Talk:Leptospirosis/GA1

GA Review

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I'll get to this ASAP. Reviewer: Ajpolino (talk · contribs) 22:31, 7 August 2019 (UTC)

GA review (see here for what the criteria are, and here for what they are not)

1. It is reasonably well written.

   a (prose, spelling, and grammar):

Working on the prose. First pass complete:

• "These symptoms are non-specific to leptopsirosis and can occur in other infectious diseases" - Is this sentence necessary? Feel free to ignore this comment and leave it in, but to me it seems removable...  Done I agree with you. Sentence removed.
• "The headache in leptospirosis is characteristaclly located at the bilaterial temporal regions, or frontal headache with throbbing pain, associated with pain behind the eyes and sensitivity to light." - This sentence is confusing. Maybe it could be broken into two sentences? Also for readers unfamiliar with "bilateral temporal regions" you wikilink to temporal bone. Is Temporal lobe more appropriate? Unfortunately there's no article or subsection I can find that covers regional headaches...  Done I replaced temporal bone with temple (anatomy). Broken the sentences into two parts.
• "However rashes can be found in front of the shinbone in the case of "Fort Bragg Fever" which was recorded among soldiers at Fort Bragg, North Carolina in 1942." - Seems a bit unecessary to say "Rash is rare, but it did happen this one time..." Are we sure this is necessary info? Maybe you could just slightly rephrase the two sentences before to emphasize that rash is rare but not impossible?... On a related note, there seems to be some sources about Fort Bragg fever on a quick web search. If it's a highly atypical leptospirosis outbreak, perhaps it merits an article of its own? Writing such a thing is certainly not necessary for this to pass GA review, but would be a nice to-do list item.  Done Moved "Fort Bragg fever" to "History" section.
• "Besides, gastrointestinal symptoms such as nausea, vomiting, abdomoinal pain, and dirrhea frequently occurs." - Reads confusingly. Maybe just remove the word "Besides", or change it to "Additionally"?  Done
• Can "high-output kidney failure" link somewhere? May be an unfamiliar term to most readers. Removed "high-output". "Kidney failure due to excessive urine output" sufficed to explain this. Done
• It can be anything from meningitis.. muscle pain." - Confusing sentence. As a reader, I expect a sentence like that to read "It can be anything from [some things] to [other things]", or just setup the sentence differently. Done Changed to "It can be anything from brain to kidney complications."
• In the last paragraph of the symptoms section, you often use the form: technical term (explanation). Perhaps you could consider replacing some with [[technical term|explanation]], e.g. [[epistaxis|nose bleeding]] for clarity and concision. Also, there's no need to introduce acronyms that you don't use later (e.g. ARDS, PT).  Done
• I think the first sentence of the "Bacteria" subsection is a little unclear. It sounds as if you're saying leptospirosis is caused by the subset of bacteria in Leptospira that are both aerobic and right-handed helices. I think what you instead mean is that leptospirosis is caused by Leptospira, all of which happen to be both aerobic and helical. If my interpretation is correct, could you reword to clarify?  Done. Rearrnaged the sentence.
• "right-handed helical" - Is there a wikilink target that would be appropriate for this, just in case a reader isn't familiar with describing helices by handedness?  Done Wikilined "right-handed" and "helix"
• The first paragraph of the Transmission sub-section is confusing to read. Maybe re-ordering the sentences would make it flow better? At the very least a topic sentence of some kind might help to set the reader's expectations. Let me know if my meaning here is unclear. Done
• The second paragraph of the Transmission sub-section seems to mostly repeat information in the Pathogenesis section. You can probably remove it. Done
• A little bit of reorganization in the Pathogenesis section would go a long way. "Leptospire is well adapted to oxidative environment" reads like a non-sequitur (presumably most readers won't connect that with being well-suited to surviving inflammation); the "Transmission" heading does not have a clear purpose to me (You just had a "Transmission" subsection above); You defined the acronym LPS above (if you're worried readers will forget you can wikilink it); you should link TLR4 or make it clear from context clues why it's important; you go back and forth between using Leptospira as a stand-in for "Leptospira species", and using Leptospires. It might be nice if you stuck to one. Done
• Diagnosis section - As above, the section would read a bit clearer if you replaced some instances of "concept (jargon)" with "[[jargon|concept]]". Maybe move to the "Pathogenesis" section the fact that "The bacteria then move into kidneys after 10 days." Also no need to introduce acronyms that you don't use later. Done. Moved the sentences to kidneys investigations.
• "This leads to a lower number of registered cases than likely exists" is unclear to me. The annual infection rate leads to an underreporting of cases? Or the fact that it's higher in tropical regions? Not sure what it's supposed to mean... Done Sentence removed
• "Between 1995 and 2005, a single successful clone of L. interrogans caused a sustained leptospirosis outbreak in Thailand." - this sentence seems out of place in the Epidemiology section. If the Thai outbreak was particularly severe, perhaps a brief discussion of leptospirosis in SE Asia would fit nicely, rather than a note about the successful strain that caused it. Done Sentence removed
• It's a little awkward that the naming material is split between the beginning of the history section and the end of that section, especially as several of the names you cover at the end are also based on occupations (as you highlight at the beginning of that section). Perhaps you could merge them somehow? Or if you prefer it remain as is, that's fine too. Certainly not a deal breaker for this. Done. Merged into the main article. Only important names mentioned.
• The opening of the section "Other Animals" is a bit jarring. I know you've stated as much above, but could you add a topic sentence of some kind? That would help the section flow more smoothly. Done Added an opening sentence.

1. b (MoS for lead, layout, word choice, fiction, and lists):

   Laid out per WP:MEDMOS; looks great!

2. It is factually accurate and verifiable.

   a (reference section): b (citations to reliable sources): c (OR): d (copyvio and plagiarism):

• I was a bit confused by the 22 species, 21 of which can be divided into three clades bit. Glanced at your source, the Nature Micro review. In box 1, it looks like the authors are saying all 22 can be divided into three clades (10 pathogens, 5 intermediate, 7 saprophytes, although only 6 of saprophytes are shown on their tree...). Maybe I'm misunderstanding this or missing some update, but could you take a look and clarify?  Done Clarified. Thanks for pointing out.

I believe that the edit done to fix this issue introduced a factual error. Two of the 10 species within the "pathogens" clade have not been shown to cause disease in humans or any animal models of leptospirosis (unless there is a more recent study that I'm not aware of). The Nature Micro review is confusing because it contradicts itself on this matter. Box 1 states, "In one clade, there are 10 pathogens thatcan infect and cause disease in humans and animals." However, according to the paragraph that spans pages 301 and 302, strains of L. alstonii, one of the 10 "pathogens," were isolated from amphibians. The same paragraph also states explicitly that another member of the pathogens clade, L. kmetyi, is not virulent in animal models or associated with disease in humans. CatPath (talk) 18:05, 11 August 2019 (UTC)

I think the way it is currently worded is good enough for the purposes of this review: the "pathogens" clade is only referred to in quotes as a name, never as just "the pathogens clade". And it's noted explicitly in the text that two of the subgroups cause human disease (though the position of the remaining two species in that poorly named subgroup is not discussed). Another sentence or two might improve the section. I'll take a crack at it later this week if no one beats me to it; let me know if I make it worse. Ajpolino (talk) 18:53, 19 August 2019 (UTC)

• I'm a little uncomfortable with the statement "A person is more likely to get leptospirosis when he is exposed environmentally rather than through their immunocompropmised status." That seems like a strong claim; in the ref given, the authors seem to go out of their way to state this only as an opinion rather than an observation ("We believe that the occurrence of leptopsirosis is related more to epidemiologic exposure than to an immunosuppressed state", N.B. this is the only claim in the discussion they state this way). Any chance you've seen this assertion elsewhere? It'd be nice if it was in a bona fide review of some kind, rather than the discussion section of a case report... Done
• In the prognosis section, there is a [vague] tag next to "For those with altered mental status, they have a high risk of death." I haven't looked at your ref there, but however you choose to interpret the tag and clarify the sentence is fine by me.
• In the "Prognosis" section you note a case fatality rate of 1% to 5%. In the "Epidemiology" section you note "The risk of death is 5 to 10%." Can you clarify which is true or how those two things are different?  Done Replaced with Evangelista 2010. The 2010 one has a citation. The 2013 fact sheet has no citation.
• The reference currently numbered 38 ([1], at the end of "...contaminated water into their eyes or nose, or exposing open wounds to infected water") looks like maybe it's a surfing blog? Can you find a more reliable reference for that material? Done Reference removed. It is basically a repitition of the first few sentences in the same paragraph.

2. It is broad in its coverage.

   a (major aspects): b (focused):

   Goes well beyond the level of the average GA

3. It follows the neutral point of view policy.

   Fair representation without bias:

4. It is stable.

   No edit wars, etc.:

5. It is illustrated by images and other media, where possible and appropriate.

   a (images are tagged and non-free content have fair use rationales): b (appropriate use with suitable captions):

6. Overall:

   Pass/Fail:

   Thank you both for your comments. It has been great to see some attention turned towards this article. Sorry for such a long wait for GA review. Happy editing! Ajpolino (talk) 18:59, 19 August 2019 (UTC)