Social Media Promotion of Raw Date Palm Sap and Emerging Nipah Virus Transmission Risk in Bangladesh: Descriptive Analysis of Multisource Data.

Background: Nipah virus (NiV) infection is considered one of the deadliest infectious diseases, with a case fatality rate of approximately 71%. In Bangladesh, the primary risk factor for NiV infection is the consumption of raw date palm sap (DPS) contaminated with excreta from fruit bats (ie, members of the Pteropodidae family). Recently, the increasing use of social media among Bangladeshi youth has enabled business groups to widely advertise and sell raw DPS. This increased access, combined with young people perceiving consumption of raw DPS as an "adventurous event," may facilitate an increase in incidences of NiV infection. Objective: We aimed to explore and document data from social media regarding raw DPS advertisements and consumption. Furthermore, we aimed to investigate the commercial distribution of raw DPS across the country. Methods: The data were accessed from common social media platforms used in Bangladesh, including Facebook and YouTube, between November 10, 2023, and January 31, 2024. We considered this period to capture public opinions, discussions, and reported incidents during the peak harvesting and consumption season of DPS. While DPS harvesting continues until March, early monitoring is essential for identifying the emerging concerns related to NiV transmission. Extracted variables were post dates and times, source locations, types of sources and posts, provider details (eg, sellers and gachis), post descriptions, user reactions, views, comments, and shares. Particular emphasis was placed on identifying the districts of both DPS suppliers and recipients. We used R version 4.3.2 and Stata version 15 for analyzing statistical data and QGIS for geographic data. Results: Of 556 social media posts, 361 (64.9%) were advertisements promoting raw DPS. Few DPS-related posts (n= 10, 1.8%) were associated with raising awareness about DPS consumption and NiV infection. In total, 473,724 people interacted with the social media posts. The identification of supplier and recipient districts revealed 14 source districts of raw DPS. The majority of raw DPS were distributed from Rajshahi, Naogaon, Rajbari, and Faridpur, which are among the most NiV-prone districts. During the data collection period, we observed an average of 996 (SD 377) liters of raw DPS sold per day from multiple gachhis (sap collectors) and sellers (vendors) in Rajshahi. Conclusions: The marketing of raw DPS through digital media platforms has increased customer interest, as evidenced by the notably high level of public engagement observed on this topic within the Bangladeshi social media context. Distributing raw DPS using digital platforms is a marketing tool that significantly increases the availability of raw DPS to previously hard-to-reach markets and potentially increases individuals' exposure to NiV infection. This study recommends a multidisciplinary approach, which incorporates context-specific public health investigations, policymaking, and digital media surveillance to address emerging public health concerns.