Wikipedia:Featured article candidates/Influenza

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[edit] Influenza

Self-nomination. An article on the viral disease influenza. The article aims to be both comprehensive and approachable and contains 36 kB of text. This article is currently GA and has recently been peer-reviewed (Link) Thank you. TimVickers 23:28, 23 October 2006 (UTC)

Weak Support: Support: Quite good. However, I sense that the tone is ambiguous at times. For example, "Vaccination against influenza with a flu vaccine is possible and in many cases recommended." In what cases would the vaccine not be recommended? Is vaccination possible (as in theoretical), or does it actually exist? The second question is answered later, but such ambiguousness hurts the article a bit.
Also, it might be good to integrate content from tributary articles into the main one. Don't just mention something; describe it in, say, a sentence or so. For example, the article mentions Pathogenesis in the "Research" section. I happen to know what pathogenesis is, and how it might affect flu treatment, but I would suggest explaining how pathogenesis is important in Influenza Research for those who don't.
On the positive side, if I were doing a report on the Influenza, this article seems authoritative and a spring board towards other useful sources. I would suggest improvement, however. I remain a "Weak Support," which may either become "Strong Support" or "Oppose" as the week continues. --Gracenotes T § 02:29, 24 October 2006 (UTC). Done. Influenza has never looked so good! ... 19:15, 24 October 2006 (UTC)
Intro to Vaccine section now reworded. 'Research' section also reworded and expanded to give some concrete examples. TimVickers 02:33, 24 October 2006 (UTC)
  • Weak oppose. This is my opportunity to point out that {{main}} is used incorrectly throughout this article, as in many others on Wikipedia. Can we either clarify the usage information on the template to permit its use in what seems to have become convention, or change the template used to, e.g. {{details}}? Thanks. Samsara (talk • contribs) 07:10, 24 October 2006 (UTC)
Changed usage of {{Main}} to {{Further}}, after reading Wikipedia:Guide to layout. This does seem a bit of a jumble of usage in Wikipedia, as there seems to be the {{main}}, {{further}}, {{see also}} and {{details}} all used for exactly the same job. However, this isn't the place to discuss general issues. TimVickers 13:39, 24 October 2006 (UTC)
  • Support. Seems very good to me.--Steven Fruitsmaak (Reply) 14:51, 24 October 2006 (UTC)
  • Support, one comment though: I don't really like the 'the CDC says' thing used a few times. There could just be a reference instead. --WS 17:30, 24 October 2006 (UTC)
Some of these have been removed already, I have cut another from the vaccine section. TimVickers 20:21, 24 October 2006 (UTC)
And what is known about the properties and structure of type B and C viruses? There is only information about type A in that section. --WS 17:39, 24 October 2006 (UTC)
Added note that other strains are similar in structure to type A. TimVickers 17:46, 24 October 2006 (UTC)
  • Support. Seems very good and comprehensive. PHG 18:47, 24 October 2006 (UTC)
  • Support Good structure, with many details and information. Hello32020 21:36, 24 October 2006 (UTC)
  • Support Tim, you're like an FA machine :) A few comments:
  • Do you know the magnification of the image in the infobox? (Also, is it my imagination or do the HK viruses in the second image have tails?)
Rod-like forms are pretty common, so I suppose they MIGHT have tails. magnification added.
So there is a rod-shaped form of the virus (or a rod-shaped assembly)? Is that what the long rods in the H5N1 image are? Maybe there should be a mention of that in the structure section... I would've guessed influenza viruses were always spherical. Opabinia regalis 00:37, 26 October 2006 (UTC)
Mention of rods added to intro of structure section. Thanks. TimVickers 01:01, 26 October 2006 (UTC)
  • The nomenclature image appears (for me, at least) before hemagglutinin and neuraminidase have been introduced in the text.
Added note to textbox below image referring reader to discussion below.
Replaced with new image.
  • "H7N7 has unusual zoonotic potential" - this statement also appears in the H7N7 article, but in neither case is the reason described. I guess this is really a criticism of the H7N7 article, but it would still be nice to have an explanation, or a citation to a place where it could be found.
Ref added.
  • Similarly, why the lower mutation rate for B?
Good question, I don't think anybody knows! The ref for this observation to a paper published in April of this year, so give them time.
  • The description of the infection mechanism really should explicitly mention the fusion peptide. It doesn't need great detail, but without this description readers might wonder why a cell would "voluntarily" import a virus.
Added.
  • The graph of H5N1 cases is a bit confusing - why include the regression line if it's only going to project another month into the future?
I think it is more to smooth the data than make a prediction.
  • "Here, the novel influenza spreads uncontrollably, causing a pandemic." - makes it sound like a pandemic is inevitable every time reassortment occurs.
Good catch, reworded.
  • "children of less than 59 months" - kind of awkward wording. (A bit off topic, but why would they choose 59 months? Weird number.)
Reworded, yes a strange number. TimVickers 05:17, 25 October 2006 (UTC)
  • I'm sure the CDC knows what they're doing with the H5N1 micrograph, but it seems odd to me. If it's colorized so that viruses appear gold, what's going on with those long rods?

Overall, great job (again)! Opabinia regalis 04:36, 25 October 2006 (UTC)

[edit] Oct 25

Comments before support. Sorry to come late to this — just a few questions/comments before I support:

  • Further reading is massive: is all of that really seminal, important and necessary, or has it acquired some spam/advertising/cruft? If you say it's necessary, I'll take your word for it :-)
Removd some that were duplicated in the reference list.
  • See also is a bit unwieldy; that's not an objection, but would you consider developing a template? I can help if you're interested (see Template:Topics related to Tourette syndrome).
The list of serotypes is duplicated in the template at the bottom of the page. Removed.
  • I'm wondering why History is at the top of the article, vis-a-vis WP:MEDMOS. I know following MedMos doesn't work for all articles, but wonder still why History is needed at the top of the article: I'm disposed to the view that History at the bottom works better for encyclopedic articles.
History is pretty important here because of the episodic nature of pandemics and the poor public awareness of the 1918 pandemic. More so than for other diseases that have constant levels of infection.
  • In the chart in Epidemiology, can you convert the external jump to a footnoted reference? The problem with the reference being an external jump is that future editors have no information for tracking down the reference should the link go dead; converting it to a bibliographic ref helps avoid that potential future problem.
Converted to ref.
  • I see some redundancy and questions (I'm not sure on some of this) that can be addressed via copyedit — things like:
    • Influenza, commonly known as the flu, is an infectious disease of birds and mammals and is caused by an RNA virus of the family Orthomyxoviridae (the influenza viruses).
    • In more serious cases, influenza causes pneumonia, and this (which) can be fatal, particularly in young children and the elderly.
    • Commas goofed up here? This huge death toll was caused by an extremely high infection rate, of up to 50% and the extreme severity of the symptoms.
    • The severity killed? Not sure that works, not sure how to fix it ... The unusual severity of the disease killed 2.5 % of those infected,
    • Influenza capitalized here, but not other places? Check through entire article for consistency? This is unusual since Influenza is normally most deadly to the very young (under age 2) and the very old (over age 70).
    • Take care with consistency in UK or US English (not sure if there are consistency problems, but just came across this and wanted to make sure you had checked): Frank Macfarlane Burnet, who showed that the virus lost virulence when it was cultured in fertilised hen's eggs ...
    • Not sure on capitalization: sometimes orthomyxoviridae is capped, sometimes not ? Similar for other viruses (see for example section Types of influenza virus).
    • This statement can become outdated (needs some time reference?): H5N1 is the current pandemic threat.
    • They can ? Influenza C viruses are known to infect humans and pigs. It can ...
    • Emergence ? Also, avoid "discussed below" as some future editor may come along, long after we're all gone, and change the order of sections. This is important in the emergance of pandemics, and is discussed below.
    • ugh ... According to the on-line version of the Merck Manual of Diagnosis and Therapy: ... they are so often wrong— can this possibly be sourced to something more reliable? Perhaps this is a personal dislike, since they are so dramatically and emphatically wrong on TS, and have made no attempts to correct their misinformation over many years.
    • Somewhere above says "sneeze", this says coughing, list below this mentions both, inconsistency in text should be worked out: The virus attacks the respiratory tract, is transmitted from person to person by saliva droplets expelled by coughing,
    • Not sure about hyphenation here? Seasonal changes in contact rates from school-terms,
    • Avoid "above" or "below" in case a future editor changes section order: Every ten to twenty years a pandemic occurs, which infects a large proportion of the world's population, and can kill tens of millions of people (see history section above).
    • I'm not sure on hyphenation? The most dangerous side-effect
    • Are these generics - should they be capitalized ? Antiviral drugs such as Oseltamivir (trade name Tamiflu) and Zanamivir are

Sandy (Talk) 17:19, 25 October 2006 (UTC)

Thank you for the suggestions. Corrections made. TimVickers 18:37, 25 October 2006 (UTC)
  • Support, that was fast, you are an FA machine! Sandy (Talk)
  • Comment
H5N1 is the current pandemic threat.
Just to check that you don't want to replace "current" with something more precise and lasting. - Samsara (talk • contribs) 06:28, 25 October 2006 (UTC)
Removed three occurances of this phrase, replaced with "2006-7 flu season" TimVickers 19:47, 25 October 2006 (UTC)
  • Support. Great article. Only one comment, there's an image superimposing a table in the "History" section. Nat91 20:37, 25 October 2006 (UTC)
What's your browser and screen resolution? I'll need to reproduce the problem to fix it! TimVickers 20:51, 25 October 2006 (UTC)
Mozilla Firefox, 800x600. Nat91 03:56, 26 October 2006 (UTC)
It's optimised for 1024x768, but I just tried your settings and had no problem on my monitor. Did the new nomenclature image fix the problem for you? TimVickers 04:19, 26 October 2006 (UTC)
I think so. I don't see the problem anymore. Nat91 20:29, 26 October 2006 (UTC)
I added such a section using content from Social impact of H5N1. Probably should be further edited ... WAS 4.250 21:18, 26 October 2006 (UTC)
The "Economic impact" section refers to the impact of animal (avian) influenza for most of its duration. Shouldn't the "Infection in other animals" come before the recently addended section upon the economy? I've changed the order, and if you object, post something here and revert it. Thanks. --Gracenotes T § 22:04, 26 October 2006 (UTC)
Good idea. I've done formatting and some editing in this section. A whole new section in just 4 hours! TimVickers 22:39, 26 October 2006 (UTC)
Nice job, if it can be expanded to past influenza's impact it would be quite comprehensive.-- Piotr Konieczny aka Prokonsul Piotrus | talk  16:10, 31 October 2006 (UTC)
There is amazingly little published research on this area, however I found one paper and have added some discussion of the economic impact of the 1918 pandemic. TimVickers 17:04, 31 October 2006 (UTC)
Good job - I support now.-- Piotr Konieczny aka Prokonsul Piotrus | talk  19:50, 2 November 2006 (UTC)

[edit] Oct 28
  • Support, This is a great article and seems to meet all the criteria. I do have a few small things I question.
    • There are a lot of long sentences. These sentences tend to use parentheses rather heavily. And in other places parentheses are used where I would generally put a piped link. I wonder if these things should be handled differently, but I am not sure they are wrong.
Replaced parentases in first paragraph of intro with piped links, thank you, a great improvement. TimVickers 01:44, 29 October 2006 (UTC)
      • Long The most common human vaccine is the trivalent flu vaccine, which contains purified and inactivated material from whatever three flu strains are judged the most useful to put in a vaccine for that flu season (typically, two types of influenza A viruses and one influenza B virus).
Cut into two sentences and re-ordered. TimVickers 01:44, 29 October 2006 (UTC)
      • Long Since it first killed humans in Asia the 1990s and became epizootic (epidemic in nonhumans) and panzootic (affecting animals of many species, over a wide area) a deadly avian strain of H5N1, called HPAI A(H5N1) for "highly pathogenic avian influenza virus of type A of subtype H5N1", has posed the greatest influenza pandemic threat.
Cut central clause, since I don't think H5N1 avian influenza is epidemic in humans. TimVickers 01:44, 29 October 2006 (UTC)
      • On the piped link; would In people, common symptoms of influenza are fever, sore throat (pharyngitis), muscle pains (myalgia) be better handled like In people, common symptoms of influenza are fever, sore throat, muscle pains; I don't know.
    • Terminology on avian flu is not consistant. It fully introduced twice. It is called "avian influenza", "HPAI A(H5N1)", "H5N1", "H5N1 avian flu" and "avian flu H5N1" at various points. In "Infection in other animals" I get the impression the above terms are not interchangable, but they seem to be used interchangably throughout the rest of the article.
Standardised either on "Avian influenza" when talking about influenza in birds in general, or H5N1 avian influenza. TimVickers 01:44, 29 October 2006 (UTC)
    • I think the article needs to be rechecked that linked terms are linked at their first use and only their first use. - User talk:BirgitteSB
I disagree that we should only link technical terms once, since some readers may not read the entire article (for example skipping the technical section on Viral structure and going straight to Treatment and Vaccination). However, I've been through and removed some duplicate links in the same section. TimVickers 01:44, 29 October 2006 (UTC)

I started to fix some of these things but thought better of it, as I'm better at gathering data than word-smithing. I agree with the piped link comment. The two long sentences are my fault - I expect they'll be fixed by Monday by someone on a wikibreak. I disagree totally with only linking terms when they first appear - more than once per paragraph is too much and once per section is generally best. See avian flu and H5N1 for their meanings - they are definitely not interchangable. For example LPAI A(H5N1) exists in North America; nonavian H5N1 is theoretically possible but does not yet exist; A(H5N1)=H5N1; H5N1 is the virus while H5N1 flu is the disease; flu=influenza; avian=bird; all subtypes of Influenzavirus A have strains that are endemic in birds and thus are "avian flu viruses" but the stains are viruses not flus and the subtypes are not "avian flu viruses" because some stains of those subtypes are not endemic in birds but instead are endemic in other animals (humans, horses, dogs, ...). WAS 4.250 07:14, 28 October 2006 (UTC)

Yes, avian flu is avian. Only birds can catch it, lest there be the necessary mutations for it to be successful in human hosts. The HxNy notation describes the two main aspects of the serotype, i.e. the glycoproteins (iirc) that the immune system latches on to. - Samsara (talk ·  contribs) 11:44, 28 October 2006 (UTC)
"Only birds can catch it" is incorrect. Humans have caught and died from the current Asian-lineage HPAI A(H5N1) which is an avian flu virus - the "A" in HPAI stands for "avian" (but the "A" in A(H5N1) stands for "Influenzavirus A" or type A or species A or Influenza A virus).

Genetic factors in distinguishing between "human flu viruses" and "avian flu viruses" include:

PB2: (RNA polymerase): Amino acid (or residue) position 627 in the PB2 protein encoded by the PB2 RNA gene. Until H5N1, all known avian influenza viruses had a Glu at position 627, while all human influenza viruses had a lysine.
HA: (hemagglutinin): Avian influenza HA bind alpha 2-3 sialic acid receptors while human influenza HA bind alpha 2-6 sialic acid receptors. Swine influenza viruses have the ability to bind both types of sialic acid receptors.

The HA changes have not yet occured in any sequenced H5N1 virus - even ones from humans that died from it and the PB2 changes don't stop it from being a flu virus endemic in birds (the definition of "avian flu virus").

Further, pandemic flu viruses have some avian flu virus genes and usually some human flu virus genes. Both the H2N2 and H3N2 pandemic strains contained genes from avian influenza viruses. The new subtypes arose in pigs coinfected with avian and human viruses and were soon transferred to humans. Swine were considered the original "intermediate host" for influenza, because they supported reassortment of divergent subtypes. However, other hosts appear capable of similar coinfection (e.g., many poultry species), and direct transmission of avian viruses to humans is possible. H1N1 may have been transmitted directly from birds to humans (Belshe 2005). [1] Recent research of Taubenberger et al has suggested that the 1918 virus, like H5N1, could have arisen directly from an avian influenza virus. WAS 4.250 14:56, 28 October 2006 (UTC)


I have a suggestion. Perhaps, instead of having all of the images in the article at the top right corner of sections, there could be a bit of variation. Maybe the image code could be implemented after the first paragraph of a section. Perhaps the image could be left of the text. That sort of thing. Gracenotes T § 14:42, 1 November 2006 (UTC)

OK, done for two images. TimVickers 15:43, 1 November 2006 (UTC)