Shepherd, T, Robinson, M and Mallen, CD (2023) Online Health Information Seeking for Mpox in Endemic and Nonendemic Countries: Google Trends Study. JMIR Formative Research, 7. e42710 - ?. ISSN 2561-326X

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BACKGROUND: The recent global outbreak of mpox (monkeypox) has already been declared a public health emergency of international concern by the World Health Organization. Given the health, social, and economic impacts of the COVID-19 pandemic, there is understandable concern and anxiety around the emergence of another infectious disease-especially one about which little is known. OBJECTIVE: We used Google Trends to explore online health information seeking patterns for mpox in endemic and nonendemic countries and investigated the impact of the publication of the first in-country case on internet search volume. METHODS: Google Trends is a publicly accessible and free data source that aggregates worldwide Google search data. Google search data were used as a surrogate measure of online health information seeking for 178 days between February 18 and August 18, 2022. Searching data were downloaded across this time period for nonendemic countries with the highest case count (United States, Spain, Germany, United Kingdom, and France) and 5 endemic countries (Democratic Republic of Congo, Nigeria, Ghana, Central African Republic, and Cameroon). Joinpoint regression analysis was used to measure changes in searching trends for mpox preceding and following the announcement of the first human case. RESULTS: Online health information seeking significantly increased after the publication of the first case in all the nonendemic countries-United States, Spain, Germany, United Kingdom, and France, as illustrated by significant joinpoint regression models. Joinpoint analysis revealed that models with 3 significant joinpoints were the most appropriate fit for these data, where the first joinpoint represents the initial rise in mpox searching trend, the second joinpoint reflects the start of the decrease in the mpox searching trend, and the third joinpoint represents searching trends' return to searching levels prior to the first case announcement. Although this model was also found in 2 endemic countries (ie, Ghana and Nigeria), it was not found in Central African Republic, Democratic Republic of Congo, or Cameroon. CONCLUSIONS: Findings demonstrate a surge in online heath information seeking relating to mpox after the first in-country case was publicized in all the nonendemic countries and in Ghana and Nigeria among the endemic counties. The observed increases in mpox searching levels are characterized by sharp but short-lived periods of searching before steep declines back to levels observed prior to the publication of the first case. These findings emphasize the importance of the provision of accurate, relevant online public health information during disease outbreaks. However, online health information seeking behaviors only occur for a short time period, and the provision of accurate information needs to be timely in relation to the publication of new case-related information.

Item Type: Article
Additional Information: ©Thomas Shepherd, Michelle Robinson, Christian Mallen. Originally published in JMIR Formative Research (, 13.04.2023. This is an open-access article distributed under the terms of the Creative Commons Attribution License (, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work, first published in JMIR Formative Research, is properly cited. The complete bibliographic information, a link to the original publication on, as well as this copyright and license information must be included.
Subjects: R Medicine > R Medicine (General)
Divisions: Faculty of Medicine and Health Sciences > School of Medicine
Related URLs:
Depositing User: Symplectic
Date Deposited: 10 May 2023 08:12
Last Modified: 10 May 2023 08:12

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