Talk:Herpes simplex

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Contents

[edit] Notes from peer review - March 2008

[edit] Peripitus

Just a few comments on what is a well written and apparently comprehensive article.

Broad bits
  • Personally I don't like references in the lead - they often show that there is unique material there rather than simply summarising the rest of the article. Please consider moving the reference into the place with the same information in the body.
  • The article is too long at 102K, also resulting in a very long table-of-contents. At the least the Epidemiology section should be a separate article called Epidemiology of herpes simplex with a referenced summary left behind.
  • There is inconsistency in the reference formatting. eg: ref#130-134, 136-137 are bare weblinks, 138 has a template error.
  • I can't see anything in the article on the scientific progression of knowledge, leading to the current stage of affairs. Cannot see anything on when and how it was identified as linked with the virus. See eg: Acute_myeloid_leukemia#History
  • Should the heading Recurrences and triggers be Recurrence and triggers ?
  • a few words explaining what a primary infection is would be pertinent at the first use (unless it is there and I missed it)
  • I'd drop the whole Legal redress section. I feel it doesn't add anything useful to the article and, given the source of the references, it is likely not a world-wide position but is rather US-centric.
done ~ Ciar ~ (Talk to me!) 02:27, 25 March 2008 (UTC)
Specific issues

From reading through a few random sections

  • In the Disorders section the statement "...although recent years are seeing an increase in oral HSV-2 infections." is vague and dates fast. It's preferable to have something more concrete like "...although oral HSV-2 infection rates increased by <x>% in the last <y> years of the 20th Century".
  • There is some redundancy - eg: in the Disorders section , including fever, and sore throat, and painful ulcers may appear - appears to say the same thing more concisely. Rare occasions of reinfections occur inside the mouth - again appears to say the same thing.
Fixed ~ Ciar ~ (Talk to me!) 02:43, 25 March 2008 (UTC)

Oral herpes is spread by direct contact with an active sore in an infected person, for instance, during kissing -> Oral herpes is spread by direct contact with an infected person's active sores, for instance during kissing.

reworded ~ Ciar ~ (Talk to me!) 02:47, 25 March 2008 (UTC)
  • HSV-2 is the most common cause of recurrent viral meningitis called Mollaret's meningitis - should this have the words "a type of" inserted after "of" unless this is the only type of viral meningitis.
reworded ~ Ciar ~ (Talk to me!) 02:54, 25 March 2008 (UTC)
  • In the Bell's palsy section, first section needs a comma, possibly just after "nerves of the face".
added ~ Ciar ~ (Talk to me!) 02:59, 25 March 2008 (UTC)
  • The penultimate sentence and its predecessor in the "Orofacial infection" section) contradict each other. try Oral herpes is usually spread by direct contact
  • In the "Natural compounds" section, However, there is currently insufficient scientific and clinical evidence "However" is not needed and "currently" adds nothing unless there is a date noting when this refers to. Please look for all uses of the word "currently" and rewrite to either remove the word or add a date/year.
  • In the "Antiviral medication" section the sentence with by interfering with viral replication, effectively slowing the replication rate needs some work. It is unclear from the writing whether the drugs work by in effect slowing the replication or are effective at the slowing. If it's the "in effect" one then the word "effectively" can be removed.
  • Same section. There are several prescription antiviral medications for controlling herpes simplex outbreaks.... Are they prescription drugs worldwide or just in the US ? Please check through the treatment section as many parts are written from a US perspective and need consideration as to whether the information is applicable worldwide.

- Peripitus (Talk) 11:50, 21 March 2008 (UTC)

A request has been made for this article to be copyedited by the League of Copyeditors. The progress of its reviewers is recorded below. The League is always in need of editors with a good grasp of English to review articles. Visit the Project page if you are interested in helping.
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Greetings from the League of Copyeditors! Please see my comments in the "Copyedit Progress" section below. Livitup (talk) 16:20, 23 May 2008 (UTC)
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[edit] Good Article Review

At this version: [1]

Reviews always dwell on faults with article so I will start on a positive note. This a very well-written and comprehensive article. During my first read through, these problems came to light:

  • The Lead is way too long.
I've copy edited and trimmed this to try and improve - hoping some "professional" copyeds come soon!~ Ciar ~ (Talk to me!) 05:26, 13 March 2008 (UTC)
  • Citations are needed for, HSV-1 being more infectious during primary episodes, the number of asymptomatic infections and HSV-1 amelioration of subsequent HSV-2 infections.
Not sure of the correct places in the text for these. I moved a ref for asymptomatic shedding/frequency to lead, but the others I can't find. I've either deleted text during the copyediting or am just missing it! ~ Ciar ~ (Talk to me!) 06:44, 14 March 2008 (UTC)
  • The dates in the Table of prevalence data do not line up very well, making the table very difficult to read. Fixed.
I don't see the problems on the computers I use, so may be a browser problem. I'll try putting phyical rows in the table when I get a chance.~ Ciar ~ (Talk to me!) 05:26, 13 March 2008 (UTC)
It looks OK with Firefox but it's a bit messy using Explorer.--GrahamColmTalk 11:41, 13 March 2008 (UTC)
I altered the table and checked it with Firefox and Explorer - how does it look at your end?~ Ciar ~ (Talk to me!) 06:30, 14 March 2008 (UTC)
  • In the Lead the prevalence in Sub-Saharan Africa is given as 80&, where as in the body it is given as 30-80 for females and 10-50 for males.
reworded/numbered this according to table~ Ciar ~ (Talk to me!) 05:26, 13 March 2008 (UTC)
  • There is a big problem with how the seroprevalence data is presented. This is the prevalence of antibody and not disease. Most readers will not know the difference.
  • There is a greater emphasis on herbal remedies than antivirals and the latter could be {{main|}} linked to the main article.
IMO, the herbal remedies don't warrant a page of their own, and I think it will be problematic, with some editors, to completely remove the section, so I have compromised and trimmed out the excessive details.~ Ciar ~ (Talk to me!) 05:26, 13 March 2008 (UTC)
  • WRT Diagnosis and testing:
"Genital herpes is more difficult to diagnose than oral herpes since most HSV-2-infected persons have no classical signs and symptoms." citation please!
The diagnosis section was covered by a rewiew article that was already cited in several sentences. I didn't wish to over cite, since this is GAR that doesn't require excessive refs, but have included the ref tag after this sentence anyway.~ Ciar ~ (Talk to me!) 06:24, 13 March 2008 (UTC)
How do you test someone who is asymptomatic? What do you swab? What specimens do you send to the lab? Serology is no use because it does not differentiate between past and current infection, (is there a test for IgM?).
H'mmmm, how to answer this? Do you wish me to spell this out in the article or just respond on the talk page? My knowledge on the matter is this. People that become infected with HSV are infected for life. The virus does not get eliminated from the body by the immune system, it just goes into hiding in the ganglia. Before it hides, the immune system (in most cases) develops antibodies against the virus, and the infected person becomes seropositive against HSV (this usually takes a couple of weeks to happen). Since the virus is not eradicated, serology is used as a predictor of persons infected with the virus - modern serology tests CAN distinguish between HSV-1 and HSV-2 since there a slight differences in the proteins that these two viral species produce (Wald's group do this - I'll see if I can find a ref to support - and also if it gives details on IgM + IgG testing). Asymptomatic people are the people infected with HSV (as determined by serology testing and/or previous symptoms) that do not have recurrences. Serology testing (as mentioned above) indicates the presence of earlier infection - yes - but since the virus is not removed from the body, it is used as a predictor for current infection (HSV produces chronic infections) - and is also used to determine HSV infection in asymptomatic individuals. Although they do not have noticable symptoms, they can still release/shed the virus, and this is detected for research purposes by rubbing swabs (like Q-tips) across the infected area (e.g. if the person is seropos for HSV-2, they usually swab the anogenital area, and the swab is tested for viral DNA by PCR) - I can search for relevant articles that show this too. Is this the info you are looking for, and do you think this level of detail should be added to the article to pass GAR? ~ Ciar ~ (Talk to me!) 06:51, 13 March 2008 (UTC)
I'll take another look at this, but I think the answer is asymptomatic people are not tested.--GrahamColmTalk 11:41, 13 March 2008 (UTC)
H'mmm, I'd say that opinion was too general. I agree that most people that do not know they are infected do not seek testing. However, some people do get tested if they find out they have had exposure to a herpes infected individual regardless of whether they develop symptoms themselves, and other people routinely get tested for STDs - if this did not happen, the existence of asymptomatic people wouldn't be known, right? Just a thought ;) Thanks for helping whittle out the probs BTW ~ Ciar ~ (Talk to me!) 19:36, 13 March 2008 (UTC)
We know about the existence of asymptomatic infections from prospective epidemiological studies. This comes round to my worry about the seroprevalence data. We need to distinguish clearly between incidence and prevalence; two releted but distinct epidemiological concepts. The way the article reads now implies a high incidence of symptomatic disease in some countries, whereas there is a high prevalence of infection. I'm nitpicking because I forsee the article going to FAC sooner rather than later and we could sort these issues out now. Please don't worry about the GA - it's in the bag.--GrahamColmTalk 19:56, 13 March 2008 (UTC)
No, I don't think this is needed to pass GAR. I've edited the serology section and would be happy to leave it at that. Also, this article will pass GAR but the references need a little work and a clear distinction must be made between seroposivity and active infection.--GrahamColmTalk 12:57, 13 March 2008 (UTC)
I added an intro paragraph to the epidemiology section for the time being with a ref I could only get the abstract for - not ideal, but the best I could find just now. Haven't been able to identify prevelance data for active disease yet! ~ Ciar ~ (Talk to me!) 07:22, 14 March 2008 (UTC)

:Although a citation is given I do not agree with: "Although these procedures produce highly sensitive and specific diagnoses, their high costs and time constraints limit their regular use in clinical practice." Even PCR isn't that expensive these days. Is this statement meant to refer to the developing countries?

The reference says discourage and I have edited this passage accordingly.--GrahamColmTalk 11:41, 13 March 2008 (UTC)

I am placing the GA review on hold and will come back to it later. Please give me a reminder on my talk page when it is ready for reappraisal. (Watching!) Graham. --GrahamColmTalk 11:05, 12 March 2008 (UTC)

  • I am promoting the Article to GA. Thanks for being patient and addressing my concerns so quickly. You don't need me to tell you that there is still much work to be done if you are considering FAC. I hope you found the review valuable. Best wishes. Graham.--GrahamColmTalk 10:45, 14 March 2008 (UTC)
Yipee....thanks Graham! I think I'll throw it in for peer review before tackling the jump to FAC! ~ Ciar ~ (Talk to me!) 23:40, 14 March 2008 (UTC)

[edit] Herpes and Alzheimer's

  • Hi There. I found some very interesting information about a possible link scientists have found between Herpes Simplex Type I and Alzheimer's disease. As the article states: "a physical connection between the herpes simplex virus and amyloid precursor protein [has been found], a protein that breaks down to form a major component of the amyloid plaques that are consistently present in the brains of persons with Alzheimer's disease." Here is the link: http://www.sciencedaily.com/releases/2003/11/031107055048.htm I'll try to write something about it if the main editors of the page think its appropriate. What do you think? Saritamackita (talk) 01:12, 15 March 2008 (UTC)
Hi Saritamackita, IMO I think, since a section on Bell's palsy made it into the article with its limited and disputed data, it would only be fair to do the same for the Alzheimer's connection (the general public may be curious about this) - only it would be better if scientific journal articles rather than popular press were used as sources and that a balanced argument is presented (i.e. although the science daily article reports a potential relationship of herpes viruses with Alzheimer's it also states that too many conclusions regarding this relationship should not be made). ~ Ciar ~ (Talk to me!) 01:23, 15 March 2008 (UTC)
thanks for the feedback. I'll keep all that in mind. My only question, though, is how do I get access to these scientific journal articles without having to pay for them? Saritamackita (talk) 01:40, 15 March 2008 (UTC)
You could try going through pubmed - some articles listed there are free, so if you are lucky, you may find a relevant free article there. ~ Ciar ~ (Talk to me!) 04:08, 15 March 2008 (UTC)

[edit] Herpes Herbal Treatment

  • Here is another popular science article about Prunella vulgaris [also known as self-heal], an herbal herpes treatment that I found interesting. http://www.sciencedaily.com/releases/2003/05/030520083354.htm. I suppose I have the same issue writing about this as I have about writing about the Alzheimer's-Herpes link though (little to no access to scientific journal articles). I'm starting to miss college right now. Those were the days of absolute access to information.

--Saritamackita (talk) 01:39, 15 March 2008 (UTC)

I just got through writing a little thing about this along with the foot note, but the foot note didn't really work out. If someone could help me with this, that would be great. --Saritamackita (talk) 02:45, 15 March 2008 (UTC)

[edit] Peer review

We got some great comments during herpes simplex peer review. I copied them to the "To Do" list for ease. If any editors want to help plough through these and improve herpes simplex for WP:FAR, please go ahead! ~ Ciar ~ (Talk to me!) 02:34, 25 March 2008 (UTC)

[edit] New Link

I found a virology article that I found very interesting about Herpes. I think it would be good as an extra information source on Herpes. Let me know what you think. http://www.futuremedicine.com/doi/full/10.2217/17460794.2.1.1?cookieSet=1 Saritamackita (talk) 05:07, 25 March 2008 (UTC)


[edit] Oral/Genital infection rates

The statistics only show HSV-1 and HSV-2 infection rates, not the location as to what's infected. Klosterdev (talk) 03:06, 2 April 2008 (UTC)

[edit] Non-drug heat treatment mentioned

There are some products (such as Hotkiss and Therapik) that use battery-powered heat and can reduce the severity of an episode. Failing to find any scholarly articles, I have added a mention of this under treatment and an on-line media link from New Zealand.SuW (talk) 21:16, 5 April 2008 (UTC)

Hi there, I reverted that addition because the link was to a press release from one of the companies themselves, and I couldn't find secondary sources. I think some sort of secondary source would be required before adding it to the article (otherwise there would be far too many links to products that claim to have some benefit). AndrewGNF (talk) 21:23, 5 April 2008 (UTC)

[edit] The pictures are...

GROSS! Why do we need to get so graphic. I'm against pictures on this article, because is can scare your every day Joe, who doesn't have a strong stomach. Herpes is bad. Nobody needs to see it. —Preceding unsigned comment added by NatWill2 (talk • contribs) 02:09, 11 April 2008 (UTC)

Nobody needs to read it. If you don't like it, don't read it. Nbauman (talk) 23:35, 7 May 2008 (UTC)

[edit] 'Stress' is not a proven trigger of outbreaks

I read the supposed reference link #49. In no way did it prove that stress caused a herpes outbreaks. Pure theory and nothing more as far as I can see. And note the name of the journal: "Hypotheses". —Preceding unsigned comment added by 63.193.144.79 (talk) 09:49, 15 April 2008 (UTC)

Many papers have cited stress as a trigger. The listed paper was perhaps not convincing. The only supposed trigger that has not been PROVEN to my knowledge is menstual cycle. I will try to post more refs in the near future. pikipiki (talk) 05:35, 8 May 2008 (UTC)

[edit] What?

"Risk Factors for acquiring HSV-2 include: ... black race;" Wait, what? First, there is a general consensus that there are no races. And how could a race have a color? It's like asking what color "red" has. This line should be rewritten, so it's not racist-POV. Also, there should be a source that says that certain ethnicities are more likely to be infected. Thanks, and don't turn this into a silly race conversation that has nothing to do with this POV. That could be held in some other article, such as race. —Preceding unsigned comment added by Ran4 (talk • contribs) 18:40, 29 April 2008 (UTC)

I believe that was one of my additions, and it is based on the NHANES surveys conducted since the early 60's and the information derived from them, as well as several retrospective seroprevalance studies done on sera collected during the NHANES studies. The information is available on the CDC.GOV website and any issues that you have with the way they title their surveys and the facts that are derived from them should be taken up with the Center for Disease Control, the US government, those researchers that have used the NHANES material in their research, or JAMA, NEJM, JID, STD, and other journals that have published these findings. If you would like more information try PUBMED.GOV and search "NHANES herpes seroprevalence". If you would really like to blow a gut, search "herpes seroprevalence survey". The paper at the top of the list, about HSV-2 in NYC, from STD April 2008, contains the phrase "Black women had the highest seroprevalence (59.7%) of any sex or race/ethnicity group." I again apologize for confusing you with facts. pikipiki (talk) 06:06, 8 May 2008 (UTC)

I also reverted your deletion. I read medical textbooks and journals all the time, and they regularly refer to "black race" or "African-American." They usually specify "self-identified." So that's what "black race" means. They also regularly refer to "Ashkinazi Jews" or "people of Celtic origin" for other diseases. Some diseases are more frequent in some populations, and "black race" is a good marker for those populations.
People with "black race," or whatever you prefer to call it, are more likely to have sickle cell anemia, and aggressive breast and prostate cancer, and diabetes, and less likely to have osteoporosis. Feel free to separate the genetic and environmental components.
The bottom line is that when a doctor has a patient in the hospital who is steadily declining while they try to figure out how to save the patient's life, they can save the patient's life more often if they use race as a clue in coming up with a diagnosis.
Would you prefer that they try to diagnose that patient without taking race into consideration? Nbauman (talk) 15:28, 8 May 2008 (UTC)

The following text is copied from a discussion on Nbauman's (talk page regarding the same subject, in an attempt to make the discussion available to all interested parties. Please help us sort out the issue in question. Thanks, ~ Ciar ~ (Talk to me!) 13:54, 9 May 2008 (UTC)

Hi Nbauman, I couldn't hep but notice the small conflict beginning on the herpes simplex page over race/gender issues in the lead paragraph, so I wrote directly on the concerned user's talkpage to invite them to comment on the article's talkpage - they may be a new user that is not completely familiar with WP procedures so may not realize there was a discussion occurring there! I agree the sentence is question is a little clunky and might benefit from rewording - maybe some compromise can be worked out! Best wishes, ~ Ciar ~ (Talk to me!) 17:51, 8 May 2008 (UTC)

Thanks. I'm trying to use it as a teachable moment. This issue comes up regularly. I didn't think of using the talk page of an anonymous user. Nbauman (talk) 17:55, 8 May 2008 (UTC)
I am a new user. My issue with the sentence is that you are taking seroprevalence data, and making a statement about risk factors based upon that data. Seroprevalence data of virus infections is not the same as risk factors. I have no problem with mentioning what percentage of the populuation of women, urban, racial, etc. have the HSV virus. But to say that simply having sex with a female, black person, poor person, or a city dweller puts you at risk of HSV2 is applying personal bias to the data. The risk factor of HSV2 is unprotected sexual contact. If you just limit your statement to the data without trying to apply an interptation (sp) to the data i will be content. Until then I will deleting that biased sentenced. (I did notice that you were previously lectured on Wiki's bias rules). —Preceding unsigned comment added by 70.165.104.101 (talk) 20:05, 8 May 2008 (UTC)
So sorry to butt in here - the risk data doesn't actually mean you are at higher risk of acquiring HSV infection if you have sex with the listed groups of individuals, it means the listed individuals show a higher risk of acquiring the virus themselves, from whatever source. Maybe we could move the discussion to Talk:herpes simplex? ~ Ciar ~ (Talk to me!) 20:28, 8 May 2008 (UTC)
Yes, let's take the discussion to Talk:herpes simplex, which is where it belongs. I'll be glad to continue it there. Nbauman (talk) 21:05, 8 May 2008 (UTC)

From my scan of the article in question, it seems to me that the indicated populations have higher seroprevalence, but not that these groups are more likely to be infected given exposure. As it's worded now, I think it's ambiguous and would agree with a change that was more specific in simply saying that these groups have higher seroprevalence. AndrewGNF (talk) 19:44, 9 May 2008 (UTC)

Risk factor is part and parcel of the epidemiology of a disease. It does not mean they are more likely to catch the disease if exposed. It is part of diagnosing the disease. To ignore risk factors is to endanger your patient. Imagine leaving a child to die because you don't want to offend them and ask if they're Jewish and might have tay-sachs. If it will make 70.165.104.101 feel better, I'm willing to post HSV-1 neonatal risk factors which are: White race, young age, first pregnacy, HSV seronegative, and receptive oral sex in the third trimester, along with the appropriate references.pikipiki (talk) 09:43, 13 May 2008 (UTC)

Nahmias AJ. Neonatal HSV infection Part I: continuing challenges. Herpes. 2004 Aug;11(2):33-7. PMID: 15955265. Reference for my comment above on NHSV-1.pikipiki (talk) 09:58, 13 May 2008 (UTC)

As part of the copyedit process I have taken that sentence out. Not due to bias or POV, but because it just doesn't belong there. My role as a copy editor is not to evaluate the factual basis of any statement, but just to make the text read well. When I get to the epidemiology section the satement, or at least the intent of the statement will go in there. You all can argue about it then. :) Livitup (talk) 20:43, 23 May 2008 (UTC)

[edit] Copyedit Progress

Greetings from this humble representative of the League of Copy Editors... :)

Normally when copyediting an article I just attack with my red pen, and upload the changes all at once or in big chunks. But since this article is long, complex, and has subject matter experts actively editing the article I'm going to take a different approach. Since you all are far more familiar with the subject than I am, I'm going to propose major changes here for your comment, before I make them. This will draw out the copyedit process, but I think the reward will be a much better article and no angry editors. :)

To start with the lead:

  • Overall comment, the lead is really long. There's a lot of detailed information that I think should be moved to individual sections of the article. I'll make those changes, but make that the last edit, so you can revert it if you think I cut too deep.
Agree, the unfortunate problem with having a long article is the intro tends to grow - I've tried to cut down some of it, but it needs someone with better grammar to form more efficient sentences. Chop away - there should not be any info in the lead that isn't covered in more detail in the main article. There is one sentence in particular (see the discussions above on this talk page) that is causing concern that may need some subtle tweaking so it doesn't get misinterpreted too - any suggestions?~ Ciar ~ (Talk to me!) 17:11, 23 May 2008 (UTC)
You wanted the red pen, you got the red pen. :) Oh, and I took care of that troubling sentence in particular. :) I think that's something you can cover in more detail in the appropriate subsection, which will probably result in people reading it better and not getting worked up about it. :) Livitup (talk) 20:32, 23 May 2008 (UTC)
  • I agree with your peer reviewer that references don't belong in the head. Hopefully my reworking the head will take care of a lot of that, but you can help me by moving the references to the first place that those facts are stated in the article.
I did this, and I think I preserved all your references too! Not bad for someone who hates research. :) Livitup (talk) 20:32, 23 May 2008 (UTC)
  • From the first paragraph: "Oral herpes, colloquially called cold sores…" I think should read "Oral herpes, the visible symptoms of which are colloquially called cold sores…" Would that be more factually correct, as the sores themselves are not herpes per se, but symptoms of the viral infection?
I do not have any problem with your alternative so would support that change.~ Ciar ~ (Talk to me!) 17:11, 23 May 2008 (UTC)
Done. Livitup (talk) 20:32, 23 May 2008 (UTC)
  • End of the first paragraph: "Occasionally, these viruses reactivate and return to the area…" Occasionally is vague, can you quantify it at all?
This is a difficult thing to do - reactivation differs from individual to individual - some people have reactivations many times in a year, others never (noticeably) reactivate.~ Ciar ~ (Talk to me!) 17:11, 23 May 2008 (UTC)
Meh, I just cut the sentence. I cover the posibility in another statement, and you can delve more deeply into this in the relevant section. Livitup (talk) 20:32, 23 May 2008 (UTC)
  • Third paragraph: "developing countries, such as those in Sub-Saharan Africa…" and "industrialized countries like the United States and countries in Northern Europe…" I think calling out individual regions or countries isn't necessary and is probably even pejorative. Can we let the terms "developing countries" and "industrialized countries" stand on their own?
Yes, the regions are described in more detail further down the manuscript in the epidemiology section - perhaps this actual sentence (in a more elgeant form ;)) can be moved to the introductory statement for that section?~ Ciar ~ (Talk to me!) 17:11, 23 May 2008 (UTC)
Cut it for now, but I'll remember to make sure the intent is conveyed in the proper section. Livitup (talk) 20:32, 23 May 2008 (UTC)
  • Also in the third paragraph: "The risk of infection for HSV-1 is associated with lower standard of hygiene and a more crowded living environment." Lower than what? More crowded than what? Again, I fear POV influence with these statements.
Ahhh, this is getting into the risk assessment statements - they need work! So, I think this part is supposed to highlight that higher seroprevalence of HSV-1 is reported in groups that live in more crowded environments - the hygiene thing I'm not sure about. With the additional sentence closing out that paragraph, I think this sentence is actually redundant and may be removed - maybe another editor should comment.~ Ciar ~ (Talk to me!) 17:11, 23 May 2008 (UTC)
I agree, and I removed it. This goes along with the general theme of not cluttering the head with details, it's just a summary. You can cover that later in the epidemiology. Livitup (talk) 20:32, 23 May 2008 (UTC)

I will go ahead and make some minor edits to the prose, punctuation, and grammar, but will wait for your comments for the bigger edits. Livitup (talk) 16:18, 23 May 2008 (UTC)

Yay! Welcome Livitup!! I am glad you have arrived - the article is in dire need of copyediting! I've responded to some of your comments above - hopefully in a helpful way. There are some other editors that regularly come through here too, so maybe they'll add some comments too. Please, work your magic and if anything looks out of place, I'm sure we can communicate that with you here. Thanks. ~ Ciar ~ (Talk to me!) 17:11, 23 May 2008 (UTC)
*shy bow* Let me know what you think of what I did to the head and we'll progress from there. Livitup (talk) 20:32, 23 May 2008 (UTC)
Wow....how do you guys do that!!??! The intro is much improved and reads very smoothly - thanks! Looking forward to the rest :o) ~ Ciar ~ (Talk to me!) 21:20, 23 May 2008 (UTC)
  • Hi again. The section lead for disorders and orofacial herpes are done. I cut out a number of lines that dealt with seroprevalence in underdeveloped vs. industrialized nations. I think that discussion belongs soley in epidemiology. I'm saving everything I cut in a Word document, so I'll make sure all the things I cut end up back in the article at some point. I also trimmed a chunk out about how the virus goes latent in the nerves. Since this seems to be the case for all the disorders, I'll go back to the section head and add this information back in there, and clarify things for a particular disorder when needed. Let me know what you think! I'll try to get a handful more disorders done tomorrow. Livitup (talk) 20:08, 29 May 2008 (UTC)
  • Up to (but not including) Ocular herpes is done. Please give feedback. :) Livitup (talk) 20:20, 30 May 2008 (UTC)
    • Sorry my responses are taking so long. I'm a little swamped right now!! I rearranged one sentence a tiny bit, but everything else looks grand! I'm happy about you moving chunks of seroprevalence data into epidemiology - it would be much better placed in that section. I can see the same thing is needed for the neonatal section, which is getting a little long. Looking good so far Livitup. Thanks, I greatly appreciate the help!! ~ Ciar ~ (Talk to me!) 20:25, 2 June 2008 (UTC)
  • I've written articles about HIV for doctors, and I've written medical articles on other subjects for non-doctors.
My impression of the lead is that the vocabulary is too difficult for the ordinary reader. Believe it or not, there are intelligent, well-educated people who couldn't define "immunocompetent."
I even think the language is too complicated for doctors. The general medical journals would simplify that language, at least in some sections of the journal. (Why say "colloquially" instead of "commonly"?)
When I finish writing something, I go through it word by word, and ask myself, "Is there a more common word that would say the same thing?" Then I go through it sentence by sentence, and ask myself, "Can I rewrite this in a simpler sentence (or two simpler sentences) that would say the same thing?"
BTW, that last edit is incorrect -- about 1/5 of the population is infected with HIV, according to blood tests, although they don't always show symptoms (I guess the article didn't make clear the meaning of "seropositive.") Nbauman (talk) 15:28, 8 June 2008 (UTC)
Hi Nbauman, The article is still a bit substandard when you consider something for FA or real publication quality (and I can say that since I have done a lot of the poor hashing of it recently!) but Livitup is doing a great job whittling the excessive and redundant text down to something comprehensive. I think once that painful job is done, we can start looking at the "complete article" and assess its shortfalls as far as content and readability to a wide audience go. I think it would be great to have your expertise for this process if you are interested in helping out. As for the words you point out, yes, I agree "immunocompetent" is not a word in common use but we should probably introduce it somewhere in the article so readers begin to understand the terminology since it is used a lot around these disease articles on wikipedia. It is, at least, linked in the lead for the time being. Colloquially, however, I do not have a problem with, and have been using this word myself since I was a young teen - and believe me, I'm no English major :o). I think, since "commonly" is used in the following sentence, the word "colloquially" allows a little variation and makes the article read a little more interestingly, don't you think? The last comment you made, I'm uncertain how to answer - are you referring to the anonymous addition (and deletion) of "HSV" infection that occurred here?. Yeah, I can understand how the seroprevalence of HSV infection is confusing. I did begin to introduce that into the epidemiology section - but again, it is not great and needs some other eyes. The HSV seroprevalence/blood test data, I think gets confused by people working in non-herpes viruses - folks I know working in the field actually base the number of people infected with HSV as the same as people with antibodies against the viruses because HSV is not typically cleared from the body (it just hides) - so the difference we need to define and make clear is HSV antibodies may be the same as infection but is not an indicator of "active" disease. Of course, the 1 in 5 HSV positive people only reflects values in the United States - we need to keep this clear too and not give the article too much North American bias. If you have any suggestions on how to define this clearly, please, please, please add it - your contributions would be most welcome and I need all the help I can get!! Thanks, ~ Ciar ~ (Talk to me!) 18:46, 8 June 2008 (UTC)
Just to take one point -- I know that many people believe that variation makes writing more interesting to read, but I object to it in medical writing, where the most important goal is to be clear to the reader (who may be reading it alone at 2am in confusion and panic). In medicine, the terms are precise, and there's a big difference between "incidence" and "prevalence," for example. I try to be safe and use the same word that my source used, unless I'm very familiar with the subject. I once worked in a law firm, where the clear, precise meaning of the language was also very important (when somebody reads a will 20 years later, for example), and they always repeated the same word for the same concept.
Then there are foreign speakers. A recent article in the New Scientist pointed out that most people who use English are not native speakers. I know lots of native speakers of French and Norweigian who speak excellent English, but there are others who are still learning it or struggle with it. Sure, they know what "colloquially" means, or they can look it up, but the more syllables you have, and the less-common words you have, the more difficult it is to read. This is especially true when the reader has the burden of trying to understand technical information. When you add the burden of a less common vocabulary to that, it becomes much more difficult to understand. There actually is published research on this, but I think it makes intuitive sense too.
The best example of medical writing for the layman that I know of is the Merck Manual Home Edition. If you want to write clearly for the layman, read that and do what they do. That's what I do.
But even medical journals, like BMJ, edit their magazine to use simpler vocabulary. Even if you're a doctor and you know all this jargon, it's just easier to read simpler language. Nbauman (talk) 20:43, 8 June 2008 (UTC)

[edit] Virus active in saliva?

I didn't see any info on this in the article, but is the HSV-1 active in your saliva at the time of an outbreak or any other time? Most cold sores occur on or around the lips which would be close enough to your mouth to assume your saliva is infected, but if you have a cold sore under or in your nose, or on your cheek, would the virus be present in your saliva as well? Related, during asymptomatic shedding, would it also be present and active in your saliva? If it was in your saliva, then technically you would be able to spread it by coughing or sneezing on someone close enough to inhale the small particles. Is there any research on this anywhere? —Preceding unsigned comment added by 209.66.100.204 (talk) 16:45, 2 June 2008 (UTC)