreak of Novel Influenza A (H1N1) in Japan: Risk Communication and Shimaguni Konjo”. American Journal of Disaster Medicine, vol. 4, no. 3, May 2009, pp. 133-4, doi:10.5055/ajdm.2009.0020.