(This blog was co-published on W2Ogroup.com)

The recent Zika infection of 14 people in a Florida community near Miami – the first case of U.S. transmission from local mosquitoes – has further raised fears that the U.S. will face a large domestic Zika outbreak. With increased news coverage on the domestically transmitted cases as well as the upcoming Olympic opening ceremonies on Friday, August 5th in Brazil, a country hit hard by Zika, there is likely to be a large amount of public discussion about the looming domestic Zika threat.

Studies have shown that physicians are one of the most trusted sources of online health information, so it is likely that patients will be turning to their physician to understand how concerned they should be about Zika and the steps they should take to avoid contracting the virus. But what are physicians saying about the Zika virus?

At W2O Group, we set out to answer that question by querying the MDigitalLife Health Ecosystem Database, the world’s first database to link physicians’ online content to their national physician identifier records, to gain insights into the networks, relationships, and social activities of online physicians.

A Brief Review of Physician Zika Conversation Timeline

Specifically addressing Zika social conversation, there have been over 51,000 posts from more than 4,700 unique physicians since January 11, 2014. U.S. physicians contributed over 29,000 posts from 2,700+ authors and Non-U.S. physicians contributed more than 22,000 posts from 2,000+ authors.

Zika Timeline With Callouts Dark

Umair ShahPhysician Zika conversation grew rapidly on January 11th of this year when the first Zika case in the U.S. was reported in Houston, TX. A doctor led the charge with this news as Dr. Umair Shah, Executive Director of Harris County Public Health & Environmental Services, shared the news via his personal twitter account as the news was released to the public. The Houston Chronicle quickly picked up the story (and included quotes from Dr. Hotez), followed by Sarah Begley’s piece in TIME and then similar pieces in nearly every other outlet. Conversation was driven higher on January 16th after Hawaiian officials announced the first baby born in the US with microcephaly linked to Zika and the CDC officially advised pregnant women to avoid traveling to areas where Zika is spreading. Physician conversation continued to rise on January 28, when Margaret Chan, WHO Director-General, announced that “the virus was detected in the Americas, where it is now spreading explosively”. Conversation reached its current peak between February 1-3, when physicians posted over 3,300 times after the WHO declared the Zika virus and related links to possible birth defects an international public health emergency.

 

Watch Monthly Physician Conversation Evolve From 2014-2016 In The Interactive Map Below

ZikaGif
After global physician conversation peaked with over 15,000 posts in February, conversation began to decline; US physicians maintained an average of 3,400 posts per month while ExUS Physicians contributed an average of 1,700 per month between March and July. U.S. Physicians did see a small uptick in conversation in April when the CDC confirmed the link between microcephaly and Zika. Additionally, there was a rise in conversation in July as the first case of US transmission was announced in Miami. We expect to see a significant spike in global conversation as we approach hurricane season in the U.S. and the Games kick off.

Conversation Over Time

Zika NGram Graph2

We tracked five different keywords throughout the course of the conversation to examine the evolution of the language used by physicians discussing Zika. During late 2015 and early 2016, a significant portion of the tweets contained some mention of “Brazil,” the origin of the outbreak. The volume of tweets mentioning the word “women” was proportional to the overall volume of the U.S. physician Zika conversation, underscoring the relevance of this conversation to women’s health. In April of 2016, tweets started emerging that contained the word “funding,” with many questioning the level of government funding to combat the growing outbreak. July saw the introduction of both “transmission” and “Florida” at a high rate, correlating with many reports examining the transmission of Zika and the rise of domestic cases in Florida.

Going Back to the Start

Dr Hotez Prediction TweetSo who actually started the online physician conversation about Zika? The first post we recorded from a U.S. physician was by Dr. Peter J. Hotez, Founding Dean of the National School of Tropical Medicine, Texas Children’s Hospital Chair in Tropical Pediatrics & President of the Sabin Vaccine Institute, on August 3, 2013. Dr. Hotez’ initial post shared a study released in the Journal, PLOS Neglected Tropical Diseases, which discussed the emergence and spread of Zika in Africa and Asia. The initial post picked up a small amount of traction with four retweets. This did not cause a blip on Twitter’s radar. Though perhaps more people should have been paying attention, since Dr. Hotez proved to be rather prophetic with his post in March 2014 on Zika. Over two years ago, he quite correctly predicted the recent cases in Miami asserting, “It’s just a matter of time before ZIKA virus emerges in southern United States”. Dr. Hotez has since emerged as one of the most cited experts in the Zika conversation, being interviewed on MSNBC, ABC, NBC Nightly News, Wired, Reuters and Forbes, among others. He not only has become one of the top media sources, he is also followed by over 280 fellow physicians on twitter.

Conclusion and Acknowledgements

Our analysis demonstrates how the online physician conversation about Zika has grown over time, and evolved both geographically and linguistically. It is our hope that monitoring this conversation can be helpful to both physicians and the public at large in keeping abreast of the current issues being discussed in the ongoing Zika outbreak.

This post was co-authored by Dr. Yash Gad, Chief Data Scientist for MDigitalLife.

As a part of a larger research initiative and partnership, we thank our colleagues from the lab of Dr. Wenhong Chen at the University of Texas Austin who provided insight and expertise that contributed to this article.

*An earlier version of this post incorrectly stated Dr. Hotez first tweet on Zika was in January 2014.