Social media has emerged as a valueable source for early pandemic detection, as repeated mentions of symptoms by users may signal the onset of an outbreak. However, to be a reliable system, validation through fact-checking and verification against official health records is essential. Without this step, systems risk spreading misinformation to the public. The effectiveness of these systems also depend on their ability to process data in multiple languages, given the multilingual nature of social media data.Yet, many NLP datasets and disease surveillance system remain heavily English-centric, leading to significant performance gaps for low-resource languages.This issue is especially critical in Southeast Asia, where symptom expression may vary culturally and linguistically.Therefore, this study evaluates the symptom detection capabilities of LLMs in social media posts across multiple languages, models, and symptoms to enhance health-related fact-checking. Our results reveal significant language-based discrepancies, with European languages outperforming under-resourced Southeast Asian languages. Furthermore, we identify symptom-specific challenges, particularly in detecting respiratory illnesses such as influenza, which LLMs tend to overpredict.The overestimation or misclassification of symptom mentions can lead to false alarms or public misinformation when deployed in real-world settings. This underscores the importance of symptom detection as a critical first step in medical fact-checking within early outbreak detection systems.

Counterfactual data augmentation (CDA) is a promising strategy for improving hate speech classification, but automating counterfactual text generation remains a challenge. Strong attribute control can distort meaning, while prioritizing semantic preservation may weaken attribute alignment. We propose **Gradient-assisted Energy-based Sampling (GENES)** for counterfactual text generation, which restricts accepted samples to text meeting a minimum BERTScore threshold and applies gradient-assisted proposal generation to improve attribute alignment. Compared to other methods that solely rely on either prompting, gradient-based steering, or energy-based sampling, GENES is more likely to jointly satisfy attribute alignment and semantic preservation under the same base model. When applied to data augmentation, GENES achieved the best macro F1-score in two of three test sets, and it improved robustness in detecting targeted abusive language. In some cases, GENES exceeded the performance of prompt-based methods using a GPT-4o-mini, despite relying on a smaller model (Flan-T5-Large). Based on our cross-dataset evaluation, the average performance of models aided by GENES is the best among those methods that rely on a smaller model (Flan-T5-L). These results position GENES as a possible lightweight and open-source alternative.