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The Discovery of the 2009 A/H1N1 Pandemic - Mexico: April 17 New Respiratory Illnesses - Including Mexico City & Oaxaca

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  • The Discovery of the 2009 A/H1N1 Pandemic - Mexico: April 17 New Respiratory Illnesses - Including Mexico City & Oaxaca

    Mexico -



    Source: http://infominuto.com/index.php/al-m...hostipal-civil

    Descartan SSO brote epidémico en el Hospital Civil
    Escrito por Jesús OLMEDO
    Jueves 16 de Abril de 2009 13:59

    Los Servicios de Salud de Oaxaca (SSO) confirmaron la muerte de una persona en el Hospital Civil “Aurelio Valdivieso” a consecuencia de un padecimiento conocido como neumonía atípica, al tiempo que rechazaron que por ese motivo se haya montado un cerco sanitario en la zona, debido a que el mal nada tiene que ver con gripe aviar.


    En este sentido, la dependencia descartó que la muerte de esta mujer en el Hospital Civil, haya sido en condiciones provocadas por una epidemia, como lo señaló el director del nosocomio, Miguel Ángel Nakamura López, en rueda de prensa de esta mañana.

    El médico detalló que el deceso de la mujer procedente de la Sierra Norte de Oaxaca, según los exámenes de laboratorios hechos por especialistas en la materia, su muerte se debió a una neumonía atípica, al tiempo que aclaró que no se debió a ninguna epidemia.

    Señaló que por instrucciones del secretario de Salud, Martín Vásquez Villanueva, se establecieron puestos de controles necesarios dentro del nosocomio.

    Por su parte Vásquez Villanueva señaló que nunca se aplicó una cuarentena en el Hospital Civil "Aurelio Valdivieso" por el caso de la neumonía atípica, "los exámenes que enviamos a la ciudad de México resultaron negativos", sentenció el funcionario estatal.

    Explicó que el caso de neumonía atípica que provocó la muerte de una persona de la zona mixe no amerita el cerco sanitario debido a que se tomaron las medidas precautorias de manera inmediata como el hecho de que la mujer fue entubada y se le mantuvo en el área de especialidades restringida, por lo que no pudo propagarse el virus como trascendió.

    El responsable de los SSO dijo que la víctima estuvo todo el tiempo en un área de especialidad y no de adultos como se rumoraba en un principio, por lo que se le separó de otros enfermos y los empleados tenían conocimiento de la delicadeza del caso y como tal trataron a la paciente, “además de que estamos en contacto directo con todos los trabajadores”.
    Comentarios

    Google translation:

    SSO discarded outbreak in the Civil Hospital

    Health Services Oaxaca (SSO) confirmed the death of a person at the Civil Hospital "Aurelio Valdivieso" as a result of a condition known as atypical pneumonia, while rejecting it for that reason has mounted a siege on the area of health because the wrong has nothing to do with avian flu.


    In this sense, the unit denied that the death of this woman in the Civil Hospital, was caused by conditions in an epidemic, as noted by the hospital's director, Miguel Angel Nakamura Lopez, in a press conference this morning.

    The doctor said that the death of women from the Sierra Norte of Oaxaca, according to laboratory tests made by experts in the field, his death was due to an atypical pneumonia, while clarifying that was not due to any epidemic.

    He noted that on instructions from the secretary of Health, Martin Vasquez Villanueva, controls were established within the hospital needed.

    For its part Vasquez Villanueva said that was never implemented a quarantine in the Civil Hospital "Aurelio Valdivieso" in the case of atypical pneumonia, "the reviews sent to Mexico City were negative," the state official.

    He explained that the case of atypical pneumonia that killed one person in the area encircling the mixe is not warranted due to health precautionary measures were taken immediately to the fact that the woman was intubated and he was kept in the area narrow specialties, so could not spread the virus as it transpired.

    Responsible for the SSO said the victim was all the time in a specialty area, not adults as rumored at the beginning, it was separated from other patients and employees were aware of the sensitivity of the case and that treated the patient, "and that we are in direct contact with all workers."
    Last edited by sharon sanders; April 18th, 2009, 12:48 PM. Reason: added country name at top

  • #2
    Re: Mexico: Descartan SSO brote epidémico (neumonia atipica) en el Hospital Civil

    Mexico -


    Source: http://www.nssoaxaca.com/index.php/c...de-coronavirus

    Desmiente SSO contagio masivo de Coronavirus
    Escrito por Agueda Robles
    Jueves, 16 de Abril de 2009 12:49

    Oaxaca, Oax. Las pruebas realizadas por el Laboratorio de Virus del Instituto de Diagnóstico y Referencia Epidemiológicos, (InDRE), a las muestras tomadas a la paciente que falleció el pasado 13 de abril en el Hospital Civil Aurelio Valdivieso descartan que se trate de Coronavirus, por lo que no hay posibilidades de un contagio masivo de una enfermedad de "Síndrome Agudo de Respiración Severo", afirmó en conferencia de prensa el doctor Miguel Angel Nakamura López, Director de Prevención y Promoción de la Secretaría de Salud de Oaxaca.

    Reiteró que a la paciente que falleció por Neumonía atípica de 39 años de edad se le tomaron muestras que fueron analizadas y resultaron negativas a los seis estudios que se realizaron, por lo que la población puede estar tranquila.

    Nakamura López explicó que la paciente de quien pidieron omitir su nombre por respeto a sus familiares, llegó al hospital el 9 de abril luego de que desde el día dos estuviera atendiendo su padecimiento con médicos particulares. La mujer presentaba dos cuadros infecciosos, el respiratorio y el diarreico, este último le fue controlado tres días después, pero el cuadro respiratorio se complicó por la diabetes que padecía sin saberlo, falleciendo 5 días después de haber ingresado al hospital.

    Por la forma en que avanzó la enfermedad, mencionó el Director de Prevención y Promoción de Salud, se mandó a realizar una prueba que arrojó el resultado de un virus desconocido, ante estos hechos y para asegurar el diagnóstico, se enviaron las pruebas al InDRE y se dio aviso a las autoridades federales, mismas que dieron prioridad a los estudios que arrojaron un segundo resultado negativo al panel viral por inmunofluorescencia.

    Ante esta situación la Secretaría de Salud de Oaxaca (SSO), mantendrá vigilancia epidemiológica durante dos periodos de incubación de la enfermedad, lo que corresponde a 15 días por periodo, en las personas cercanas a la mujer fallecida, así como al personal del Hospital Civil.

    Por su parte el Director del Hospital Civil, Jesús Manuel Salcedo Cruz, dijo que el personal de este Instituto puede estar tranquilo ya que este fue un caso aislado que se presentó, y del cual se tomaron todas las medidas preventivas para descartar cualquier tipo de transmisión.

    Por la tarde el Secretario de Salud, Martín Vasquez Villanueva, realizó un recorrido por el área de urgencias del Hospital Civil "Aurelio Valdivieso" para conocer de primera mano la situación prevaleciente en el lugar y comprobar que no existe riesgo alguno ni para el personal que ahí labora, ni para los pacientes que son atendidos.

    Google translation:

    SSO denieth massive Coronavirus infection
    Written by Agatha Robles
    Thursday, April 16, 2009 12:49

    Oaxaca, Oax. Tests conducted by the Virus Laboratory of the Institute of Epidemiological Diagnosis and Reference, (Indre), the samples taken from the patient who died on April 13 at the Civil Hospital Aurelio Valdivieso discarded Coronavirus it is therefore there is no prospect of a massive infection from a disease of Severe Respiratory Acute Syndrome, "he said at a press conference Dr. Miguel Angel Lopez Nakamura, Director of Prevention and Promotion of the Ministry of Health in Oaxaca.

    He reiterated that the patient who died of atypical pneumonia by 39 years of age he took samples that were analyzed and were negative for the six studies that were conducted, so that people can be calm.

    Nakamura Lopez explained that the patient who asked not be named out of respect for his family, arrived at the hospital on April 9 after he was two days since taking your condition with physicians. The woman had two infections, the respiratory and diarrhea, the latter was controlled after three days, but the picture was complicated by respiratory diabetes without knowing that she had died 5 days after admission to hospital.

    By the way the disease progresses, referred to the Director of Prevention and Health Promotion, was sent to a test, giving a figure of an unknown virus, given these facts and to ensure diagnostic tests were sent to the Indre and was notified the federal authorities, which gave priority to studies that showed a negative result to the second panel viral immunofluorescence.

    In this situation the Ministry of Health in Oaxaca (SSO), maintain surveillance during two periods of incubation of the disease, which corresponds to 15 days per period, with close to the deceased woman and the staff of Civil Hospital .

    For its part, the Director of Civil Hospital, Salcedo Jesus Manuel Cruz, said that the staff of the Institute can rest easy because this was an isolated case that was presented, and which were taken all preventive measures to preclude any type of transmission .

    In the afternoon the Secretary of Health, Martin Vasquez Villanueva, conducted a tour of the area of Civil Emergency Hospital "Aurelio Valdivieso" to learn first hand the situation on site and verify that there is no risk to staff or working there, or for patients who are cared for.

    Comment


    • #3
      Re: Mexico: Descartan SSO brote epidémico (neumonia atipica) en el Hospital Civil

      Mexico -


      Source: http://www.tiempoenlinea.com.mx/

      '2009-04-18'
      Ni ‘gripe aviar’ ni emergencia epidémica en Oaxaca, aclara SSO
      Misael Sánchez / Tiempo

      [23:57] En Oaxaca no hay ninguna emergencia epidemiológica ni mucho menos algún caso de “gripe aviar” porque el diagnóstico del Instituto Nacional de Diagnóstico y Referencias Epidemiológicas (INDRE) a las muestras que se tomaron en el Hospital Civil “Dr. Aurelio Valdivieso” dio como negativo para virus que representan un peligro para la salud pública, dijo ayer el titular de los Servicios de Salud de Oaxaca, Martín Vásquez Villanueva.
      “Para fortuna de Oaxaca no fue un caso que implicara una emergencia epidemiológica”, apuntó luego de señalar que la cronología del hecho concluyó con los resultados negativos de las muestras que se realizaron en la capital del país.
      Rechazó que se hubiera registrado un caso de “gripe aviar” como se informó de manera irresponsable y dijo que todas las áreas del hospital continúan trabajando de manera normal.
      “Los más de 1 mil trabajadores del Hospital Civil están comprometidos con la sociedad oaxaqueña y así están laborando para brindar un servicio de calidad y calidez”, apuntó.
      Tras lamentar el deceso de la paciente de 39 años por neumonía atípica, dijo que los resultados negativos de los análisis que realizó el INDRE y también la Unidad de Inteligencia Epidemiológica en Salud, el Centro de Vigilancia Epidemiológica y Control de Enfermedades y el Instituto Nacional de Enfermedades Respiratorias permiten establecer que todo volvió a la normalidad en el Hospital Civil.
      Vásquez Villanueva realizó un recorrido por la zona de urgencias del nosocomio, acompañado de Jesús Manuel Salcedo, director del Hospital Civil “Dr. Aurelio Valdivieso” y aseguró que no existe ningún virus que ponga en riesgo la salud pública.
      Tras detectarse el caso de neumonía atípica en la paciente oaxaqueña, quien falleció en días pasados, las autoridades sanitarias reportaron que el cuadro fue atendido en la unidad médica de segundo nivel, donde la paciente reportó un cuadro diarreico y de diabetes que desconocía.
      Vásquez Villanueva dijo que ante la necesidad de salvaguardar el bienestar de la ciudadanía y, principalmente de los pacientes, en el Hospital Civil se implementaron todas las medidas de higiene y seguridad necesarias.
      Asimismo destacó que por instrucciones del gobernador Ulises Ruiz se mantiene una vigilancia que garantice que el nosocomio siga siendo una institución descartada como zona de riesgo.
      También dijo que las personas que estuvieron en contacto con la paciente que falleció están en observación para valorar su estado clínico y que será por un período de 15 días con el propósito de ratificar los resultados obtenidos en el INDRE y el Centro Nacional de Vigilancia Epidemiológica y Control de Enfermedades.

      Google translation:
      '2009-04-18 '
      Or 'bird flu' epidemic or emergency in Oaxaca, said SSO
      Misael Sánchez / Tiempo

      [23:57] In Oaxaca there is no epidemiological emergencies, much less a case of "bird flu" because the diagnosis of the National Institute of Epidemiological Diagnosis and Reference (Indre) on samples taken during the Civil Hospital "Dr. Aurelio Valdivieso "was negative for viruses as they represent a danger to public health, said the head of the Health Services in Oaxaca, Martin Vasquez Villanueva.
      "For good fortune of Oaxaca was not a case involving an epidemiological emergency," he said after noting that the timing of the event ended with negative results from samples which were held in the capital.
      Denied that had been registered a case of "bird flu" as reported in an irresponsible manner and said that all areas of the hospital continue to work as usual.

      "More than 1 thousand workers of Civil Hospital are committed to the Oaxacan society and are working to provide quality service and quality," he said.
      After lamenting the death of the patient of 39 years for SARS, said the negative results of the analysis performed INDRE and Epidemiological Intelligence Unit in Health, the Center for Epidemiological Surveillance and Disease Control and the National Institute of Respiratory diseases can be established that everything returned to normal in the Civil Hospital.
      Vasquez Villanueva conducted a tour of the emergency hospital, accompanied by Jesus Manuel Salcedo, director of the Hospital Civil "Dr. Aurelio Valdivieso "and said that there is no virus to jeopardize public health.
      Detected after the case of atypical pneumonia patients in Oaxaca, who died in recent days, health authorities reported that the painting was treated in the medical unit of the second level, where the patient reported diarrhea, and a table of known diabetes.
      Vasquez Villanueva said that the need to safeguard the welfare of the citizenry and, most of the patients at the Civil Hospital were implemented all the measures of hygiene and security.
      They also pointed out that on the instructions of Governor Ulises Ruiz remains vigilance to ensure that the hospital still discarded as a risk area.
      He also said that people who were in contact with the patient who died under observation to assess their clinical status and will be for a period of 15 days for the purpose of ratifying the results obtained in the Indre and the National Epidemiological Surveillance and Disease Control.

      Comment


      • #4
        Re: Atypical Pneumonia Cases - Various Countries

        Mexico, Oaxaca

        17/04/2009, 05:04:08 AM

        Out emergency
        Health Services in the State, denied that there is bird flu or health emergency at the hospital "Dr. Aurelio Valdivieso ", but damned if the doubts, and to strengthen epidemiological surveillance, after the death of a woman by atypical pneumonia. The patient had an episode of atypical respiratory infection that resulted in less than a week an acute pneumonia, which caused the death of a woman 39 years of age. After the laboratory analysis was negative in two tests that have serious cronavirus virus that causes severe acute syndrome or avian flu.

        http://74.125.93.132/translate_c?hl=...EK1lJ5KayMTJZQ

        Comment


        • #5
          Re: Atypical Pneumonia Cases - Various Countries

          Source: http://www.tiempoenlinea.com.mx/

          Google translation:

          Atypical confirm Neumanía
          Ivan Castellanos / Time

          [08:28] The Chief of Epidemiology of the Health Services of Oaxaca (SSO), Ruben Coronado García, denied that there are cases in the state of coronavirus or avian flu, following the case of atypical pneumonia that was presented at the Civil Hospital "Aurelio Valdivieso".
          She told the media the epidemiological and clinical procedures were carried out since the submission of this case, which ruled out any contagious disease, which was analyzed and confirmed by the National Institute of Epidemiological Diagnosis and Reference (Indre) in the capital.

          In this sense, the patient said Adela María Gutiérrez Cruz 39 years of age, who presented the atypical pneumonia, the illness was two in April, but was hospitalized until the same nine months, with a table that was complicating respiratory .
          He noted that this was presented at a hospital with pneumonia declared, and in addition to these symptoms, and had difficulty breathing, coupled with this, I had a picture of diarrhea, and diabetes that had not been diagnosed.
          Since that time had already begun the process of investigation to determine which was the cause of his condition and to identify the disease that plagued.
          However, they took their samples to be analyzed in a laboratory that does not have regulations that are required for this type of study, thus, the result was that the patient had an unknown virus, which, to be confirmed two days later was presented as negative.
          "However, samples were sent to the National Institute of Epidemiological Diagnosis and Reference in the capital, where he performed analysis of influenza type A and B, influenza 1, 2, 3, respiratory syncytial virus, Adenovirus, Influenza type A and B under the RT-PCR and Metapneumovirus, where all were negative, "said Garcia Coronado.
          Detailed studies that were conducted for those who attended the hospital in direct contact with this person who lost his life to have low defenses, which were also presented 16 boxes of respiratory infection, but were considered by physicians as normal and some of them, and presented before entering the patient.
          It also investigated the contacts he had outside the hospital, which amounted to about 300 people of which were detected around 36 tables with respiratory infection, which are under observation.

          "Without any fear we can say that no coronavirus or avian influenza as noted, the general population may be quiet, the Secretary of Health, Martin Vasquez Villanueva visited the area where the patient was without any problem," said Chief of Epidemiology of SSO.

          Comment


          • #6
            Alert: Possible atypical pneumonia outbreak in Oaxaca

            http://www.diariodespertar.com.mx/Ag...tal-Civil.html

            The above article (in Spanish) seems to indicate that there is a nasty outbreak going on in this hospital in Oaxaca. There appear to have been at least two deaths (and the timing from other articles seems to indicate that they are too close together to have infected each other). Several other hopsital workers are ill. Some sources have mentioned a third death in another hospital. Other sources have mentioned that in a preliminary test that 39 year old woman tested positive for a coronavirus, but then later negative by PCR for SARS. I fear a new novel coronavirus. I can't believe I am the only one who is reading this...

            Comment


            • #7
              Re: ALERT: Possible nasty SARS-like outbreak in Oaxaca

              I am only a concerned lay reader. I need the help of all of you to alert the possible authorities (WHO?) and get this outbreak contained. I have read other sources on this (try googling any combination of the name of the hospital: Aurelio Valdivieso, the words oaxaca, neumonia, etc.). I have been reading this articles for about four days and cannot believe there hasn't been a huge alert.

              Comment


              • #8
                Re: ALERT: Possible nasty SARS-like outbreak in Oaxaca

                There was a case of atypical pneumonia at that hospital. According to news article I have read, there is no epidemic there:
                http://www.flutrackers.com/forum/sho...light=atypical

                In fact there is a avian flu workshop going on there at the moment:

                http://www.flutrackers.com/forum/showthread.php?t=99752

                Comment


                • #9
                  Re: Alert: Possible nasty SARS-like outbreak in Oaxaca

                  http://www.diariodespertar.com.mx/Ag...tal-Civil.html

                  Look at that link (its in Spanish). The hospital workers say there have been at least two deaths, and a few others are ill. The hospital has been closed for disinfecting. Other sources indicate that the second death occurred before 4/16 (it was first reported then), and that a lot of contacts (36 from before she was hospitalized, and 16 HCW) have respiratory symptoms. And the end of that article mentions that two of the hospital workers are in bed (admitted).

                  Comment


                  • #10
                    Re: Alert: Possible atypical pneumonia outbreak in Oaxaca

                    http://www.adnsureste.info/index.php?news=11747

                    This article mentions the two deaths in the hospital, but also mentions a thrid on in ISSSTE, something I haven't read in any other source.

                    Comment


                    • #11
                      Re: Alert: Possible atypical pneumonia outbreak in Oaxaca

                      http://www.diariodespertar.com.mx/Ag...Sanitaria.html

                      This article from 4/16 already mentions a second death. That's why I think the two deaths are too close together to be transmission from on to the other, and why I fear a large outbreak.

                      Comment


                      • #12
                        Re: Alert: Possible atypical pneumonia outbreak in Oaxaca

                        SOurce: http://www.diariodespertar.com.mx/Ag...tal-Civil.html

                        This is a translation:
                        Tense calm anxiety and deprive the Civil Hospital
                        20/04/2009 04:00:00 Juan Carlos Zavala
                        Font Size: Decrease font Enlarge font
                        Relatives of inmates image in the Civil Hospital in the waiting room.

                        Executives deny that there is an emergency, but at least 16 workers have respiratory infections


                        After the health alert issued at the Civil Hospital "Dr. Aurelio Valdivieso "by the alleged existence of a deadly virus or bacteria, everyday tasks run in a climate of apparent calm.
                        The area remains closed and Emergencies Adults remain so for at least 15 days due to a "process of pre-cleaning and disinfection," scheduled for two weeks, according to the circular signed by the head of the Equality Unit Medical Care, Liliam Irasema Pérez García, and dated last April 15.
                        In "The house, a larger room to meet people who require emergency department when it is saturated, only two patients.
                        In the waiting room, who have relatives in internal Pediatric Emergency ensures that no one has said anything about who should take precautions against possible contagion, although they have been witness to the thorough cleaning in the hospital in recent days.

                        Concern among workers
                        In this regard, a hospital worker who requested anonymity, felt it unfair that their managers are not clear on the information provided them about the case of women of 39 years who died on April 13, five days after admission, presume pneumonia. According to the official versions, died of atypical pneumonia, with viruses or bacteria that caused it is still unknown.
                        According to the director of Promotion and Prevention Health Services Health Oaxaca (SSO), the woman was admitted to hospital with a picture of pneumonia advanced, because the symptoms were six days before admission: she had diarrhea and was detected diabetes, a disease that was never treated.
                        He insisted that the death was caused by an atypical pneumonia, which is considered because the clinical picture of this disease out of the normal fee is, usually, the evolution of the disease is later, but in eight days she developed the disease.
                        So far, the SSO argue that there is only one death from this cause, and no infections were detected between the medical staff or close contacts such as family members and colleagues of the deceased. And denied that the mild respiratory infection presenting 16 employees of the hospital has no connection that might indicate an infection.
                        However, some hospital doctors say that there are at least another death from the same cause, a doctor and a nurse in bed, and still fear for the possible presence of a virus or bacterium deadly consequences.

                        Comment


                        • #13
                          Re: Alert: Possible atypical pneumonia outbreak in Oaxaca

                          Perhaps someone can submit the above article(s) to Pro-med?

                          Comment


                          • #14
                            Re: Alert: Possible atypical pneumonia outbreak in Oaxaca

                            I tried to, but I don't know if it worked. I've never submitted to ProMed or this forum before (that's where the four day delay came from), but the fact that no one else was reading what I was caused me to act. I would greatly appreciate everyones help in getting to the bottom of this and stopping this outbreak.

                            Comment


                            • #15
                              Re: Atypical Pneumonia Cases - Various Countries

                              [just putting this here to keep it all together]

                              Oaxaca recorded 216 thousand cases of Acute Respiratory Infections


                              Most are caused by viruses: SSO

                              Source: Yadira SOSA
                              Date: 2009-04-20 06:04:46


                              Oaxaca is in the place of the 22 national board of Acute Respiratory Infections (ARI) with 215 thousand 815 cases so far this AOO. For the position it occupies in the country, considering the number of people n ˙.

                              ÏThe most of the IRA are caused by viruses. In the state records annually m s of 800 thousand cases, of which 5 thousand was complicated with pneumonia, as in the case ocurriÛ Hospital Valdivieso, recientementeî, in an interview seÒalÛ Miguel ngel! LÛpez Nakamura, director of PrevenciÛn and PromociÛn of Health in the state.

                              In the alert emitiÛ the Ministry of Health at the national level, which asegurÛ seasonal influenza cases has tripled in the country, in Oaxaca afirmÛ ˙ n number of cases did not represent any warning, any time you are within the framework of expectations.

                              Adem s, he said, ìOaxaca participates in the international monitoring system for monitoring epidemiolÛgica influenza virus, there are two centers in the city that will send samples to National Reference DiagnÛstico and EpidemiolÛgicos because the World Health OrganizaciÛn A monitoring in all countries, to produce the vaccine that is used from October to diciembreî.

                              ExplicÛ that seasonal influenza is a benign disease such as colds ÏThe com ˙ ni, but has the feature table is ÏThe m s severoî. The symptoms are pain sicos cl headache, high fever, pain in the ˙ m sculos and joints, and sometimes bleeding from the nose.

                              Does also may complicate infecciÛn an aggregate that can lead the patient to a pattern of severe pneumonia, and can lead to death. But under normal conditions of attention, with the general care given, the box is benignoî influenza, said.

                              Of cases of influenza in the state, Nakamura LÛpez seÒalÛ that cases of acute respiratory infecciÛn, but no diagnÛstico etiolÛgico. Does looking in the etiology of acute respiratory infecciÛn, in the case of neumonÌaî, puntualizÛ.

                              Noticia descargada del Imparcial en linea (www.imparcialenlinea.com) el dia 20/04/2009, 04:19:44 PM

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