The content of social media's shared images about Ebola: a retrospective study.
OBJECTIVE
Social media have strongly influenced awareness and perceptions of public health emergencies, but a considerable amount of social media content is now carried through images, rather than just text. This study's objective is to explore how image-sharing platforms are used for information dissemination in public health emergencies.


METHODS
Retrospective review of images posted on two popular image-sharing platforms to characterize public discourse about Ebola.


METHODS
Using the keyword '#ebola' we identified a 1% sample of images posted on Instagram and Flickr across two sequential weeks in November 2014. Images from both platforms were independently coded by two reviewers and characterized by themes. We reviewed 1217 images posted on Instagram and Flickr and identified themes.


RESULTS
Nine distinct themes were identified. These included: images of health care workers and professionals [308 (25%)], West Africa [75 (6%)], the Ebola virus [59 (5%)], and artistic renderings of Ebola [64 (5%)]. Also identified were images with accompanying embedded text related to Ebola and associated: facts [68 (6%)], fears [40 (3%)], politics [46 (4%)], and jokes [284 (23%)]. Several [273 (22%)] images were unrelated to Ebola or its sequelae. Instagram images were primarily coded as jokes [255 (42%)] or unrelated [219 (36%)], while Flickr images primarily depicted health care workers and other professionals [281 (46%)] providing care or other services for prevention or treatment.


CONCLUSIONS
Image sharing platforms are being used for information exchange about public health crises, like Ebola. Use differs by platform and discerning these differences can help inform future uses for health care professionals and researchers seeking to assess public fears and misinformation or provide targeted education/awareness interventions.
Penn Medicine Social Media and Health Innovation Lab, University of Pennsylvania, Philadelphia, PA 19104, USA. Electronic address: seltzer@uphs.upenn.edu.
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Seltzer
Penn Medicine Social Media and Health Innovation Lab, University of Pennsylvania, Philadelphia, PA 19104, USA.
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Jean
Penn Medicine Social Media and Health Innovation Lab, University of Pennsylvania, Philadelphia, PA 19104, USA.
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Kramer-Golinkoff
Penn Medicine Social Media and Health Innovation Lab, University of Pennsylvania, Philadelphia, PA 19104, USA; The Center for Health Equity Research and Promotion, Philadelphia Veterans Affairs Medical Center, Philadelphia, PA 19104, USA.
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Asch
Penn Medicine Social Media and Health Innovation Lab, University of Pennsylvania, Philadelphia, PA 19104, USA.
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Merchant
D000354:Africa, Western; D004630:Emergencies; D007722:Health Knowledge, Attitudes, Practice; D019142:Hemorrhagic Fever, Ebola / Q000523:psychology; D006801:Humans; D033181:Information Dissemination / Q000379:methods; D010781:Photography; D011634:Public Health; D012189:Retrospective Studies; D061108:Social Media / Q000706:statistics & numerical data*
Communication; Ebola; Public health; Public opinion; Social media