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Saúde e Sociedade

Print version ISSN 0104-1290On-line version ISSN 1984-0470

Saude soc. vol.28 no.3 São Paulo July/Sept. 2019  Epub Oct 07, 2019

http://dx.doi.org/10.1590/s0104-12902019181104 

Articles

Does health news depend on patients’ nationality? An Ebola case study

Alberto Peña Gómeza 
http://orcid.org/0000-0003-4642-7619

Raquel Rodríguez Díazb 
http://orcid.org/0000-0002-8097-6585

aAgencia Efe. Santiago, Chile. E-mail: albertopenagomez@gmail.com

bUniversidad Rey Juan Carlos. Facultad de Ciencias de la Comunicación. Departamento de Ciencias de la Comunicación y Sociología. Madrid, España. E-mail: raquel.rodriguez@urjc.es


Abstract

It is increasingly common to see the issue of health included in the general press, particularly when the topic being discussed affects developed nations. This research project shows the differences that appear in press coverage when there is a relevant event, such as an epidemic, which affects both developed, western nations and underdeveloped African ones. This work shows that, in the case of the Ebola epidemic - which was recognised as such by the World Health Organisation in 2014 -, the press only gave the problem greater coverage when there were cases of westerners being directly affected by it. That can be observed in the results of the content analysis in three daily newspapers from different countries: El País (Spain), Le Figaro (France) and Reforma (Mexico), between March 2014 and January 2015.

Keywords: Ebola; Africa; Agenda; Health and Communication

Resumen

La salud cada vez tiene más presencia en la prensa generalista, especialmente cuando los temas que se abordan afectan a países desarrollados. Esta investigación expone las diferencias que se generan en la cobertura periodista cuando ocurre un hecho relevante como pueda ser una epidemia y que afecta tanto a países occidentales como a países africanos subdesarrollados. El trabajo que presentamos evidencia que en la epidemia de Ébola, reconocida como tal por la Organización Mundial de la Salud en el año 2014, el volumen de las noticias sobre la epidemia solo aumentó la información relativa a esta enfermedad cuando hubo occidentales afectados directamente por la misma. Así se observa en los resultados que ofrece el análisis de contenido realizado en tres diarios de diferentes nacionalidades como son el español El País, el francés Le Figaro y el mexicano Reforma durante las fechas de marzo de 2014 a enero de 2015.

Palabras clave: Ébola; África; Agenda; Salud y Comunicación

Introduction

The media play a great role when informing about health, not only because it relates the main issues of our reality, but because health is a matter of constant public opinion concern, as expressed by the sanitary barometer of the Center for Sociological Research (CIS, 2012). Citizens turn to the press to be informed about health contents and healthy aspects linked to public health, so that this type of dynamics can turn them into informative news stories and promoters of health (Arredondo, 1994).

The reference press includes more and more health content, while, for the audience, there is a demand for these contents, as expressed by the Vila Casas Foundation report called Informe Quiral 10 años (10-year Quiral Report) (Revuelta; de Semir, 2008). Likewise, different researchers testify (Ronco; Peñafiel; Echegaray, 2014) and even as specific as the Quiral 2014: La Comunicación Pública sobre la Enfermedad del Ébola (Quiral Report 2014: Public Communication on Ebola Disease) (Revuelta et al., 2015), dedicated to Ebola, can be for this investigation.

Good journalistic information in the field of public health not only contributes to being well informed, but also becomes a didactic and pedagogical speaker for society, since well-informed citizens can prevent diseases, detect them at an early stage or do better against the ailment (Camacho, 2010). The quality of this type of texts means that the editor is trained and knows how to explain journalistic news aiming not only to inform, but also to provide information that improves the quality of life of a society (Calvo, 1992; Costa, 2008; Dalleya; Buunka; Umitic, 2009).

On the other hand, it should be noted that health and scientific information is too complex depending on the degree of specialization in question, so it needs information professionals to simplify it, highlighting the key aspects that citizens should know (España, 1999; Fernández; Pritchard, 2012; Giraldo; Rodríguez, 2017; Guzmán; Rodríguez, 2016; Roberts; Good, 2010). Different authors and studies argue that the communication and health connection entails a necessary and instrumental relationship for individuals (Miller et al., 1998; Seale, 2003; Slater et al., 2009) despite the fact that aspects affecting majorities, developed against underdeveloped countries and capacity against disability (Rivarola; Rodríguez, 2015) have a greater presence in the media.

The case of Ebola

The Ebola virus caused an epidemic during 2014 and 2015, and to the date it has been the most serious by far since data on this disease are recorded according to the World Health Organization (OMS, 2015). The total number of infected diagnosed by the EVD virus - technical name of Ebola - amounts to 25,550, of which 10,587 have died from the disease (OMS, 2015).

The main difference on this occasion was the detection of the virus in three different continents - Africa, Europe and North America -, since on previous occasions the epidemic focuses were located and controlled in specific and determined regions. This case followed, in the first moments, the historical patterns of the virus concentrating in Guinea, but the dissemination of European and North American health professionals in the area to combat Ebola, in addition to the volunteers and religious people sent to the first focus’ place, generated a rapid and uncontrolled propagation increased by the porosity of those countries’ borders, shortly affecting neighboring nations such as Sierra Leone, Liberia, Mali, Nigeria and Senegal.

Despite the spread of the virus to these countries, the Ebola epidemic was geographically identified although it was out of control. However, the diagnosis of the virus in western citizens who worked in the field and their subsequent repatriations resulted in an expansion of Ebola outside the African continent, where until now it was unthinkable that it could affect the contagion.

Spain, the United States and the United Kingdom received citizens who had been exposed or infected by the virus, which meant a change in the trend for the mass media when it came to reporting the epidemic. Until then, the information focused on citizens of African countries who died for thousands on that continent, but, from that moment, the information took a turn, now western citizens died within their own countries and not in those of Africa.

This event moved the informative focus to the west, although the epidemic crisis remained in Africa. Of the 25,550 affected by the Ebola virus in the world to date, only nine of them were western, however, the international press treated them differently depending on the origin of each of them and the geographical location where it happened. To understand this event, it is necessary to clarify that almost the entire world information flow is generated in the Northern Hemisphere, specifically in Europe and North America, which implies a partial informative vision of the culture, history, customs, religion, the politics and economy of these places.

The differentiation between information about Africa and about Europe or North America is not only evident because it affects the study, but because it could be extended to different events, such as terrorist attacks (University of Garissa, Kenya 2015; and Charlie Hebdo, France 2015), aviation accidents (Air Algérie, Mali 2014; and Germanwings, France 2015), armed conflict (Rwanda, 1994 and Yugoslavia, 1991-1999) or natural disasters (Food crisis in the horn of Africa, Somalia, Ethiopia, Kenya 2011- 2012; and Hurricane Katrina, Bahamas, Cuba, USA 2005).

These elements are the basis of this research, applying it to the specific case of the Ebola epidemic of 2014-2015. Despite Africa being the continent with almost all affected, the press in developed countries gave it greater visibility when westerners were directly involved. Previous studies indicate that, in general, the information and possible solution to diseases located in underdeveloped countries do not seem to matter to the world if there is no profitability. Jurado (2003) states that while in Africa the disease continues to kill people, pharmaceutical multinationals look the other way until they find it beneficial to invest because there will be infected westerners and the hypothetical vaccine is profitable for them.

Recently, it has monopolized attention globally due to the magnitude and spread of the disease in west African countries, where it had never been present before. As the outbreak continued to expand, many volunteer doctors and health workers from other countries were infected and sent back to their respective countries despite complaints from their compatriots. (Roberts, 2015, p. 6-7, free translation)

The patients’ repatriation phenomenon made the epidemic stronger thanks to the ease of expansion the virus found with these transfers. Those affected by Ebola were not located only in the infection’s origin area anymore, which started several outbreaks in neighboring countries, such as Liberia or Sierra Leone, and, subsequently, the return of westerners had the same effect in Europe and North America.

The spread of the virus to non-endemic countries caused the information center to also move there due to the proximity of the event with the western world and, therefore, with the western population and culture. While Ebola was on the African continent, the virus was distant news, however, as the cases of Europeans and Americans were detected, the news began to cover the media agenda.

Theoretical framework

The press plays a role of social counselor, the issues that the media select show us a reality of second hand or pseudo-reality (Lippmann, 1922). The theory of the agenda (McCombs, 2006; McCombs; Shaw, 1972) highlights the importance of the capacity of the press in deciding what the most prominent informative topics will be; the debate on the public agenda will depend on its inclusion and media development. That is why “the media are not, at all, a channel for the great events of the day. The media builds and presents the public with a pseudo environment that significantly shapes the way it sees the world” (McCombs, 2006, p. 58).

The press can, depending on the treatment of a topic in the media, influence the public image of that topic, include it in the agendas, raise awareness about it and educate the population on the health field (Peñafiel et al., 2014; Revuelta, 2006, 2012; Ugarte; Menéndez; Cuesta, 2010; Wallington et al., 2010). In this sense, the agenda-setting theory goes beyond the classic concept set forth by Cohen (1963), which stated that the news tells us what subjects we should think about. McCombs and Shaw (1993) state that the way in which a topic is focused on the press can have repercussions on the behavior of the audience or on the public agenda. Considering this, the press contributes with an agenda of informative proposals, concerning health issues, with a clear influence on the audience’s perception of the news (Martín, 2000).

The media not only set the agenda for public debate topics, but also define a series of guidelines or frameworks with which they intend to provide the keys to offer their readers a certain interpretation of the facts they report. The framing theory proposes an analysis of the agenda items, or some of them, under the criteria of cognitive frameworks focused on simplifying and interpreting reality. The choice of the topics which feature on the agenda, as highlighted by the press, provides cognitive frames which are necessary to simplify a more complex reality for audiences. At the same time, they are a starting point for the construction of the journalistic account.

Entman (1993), in his definition of framing, states that it involves the selection of only some aspects of a reality or a theme to offer a specific interpretative angle. In this sense, the author exposes in a frame about a media issue if it provides a possible definition of the given problem, an interpretation that explains the cause of that problem or issue, a moral evaluation and/or a recommendation or solution for the matter.

The framing theory came to break the objective claims by introducing the subjective element in the communicative process. Journalists, depending on their ideological, cultural, religious orientations, their personal experiences, build reality from a subjective point of view. (Giménez Armentia, 2006, p. 55, free translation)

Agenda-setting and framing are two distinct processes which have clear links between them. Frames do not focus on the topics, despite the fact that one or more stem from them, but rather on their possible interpretations. Both processes show that the media occupy a prominent place in the cognitive process, especially since the inclusion of the topic in the media agenda. In this sense, we interpret what are the most important issues in our environment. We even learn from the media to give relevance to these issues, through frequency and visibility that the press itself gives them (Dearing; Rogers, 1996; McCombs, 1996; McCombs; Shaw, 1972; Rodríguez, 2004).

In the journalistic processes, the newsrooms are limited, by economy, time and resources, in general, to be able to cover part of that “everything” that happens in the world, to move the professionals from each of those distant places to their informative centers when some event occurs. In these cases, it is the international news agencies that in most cases cover events far from the borders of the western media countries. The international press has to draw on the news agencies to obtain a greater range, making them a key factor in their communication exercise.

Although they (the international information agencies) are not absolutely dominant for the total of the news (they are presented in proportions similar to those of the correspondent or special envoy), they are for the underdevelopment coverage: in general terms, as we move away from the center, the sources of the news, on the one hand, are becoming less direct (as the proportions of both the correspondent and the Spanish agency decrease); and on the other, they are less important to be commented on through articles. (Penalva, 1998, p. 356, free translation)

News agencies are the dominant and dynamic element of the proposal of an informative topic and its approach, especially those places where the media’s own editors have less access or resources. In this direction, Gelado (2009, p. 249) points out that: “Since the main current news agencies and their clients are, mostly, western, the ethnocentric bias is evident; not only regarding the amount of news, but also its character.”

The treatment of information on the Ebola epidemic occupies central place in this study, many western countries lived this event not only as a public health crisis, but also as an informational and political crisis. Such as Spain, as reported by several studies (Barberá; Cuesta, 2015; Jury; Jury, 2014). To this was added the Quiral Report 2014 (Revuelta et al., 2015) also dedicated to this disease, already mentioned above, evidencing that communication in epidemic outbreaks and the existing ethical dilemmas that may appear in management and communication must be improved.

Objectives, hypotheses and methodology

The humanitarian crisis generated as a result of the geographic extension of the disease, from its origin in Guinea to its repercussion in Spain, the United States and the United Kingdom, allows us to, a posteriori, take stock of the informative treatment carried out by part of the media on this epidemic.

It is intended to resolve the importance with which these specific media outlets on which the study is based - El País, Le Figaro and Reforma - treated information about the virus depending on the nature of those affected or the victims.

According to the peculiarities that exist when Africa is informed and about health news, the epidemic in this continent, in Europe and in North America later, gathers conditions so that the news develop in a different way depending on the geographic center of the information. The objective of this work is to analyze the informative treatment of news about the virus according to where events take place: in territory or over African population, or in territory or over European or North American population.

It aims to show that both Africa and the citizens of this continent hardly enter the media agenda unless an exceptional event enters the scene, as was the Ebola epidemic. Even so, the nationality and geographic location of those affected were a decisive element in the information coverage, having more or less visibility on the media agenda. To analyze the western press in different geographical areas and whether it introduced Africa in their agenda with the Ebola virus case is the central element in the investigation.

According to the data presented by the WHO (OMS, 2015), the number of western citizens affected by the Ebola virus at that time represented a minimum part (only 0.35%) of the total affected in the epidemic. Despite this, most of the information from developed countries focused on cases of patients from these countries.

Based on these elements, as hypothesis of this research project:

H1 - The information coverage of Ebola in Africa significantly enters the media agenda when the event affects a few westerners.

Sample

A content analysis was carried out in three written press media, of national circulation, of three different countries depending on the relationship with the Ebola virus epidemic: the printed version of El País (Spain), for being a western country directly affected by the virus (several affected); the printed version of Le Figaro (France), for being a European country without contagion within its borders and for the informative relationship of the Gallic country with its former colonies, some affected by the epidemic; and Reforma (Mexico) for being a country not linked to the events.

Bearing in mind that at the end of this study the Ebola epidemic was not yet over, it was chosen to analyze the news of these three media between the following dates: from March 21, 2014 - the first confirmation of the virus in Guinea by the World Health Organization - to January 24, 2015, hospital discharge date of the last infected western patient that sets the deadline for the case study. These dates totaled 11 months, in which the disease first spread through the African countries and then to Europe and North America.

As a chronology and regarding the Spanish case, it seems pertinent to introduce the sequence of the events of several Spanish cases that were widely disseminated, especially in the Spanish and international press, besides being one of the cases, a contagion in Spain, also cured in this country. Barberá and Cuesta (2015) report in the following paragraphs who were the Spanish patients (2014), how they became infected and where the events occurred:

The priest Miguel Pajares, with Ebola, and the religious Juliana Bonoha, without the virus, are repatriated from Liberia to Madrid. Both enter the hospital Carlos III of Madrid. Earlier, on March 22 of that year, Guinea’s Ministry of Health, Conakry, informed the World Health Organization of an outbreak of hemorrhagic fever due to the Ebola virus.

On August 12, Miguel Pajares dies, becoming the first mortal victim for Ebola outside of Africa. And after 21 days of isolation, the religious woman leaves the hospital. The Spanish government announces on September 20 that it will repatriate another priest, Manuel García Viejo, who dies five days later in the same hospital. No drug could be supplied because the stocks of the experimental ZMapp serum were depleted.

On September 29, Teresa Romero, nursing assistant who had attended the two religious people, feels feverish episodes. On October 5, she was transferred to the Alcorcón hospital, and the next day the first case of contagion of Ebola outside Africa was found and she was taken to Carlos III of Madrid. On this date, the Minister of Health gives a press conference, which later causes controversy, to explain the situation. A month later, on November 6, Romero is discharged.

In order to delimit the study sample of the three newspapers mentioned above, the online database Lexis Nexis Academic was used, with the keyword “Ebola” being used in search engines for headlines. From the resulting sample, the headline, the subtitle and the first paragraphs of each news story were analyzed to determine the theme of each story and thus classify them.

The final result after the analysis of the sample generated 446 news, although during the process it was observed that some of them appeared duplicated when belonging to different versions of the newspapers; so eliminating the repeated news, the final sample was 410 news stories among the three newspapers distributed as follows: 222 news stories (240 before applying the repeat filter) in the newspaper El País (Spain), 116 news stories (134 before applying the repeat filter) in the newspaper Le Figaro (France), and 72 news stories (72 before applying the repeat filter) for the newspaper Reforma (Mexico).

At the beginning of the study, different variables were considered with different categories that offered doubts for some of them, so a pretest (10% of the sample of each newspaper was analyzed) was carried out on the sample that helped to define and specify the variables and their categories. From the result of the pretest, the coding sheet set out in the Annex was defined. Through the final variables, various elements were established such as: medium, date, origin, section, geographical location of the event, assessment of the news, the topic mentioned and the size of the news.

Results

As we have already indicated, the analysis of the sample resulted in a total of 410 news stories among the three media outlets, being El País the one that collects the largest number of information, 54% of the sample, followed by Le Figaro with 28% and Reforma with 18%.

The news of the sample is not distributed in an equitable way throughout the historical series, but they increase and decrease along with the infections of westerners and the transfers to their origin countries. Graph 1 shows the chronology of the events and illustrates the informational trend according to time.

Graph 1 Temporality of the news according to the media 

Since the beginning of the study chronology, following the first case diagnosed in Guinea on March 21, 2014, it is noticed that there is hardly any news about Ebola in any of the three media outlets until after five months of the first case, when the situation in Africa during that time coincides with the fleeting spread of the virus to neighboring countries, affecting and killing thousands of people.

However, two important events happen in July that change the informational trend: Nigeria is affected by the virus and, above all, the first non-African victim, Samuel Brisbane, an American doctor, dies. Following the first western case, the news is spreading increased by the Ebola infection of the Spanish priest Miguel Pajares in early August, being repatriated to Spain, where he dies few days later in a hospital in Madrid.

In October, the peaks with the highest informative activity are recorded because the first infections within Spain and the United States coincide. In a more detailed analysis of each of the media crossing chronological data and geographic origin of the information (Africa, Europe or North America), it is observed that both El País and Le Figaro follow a similar pattern in their informative trend, giving the greatest relevance to the African continent until September, when Europe takes center stage - because of the Spanish cases cited. In the case of Reforma, the pattern is totally different, giving maximum prominence at all times to North America, so it can be deduced that the geographical factor also influences in this case.

Based on the chronological data and the trend changes according to geographical criteria, the sample content was analyzed to know the amount of news that each media outlet dedicated to each location of the event (Table 1).

Table 1 Geographical allusion of the news in each media outlet 

Location El País Le Figaro Reforma Total
Africa 91 41% 69 59% 22 31% 182
North America 24 11% 14 12% 46 64% 84
Europe 107 48% 33 28% 4 6% 144
Total 222 116 72

The amount of news reflect that each media outlet dedicated more news to the geographical area that most influenced it. Thus El País dedicated most of the news to what was happening in Europe - and more specifically in Spain -, the newspaper Le Figaro did the same with Africa for its historical relationship with the continent, and Reforma focused its news on contagion in the USA and how to prevent it from spreading to Mexico.

To add more value to the news impact criterion according to the geographic location variable, the amount of elements of the sample that contributes to each criteria (Africa, Europe and North America) to the said variable were considered. Of the total of 410 news stories, 182 were about Africa or Africans, 144 about Europe or Europeans, and 84 about North America or North Americans.

As the intention of the study is to establish a relationship between the total of news stories that each media outlet devotes to each location and the amount of people affected by the Ebola epidemic, depending on whether it occurs in Africa or in the west (Europe and North America), a sum of the total cases of these continents was carried out to compare them. Which means 182 news stories about Africa and Africans (99.65% of those affected), and 228 news stories about the west and westerners (0.35% of the total affected).

On the other hand, an analysis of the newspaper’s sections where the news was located in each media outlet was carried out intending to observe how each one of them focused on the Ebola epidemic according to each one’s nature (Graph 2).

Graph 2 Distribution by sections according to the media outlet 

Based on the different results according to the section where the newspapers located the news about the Ebola epidemic, the “Society” section (54%) predominates in El País; Le Figaro, the “Health” section (69%); and in Reforma, the “National” section (38%). For the Spanish case, it is likely that the newspaper’s report focused the case of the nursing assistant in that section, infected at the Alcorcón Hospital (Madrid).

Graph 3 breaks down the arguments on which each information was based, being mostly repeated in the three newspapers the news about those affected, actions to combat the virus and specific geographical locations, with the particularity that in El País they are the affected is the argument that covers more information coverage with 26% of the total sample. While Le Figaro and Reforma are the actions to combat the virus, the most recurring issue with 33% and 38%, respectively.

Graph 3 Argument of the news according to media outlet 

El País highlighted in its information arguments or themes concerning those affected or actions to combat the virus, but depending on the geographical location of the event; in each information certain interesting details were appreciated. The news concerning Africa had as an argument 27% specific geographical locations affected by the virus. As for the information on North America, the most prominent argument focused on actions to combat or prevent Ebola (42%), in addition to a remarkable 8% in news related to repatriations. This last criterion was also shared by the news about Europe or Europeans, in which a significant 12% of information related to Ebola with politics was observed.

In the distribution made by Le Figaro regarding the choice of arguments, those related to North America and Europe stood out by volume of news. Above all, they highlighted the information on actions to combat or prevent this disease both in Europe and in North America (45% and 43%, respectively) compared to just over 20% that had their geographic location in Africa.

In the case of Reforma, it is important to note that the results regarding the amount of news from each of the geographical locations were quite different from each other. In spite of this, it is worth highlighting how the informative news about the Ebola virus is abundant in the African information (29%). Regarding North America, the news related to the actions to combat or prevent the virus stood out above the rest, although in this case most of them actually turned on methods to prevent it from spreading from the USA to Mexico.

Discussion and conclusions

According to the results obtained, it can be observed that, although the Ebola virus already affected Guinea before the period included in the study, there was hardly any news during the first five months (from March to July 2014) since WHO determined that Ebola was a dangerous virus and confirmed the first cases in Africa. The research shown in this article evidences with its hypothesis that the informative facts that affect westerners have a greater impact on the press despite, in an epidemic case such as Ebola in Africa, the number of people affected in this other continent being much higher.

The results reveal that, once a westerner was infected, the affected Africans went to the informative background despite being 99.65% of the total affected by the epidemic, the informative treatment given to the specific issue was based on whether it had affected people from developed versus underdeveloped countries.

It was mentioned that 0.35% of those affected were western (European and North American), according to WHO data (OMS, 2015), representing 56% of the news in the three media outlets analyzed (Figure 1). If we made a “symbolic estimate,” the media impact that each of the affected western citizens had and the equivalence that it implied regarding African citizens.

Figure 1 Information relevance of those affected 

We believe that it can be enlightening and a “wake-up call” to elaborate a symbolic calculation, shown in Figure 1 as a reflection. When dividing the total number of affected westerners (9, European and North Americans) by the total percentage of news whose argument are these two geographical locations (56%), the average informative relevance of each of these affected people is obtained (6.22%). Using this same formula with the total of African citizens affected by the virus (25,541), and with the intention of equating the equivalence in African citizens regarding informative relevance of a westerner, it is divided again by 9 and the result obtained is approximately 2,504. That is, for each affected or African victim, the media dedicated only 0.001% of their information coverage.

Although we propose the illustration as a representative of a symbolic calculation, we consider that the results of this investigation contribute not only to evidence what is the treatment of health in the media, but to show that certain continents, such as Africa, are not a clear example of an informative agenda item unless the western community is involved in its problems.

A reflection should be made on the part of the journalistic criteria that do not focus so much on nationalities, but on the very dimensions of events. The case of the Ebola epidemic has served as a case study to illustrate the insertion of Africa into the agenda (McCombs, 2006) despite having a western view of events according to the approach of the journalists who prepare the news. Muro Benayas (2006, p. 22) points out about information professionals: “Although impartiality and rigor are attributes that are part of the imaginary of all agencies, their practice is associated with a certain worldview - Anglo-Saxon, Arabic, Latin American or Asian - that plans above the neutrality of their editors.”

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Annex

Selection criteria sheet of the analyzed news

Category Variable Subvariable
1. Media 1.1 El País
1.2 Le Figaro
1.3 Reforma
2. Date 2.1 March 2014
2.2 April 2014
2.3 May 2014
2.4 June 2014
2.5 July 2014
2.6 August 2014
2.7 September 2014
2.8 October 2014
2.9 November 2014
2.10 December 2014
2.11 January 2015
3. Origins 3.1 Agency
3.2 Newspaper
4 Section 4.1 Cover
4.1.1 Africa
4.1.2 North America
4.1.3 Europe
4.2 Inside the newspaper
4.2.1 Society/culture
4.2.2 National/local
4.2.3 Opinion
4.2.4 Health/science
4.2.5 Others
4.2.6 International
5 Geographic location of the topic 5.1 Africa
5.2 North America
5.3 Europe
6 Assessment of the news 6.1 Positive
6.2 Negative
6.3 Neutral
7 Topic discussed 7.1 Information about the disease
7.2 Dead/affected
7.3 Prevention/actions
7.4 Policy
7.5 Geographical location
7.6 Repatriations
7.7 Cured
7.8 Other
8 News size 8.1 Less than 300
8.2 From 301 to 600
8.3 More than 600

Received: November 26, 2018; Accepted: May 22, 2019

Correspondencia Raquel Rodríguez Díaz Camino del Molino, s/n. Fuenlabrada, Madrid, España. CP 28943.

Authors’ contribution Peña and Rodríguez designed the research. Peña collected the data from the case study and both authors wrote the article.

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