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The aims of this study were (i) to evaluate the relationship between official data on invasive meningococcal disease cases in Sardinia and the reporting of the cases by a regional online newspaper and (ii) to identify indicators useful for understanding the community outrage related to health events. Cases of meningococcal disease, selected from articles published between 1999 and 2016 on a regional newspaper database, were compared to those reported to the Infectious Disease Information Service. In order to evaluate the equality of the two distribution records, the Kolgomorov Smirnov test for two samples was applied. A community outrage indicator was obtained by calculating the number of published articles for each case of meningococcal disease identified. The outrage indicator was evaluated in comparison with other phenomena: drinking water supply limitation and domestic accidents. Overall, 2724 articles on meningitis/sepsis referring to 89 cases related to meningococcal disease were considered. Significant differences between the distribution of cases officially reported and those found in the newspaper (combined K-S = 0.39; p = 0.08) were not observed. The meningococcal disease outrage indicator showed an average of seven items per case. Comparing the meningococcal disease outrage indicator with those regarding the limitation of drinking water supplies and domestic accidents, a different risk perception by the reference media was found, with the highest outrage for meningococcal disease. The present study supports the role played by emotional factors as behavioral determinants in emerging threats to public health. The analysis of the data allowed us to highlight that the proposed outrage indicator could be a feasible proxy of emotional epidemiology. Finally, data confirm that meningitis is perceived as a highly outrageous health threat.

In the Digital Era, Is Community Outrage a Feasible Proxy Indicator of Emotional Epidemiology? The Case of Meningococcal Disease in Sardinia, Italy