User:AlisonM1991/sandbox

Suggested Changes
Hi Everyone. We are a group of medical students editing this Wikipedia page as part of an assignment. We made a list of our suggestions for the tularemia article. We would really appreciate any feedback/guidance on these points.

1.Overview: In the overview second paragraph, when describing animal reservoirs and modes of transmission keep the same text but add some more current reviews. When explaining how the disease is spread in the same paragraph add: "Other ways in which humans can contract the disease include direct contact with infected animals and exposure to contaminated soil or water. " 2.Signs & Symptoms/Clinical Presentation: Reorder this section with classic signs & symptoms listed first, followed by clinical subtypes and then mortality. Mortality statement in this section is unsupported, therefore change phrase to “The rate of mortality (death) associated with tularemia has decreased from 60% to less than 4% since the invention of antibiotics. "
 * one reference is generally enough, as long as it supports the text(statement)Citing_sources--Ozzie10aaaa (talk) 23:42, 8 November 2017 (UTC)
 * Thanks for this suggestion! We selected the most relevant reference.

3. Pathology: Insert the following sentences into the Pathology section: "Cultures are also completed to determine the specific strain of Francisella Tularensis bacteria.  This is important because different strains (holarctica, mediatica, novicida) are susceptible to different types of antibiotics. " Insert the following sentences to clarify methods of diagnosis: "There are two forms, agglutination based tests (tube based and microagglutination) and serum based tests. A titer of 1:160 and 1:128 respectively confirms diagnosis in agglutination based tests. For serum based tests, diagnosis is confirmed when there is at least a four-fold increase in serum antibodies assessed two weeks apart. "

4.Cause: Change the first sentence of the cause section to read: “Francisella tularensis is a facultative intracellular bacterium; meaning, it can survive outside of a host or within cells. " This change will improve the accuracy of the statement and avoid confusion stemming from the word “parasite”.

5.Prevention/Treatment: Update information on vaccinations to read: "Currently, there are no safe, available, government approved vaccines against tularemia. However, vaccination research and development continues, with live attenuated vaccines being the most thoroughly researched and most likely candidate for approval. Sub-unit vaccine candidates, such as killed-whole cell vaccines, are also under investigation, however research has not reached a state of public use. "

Update information on optimal preventative practices and remove information regarding fluoroquinolone use as a possible treatment to read: “Currently, optimal preventative practices include limiting direct exposure when handling potentially infected animals, such as wearing gloves and face masks while handling potentially infected animals (importantly when skinning deceased animals). If infection occurs or is suspected, current best treatment practices include administration of streptomycin and/or gentamicin antibiotics. ”
 * a)yes this does seem like a good improvement to this section( added {{Reflist} at bottom for clarity)--Ozzie10aaaa (talk) 23:45, 8 November 2017 (UTC)

6. Epidemiology: Remove the introductory sentence: "The disease is endemic in North America and parts of Europe and Asia", as it is not cited and gives contradictory information. We'd like to replace the previous sentence with: "Tularemia is most prevalent in the Northern Hemisphere (between 30º and 71º north latitude). "
 * b)redid reference, Tularemia vaccines.Putzova D1, Senitkova I1, Stulik J2. please use thank you--Ozzie10aaaa (talk) 00:12, 9 November 2017 (UTC)
 * Thanks! We believe we have appropriately fixed the reference.

Thanks everyone for your help! AlisonM1991 (talk) 17:23, 8 November 2017 (UTC)
 * COMMENT: Small stuff - As of 11/8 your refs 7 & 8 are identical and both are not formatted correctly (hence the red). [Since fixed.] The WHO citation is not in proper format. Do you have content to create a Prognosis section, to be before the History section? David notMD (talk) 22:08, 8 November 2017 (UTC)
 * Thank you for your comments! We believe we have fixed the WHO citation. We should enough content to add a “Prognosis” section, where we can add information from more recent references and reallocate material from other sections (ie. the details about mortality). If this is within the scope of this project, we would be happy to add this section.