MD Mag: Zika Survey Results Are In

Zika virus infection is making headlines around the world. MD Magazine editors wondered how US physicians feel about the threat posed by the virus so we surveyed physician subscribers on their attitudes and opinions related to Zika.

Of 847 MD Magazine physician readers who opened an email alerting them to the MD poll “Zika: Are US Physicians Worried?” 232 (27%) responded. The short answer is yes, they are worried—to varying degrees.

More than 90% said Zika is a threat to US public health, but opinions were split on how severe that threat may be. About 30% said it is a minor threat to the entire US and about 16% said it is a major threat. About half of the respondents rated the threat as one that applies only to regions where mosquitos live year-round and that group of respondents split evenly on whether the danger was major or minor.

One respondent took the question in another direction.

“Zika is a minor threat to the US and a major threat to the Right to Life movement and the Catholic Church,” said a Long Island, NY dermatologist, referring to prohibitions on abortion and birth control in some countries where Zika is a major problem.

The virus usually causes at worst a short mild illness but has been associated with an increase in microcephaly in newborns, a condition that so far cannot be detected in a fetus until around the 24^th week of a pregnancy.

But overall, physicians are not convinced that Zika infection causes microcephaly in newborns exposed in utero. More than 60% said that was not necessarily true and that more research is needed to determine what factors are involved in the association.

“Zika has been around for years, why [is it] now causing microcephaly?” a family medicine physician in Aurora, CO asked.

But an infectious disease specialist in Vineland, NJ said the causal evidence is clear because of “finding Zika nucleic acids in fetal brains.”

Most doctors (58%) said patients have not asked them about Zika. And about half said there is no reason to restrict trade or travel to prevent the spread of the virus—unless the travelers are young or pregnant women.

“It will spread no matter what we do until there is vaccine,” said an obstetrician in Birmingham, MI.

The strongest responses in the survey were to questions about preventing sexual transmission of the virus, with more than 80% of physicians agreeing that Zika-exposed men should either abstain or use protection when having sex with women who pregnant. The same percentage said such precautions should apply to exposed men having sex with any woman of child-bearing age.

How much should the US spend on Zika prevention and research? The White House has asked Congress for $1.8 billion but about 59% of doctors said they opposed the idea. Diverting Ebola funding was a more popular idea, with 54% of respondents saying they would like that; 33% were opposed, and the rest had no opinion.

One internist said he would “need to know how they came up with the figure,”

Doctors were uncertain about the potential role of climate change in the spread of mosquito-borne illnesses including Zika, with nearly 38% saying they had no opinion.

But among those who did, 33% said global warming was not to blame while 29% said warmer temperatures were allowing mosquitos to live year-round in more areas and thus contributing to Zika’s spread.

The notion of the US appointing a “Zika czar” to reassure the public that federal health agencies are on top of the Zika threat did not go over well: only 20% of physicians thought that was a good idea; 70% opposed it and the rest had no opinion.

One obstetrician said it looked like a good job and added, “I am available for the post.”

Full questions and responses are here.