JMIR Publications

ABSTRACT

Background:

Public health crises often reshape online discourse by amplifying uncertainty, frustration, stigma, and misinformation, with important implications for risk communication.

Objective:

This study examines these dynamics on Reddit during a recent outbreak, using Mpox as a case study.

Methods:

We analyze sentiment, topical themes, and audience engagement in posts and comments drawn from four Mpox-related subreddits. Using natural language processing methods, we applied sentiment analysis and Latent Dirichlet Allocation to classify 1,169 posts and 6,571 comments into sentiment categories and nine distinct topics. We then used Kruskal-Wallis tests, Dunn’s post-hoc comparisons, and Vargha-Delaney A to assess relationships among sentiment, topic, and engagement metrics.

Results:

Engagement was unevenly distributed: negative posts and posts emphasizing systemic public health failures or sociopolitical reactions attracted higher upvotes whereas more technical or epidemiological content received lower engagement. Although neutral comments were most frequent across all sentiment categories, positive posts tended to elicit more positive comments, and negative posts drew more negative responses. Comments responding to posts about systemic failures and heightened risk narratives were significantly more negative, while discussions centered on scientific and policy debates tended to be more positive. Comment topics did not necessarily align with original post topics; sociopolitical reactions dominated regardless of post content, and stigma.

Conclusions:

Overall, the findings highlight how audience reactions can amplify emotionally charged narratives and reframe technical information into socially and politically charged debates. These insights can inform public health communication strategies by anticipating likely audience responses, mitigating stigma and misinformation, and fostering constructive dialogue during health crises.