Talk:Dengue fever/GA1

GA Review
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I will be reviewing this article. Comments will follow below. Reviewer: JFW &#124; T@lk  20:02, 22 December 2010 (UTC)


 * Many thanks. Doc James  (talk · contribs · email) 23:39, 22 December 2010 (UTC)


 * General
 * Some of the references are not templated, particularly those to web-based resources
 * This page also covers dengue virus (redirects here), so perhaps better to bold the first instance and increase the amount of information about the virus in the intro
 * Have moved the virus content to its own page.
 * There are several links to disambiguation pages in the article (see tool)
 * Fixed
 * I'm not sure why dengue shock syndrome has its own page, while dengue virus is discussed in this article. Would a merge enhance the content?
 * Agree and have merged (all content was basically covered here ).
 * Intro
 * Optional: would you consider adding sources (broad strokes only) to the introduction?
 * It is all reffed in the body. The WHO 2009 paper does cover it all. Doc James (talk · contribs · email) 04:20, 23 December 2010 (UTC)
 * Perhaps more emphasis on the virus, as above
 * Classification
 * Is this the place to mention the four serotypes of the virus (DEN1-4)

Will continue after doing some background reading. JFW &#124; T@lk  23:59, 22 December 2010 (UTC)


 * Signs and symptoms
 * Given that dengue hemorrhagic fever now redirects here, perhaps we need a bit more information on the nature of the bleeding in DHF. We also provide relatively little information on the sites of fluid accumulation, e.g. ascites and pleural effusions. Do we need to discuss abdominal compartment syndrome and myocardial dysfunction as mentioned by Peads10?
 * Discuss the bleeding to some extent right now. We do mention shock wrt myocardial dysfunction. Doc James (talk · contribs · email) 04:54, 14 January 2011 (UTC)
 * Do we need to mention dengue encephalitis and other end-organ problems? (WHO pg 35 lists them.)
 * Done Doc James  (talk · contribs · email) 04:54, 14 January 2011 (UTC)


 * Do we need to mention whether the virus is transmissible between people or not?
 * We do discussion that it is transmissible via blood transfusion. Doc James (talk · contribs · email) 04:54, 14 January 2011 (UTC)


 * Mechanism
 * Currently we have no section on how dengue virus causes the symptoms. The CMLS source that we already quote, as well as the CMR 2009 reference I supplied above, may be useful. (COI: both papers are from Dutch groups.)
 * We could also use this area to discuss the finer details of end-organ dysfunction and DIC.
 * Would that not be best on the DIC page? Doc James  (talk · contribs · email) 04:54, 14 January 2011 (UTC)


 * Diagnosis
 * Peads10 places a degree of evidence on the use of ultrasound in identify capillary leak (gallbladder wall oedema and fluid in body cavities) - should we mention this?
 * The warning signs are currently listed, but we don't discuss their relevance beyond diagnosis. I seem to recall that a decision to admit for observation may be based on the presence of warning signs.
 * Added that warning signs typically occur before severe dengue. Yes as per discussed in management section. Doc James (talk · contribs · email) 04:54, 14 January 2011 (UTC)


 * WHO has a fairly elaborate section on the diagnostic modalities. Should we at least mention which modality is most useful at which stage of the disease? Serology is apparently pretty useless in the initial stages of the disease.


 * Prevention
 * Are there any specific international efforts we need to discuss here, e.g. surveillance? WHO has some interesting recommendations (e.g. using the Poecilia reticulata fish to eat mosquito larvae, pg 71). Various advocacy models are discussed in that chapter also - not sure how immediately relevant they are.
 * Worth mentioning that dengue is regarded a "neglected tropical disease" (one of 17) by WHO?


 * Management
 * Do we need to specify the types of fluids recommended by various sources (saline, Ringer's, hydroxyethyl starch)? Do we need to explain that diuretics are usually of no benefit?
 * The WHO says isotonic and I have added that. Doc James (talk · contribs · email) 05:02, 14 January 2011 (UTC)


 * We are currently not covering triggers for transfusion and the relative uselessness of platelet transfusions and plasma
 * Added Doc James  (talk · contribs · email) 05:16, 14 January 2011 (UTC)


 * We could still discuss organ support modalities mentioned in Peads10
 * WHO has a lot of content on preparedness for epidemics. This seems somewhat relevant.


 * Prognosis
 * A very short section. Worth merging or expanding?
 * Will see if I can expand it. Doc James  (talk · contribs · email) 04:55, 24 December 2010 (UTC)


 * Epidemiology
 * Do we need to mention the estimated annual number of people dying from dengue? Can't immediately find the figure in WHO, but I'm sure it can be retrieved. - none of the sources mentions actual death rate
 * Found a 2009 WHO source that gives it at 2.5% of 500,000 or doing the math 12,500. Doc James (talk · contribs · email) 17:00, 27 December 2010 (UTC) Also see


 * History
 * In "etymology", does the IPA pronunciation guide not really belong in the introduction?
 * In "literature", is there any better source for the term "dandy fever"?


 * Research
 * Some of the modalities discussed here are already in use. Should we move them to "prevention"?
 * There is an inherent risk of NOR and WP:NOTCRYSTAL with these sections, as we don't know which modalities will eventually be applied widely. Is there a secondary source we could use to scaffold this section? WHO discusses antivirals, something we ought to mention.

I will continue to help with the above issues. JFW &#124; T@lk  04:01, 24 December 2010 (UTC)


 * May need a few days to get through these... Doc James  (talk · contribs · email) 04:55, 24 December 2010 (UTC)


 * I might have a read of the "Dutch reviews" and start work on the "mechanism" section. JFW &#124; T@lk  05:42, 24 December 2010 (UTC)

Further comments
I still have the following comments:
 * Signs and symptoms:
 * It currently sounds like all dengue infections have a "critical phase", but only 5% get DHF or DSS. Unsure how we could make this better.
 * Changed to "the critical phase, if it occurs"


 * I slightly rephrased what we quote from "Neurol India", as I don't think the author specifically attributed the encephalopathy to liver dysfunction.
 * The India ref states "Encephalopathy in dengue infection is well recognized, however, to-date it remains unclear whether the virus is neurotropic; it is unclear whether encephalopathy is mediated by direct infection of the nervous system, or indirectly via other mechanisms. In particular, hepatic encephalopathy is well reported in dengue." Thus they specifically mention the liver.
 * I agree. Rephrased now. JFW &#124; T@lk  10:15, 16 January 2011 (UTC)
 * Prevention
 * We could say more about international efforts as suggested above.
 * You mean a discussion of integrated vector management as a method of mosquito control ? I have added the sentence "A number of novel methods have been used to reduce mosquito numbers including the placement of the fish Poecilia reticulata or copepods in standing water to eat the mosquito larva. "


 * Prognosis
 * Worth merging with "epidemiology", as very short?
 * Sure until it is bigger... Doc James  (talk · contribs · email) 01:08, 16 January 2011 (UTC)

Good luck with the final steps. JFW &#124; T@lk  00:11, 16 January 2011 (UTC)


 * [[Image:Symbol support vote.svg|20px]] Looks great. I've done some final micromanaging and perfectionist i-dotting and t-crossing. Ready for GA by all accounts. JFW &#124; T@lk  14:47, 16 January 2011 (UTC)