Cambodia: Ministry of Health announces H5N1 bird flu in a 21-year-old woman & 4 year old female in Kampot province - November 24+, 2023​

[Shiloh]

Source: https://www.khmertimeskh.com/501397...lu-in-a-21-year-old-woman-in-kampot-province/


November 24, 2023
Ministry of Health announces H5N1 bird flu in a 21-year-old woman in Kampot province​


The Ministry of Health, on Nov 24, announced the positive detection of the H5N1 bird flu virus in a 21-year-old woman in Dong Tong district, Kampot province.

The discovery was made when the patient became ill on November 19, 2023, and was brought to the Khmer-Soviet Friendship Hospital on November 23, 2023, with respiratory symptoms including fever, shortness of breath, and cough. The patient is currently being treated in the emergency room by a team of doctors.

According to the Ministry of Health, inquiries show that about a week ago, there were a series of dead chickens at home and in the village.​..

 

[Michael Coston]

https://www.facebook.com/photo/?fbid=750613090428790&set=pcb.750613113762121

​

Translation from the Cambodia MOH Facebook Posting

Kingdom of Cambodia, Nation, Religion, King
Ministry of Health
Press Release

On cases of bird flu in 21-year-old women

The Ministry of Health of the Kingdom of Cambodia would like to inform the public that there is another case of bird flu in a 21-year-old woman and was confirmed positive for the H5N1 bird flu virus from the National Institutes of Health. Public and Institut Pasteur du Cambodge on November 23, 2023, residing in Trapeang Russey village, Damnak Sokrom commune, Dong Tong district, Kampot province. According to the investigation, about a week ago, there were a series of dead chickens at home and in the village. The patient became ill on November 19, 2023, then developed respiratory symptoms, including fever, dyspnea and cough, and was rushed to the Khmer-Soviet Friendship Hospital on November 23, 2023. The patient is currently in the emergency room with intensive care by a team of doctors.

On the night of November 23, 2023, the emergency response teams of the Ministry of Health at the national and sub-national levels were working with the working group of the Ministry of Agriculture, Forestry and Fisheries and the Ministry of Environment to investigate the outbreak of this bird flu and Respond to methods and technical protocols to find sources of transmission in both animals and humans, and continue to search for suspected and affected cases to prevent transmission to others in the community, and distribute Tamiflu to You are closely involved and campaigning for the health of the people in the village where the incident took place.

The Ministry of Health would like to remind all citizens to always pay attention to avian influenza because H5N1 avian influenza continues to threaten the health of our people and also would like to inform you if there is a fever. Do not cough or have difficulty breathing or have health problems. Do not go to crowded places or towns and seek consultation and treatment at the nearest health facility on time.

 

[sharon sanders]

Updated: FluTrackers 2016+ Global H5N1 Human Cases List​

 

[Treyfish]

Bird Flu Strikes Woman in Kampot province

PHNOM PENH – A 21-year-old woman in Kampot province tested positive for the H5N1 bird flu on Nov. 23. The Ministry of Health said the patient showed symptoms four days earlier.
....
The patient said many chickens had died near her house in Trapeang Russey village in Kampot province a week before she showed symptoms.
The ministry said working groups at national and sub-national levels had been working with experts from the Ministry of Agriculture, Forestry and Fisheries to research the case and respond with technical and scientific measures to find the source.
Experts are looking out for suspicious cases and people who are infected to prevent its spread in the community and to treat victims with Tamiflu medication.
The ministry says people with symptoms should keep away from crowded areas and see a doctor quickly.

This year, three H5N1 bird flu cases have been found in Cambodia. In February, an 11-year-old girl died in Prey Veng province in the first case in nine years. The second was the girl’s father, who tested positive but showed no symptoms.

In October, the third case was a two-year-old girl, also from Prey Veng province.

..
“To prevent infection, the ministry urges the public to wash their hands often with soap before eating and after touching birds,” the ministry said.

“Children must stay far away from birds, and birds must be far from homes. People must not consume ill or dead birds and chicken must be cooked properly.”
The ministry urged the public to be more cautious of the H5N1 bird flu and the harm it causes.

For up-to-date information, contact the Ministry of Health at 115 or 012 488 981/012 836 868.
​:tiphat: https://cambodianess.com/article/bird-flu-strikes-woman-in-kampot-province​​​​​​

 

[Treyfish]

Third Bird Flu Case Reported in Two Months

• Posted Nov 24, 2023 14:24 by Saroeun Phallika

.....The Ministry of Health reminded citizens to be vigilant about monitoring symptoms like fever, cough or difficulty breathing which could indicate a bird flu infection. Those with symptoms should seek timely consultation and treatment at the nearest health facility. While spreading the virus from human to human is rare, the Ministry said those with symptoms should not attend gatherings or travel to highly-populated towns.

This is the 60th case of bird flu reported in Cambodia since 2005, 40 of which have been fatal. Last month, two Cambodians died from bird flu infections including a 2-year-old girl and a 50-year-old man in Prey Veng and Svay Rieng Provinces respectively.
​:tiphat: https://eacnews.asia/home/details/26548

 

[Michael Coston]

Cambodian MOH Announces Another H5N1 Case (4 y.o. girl)

#17,781

In the past hour the Cambodian MOH has announced the second H5N1 case from Kampot Province, which follows yesterday's announcement of the infection of a 21 y.o. female. This latest case was apparently discovered during a canvassing of the neighborhood, as she lives next door to the first case.

This is the 6th case reported in Cambodia in 2023, which comes after going 9 years with a case. Two cases were reported last February, while the 3rd and 4th cases were reported in October.​

The first four cases were confirmed to have been from H5N1 clade 2.3.2.1c - an older lineage of avian flu which predates our current clade 2.3.4.4b epizootic - and it is likely (but not confirmed) that these latest cases belong to that same clade.

What we know at this time comes from the following announcement from the Cambodian MOH Facebook page.



The translation follows:

Kingdom of Cambodia, Nation, Religion, King
Ministry of Health
Press Release

Cases of bird flu in 4-year-old girls


The Ministry of Health of the Kingdom of Cambodia would like to inform the public that there is another case of bird flu in a 4-year-old girl and was confirmed positive for H5N1 bird flu virus (H5N1) from the National Institute. Public Health and Institut Pasteur du Cambodge on November 24, 2023, residing in Trapeang Russey village, Damnak Sokrom commune, Dong Tong district, Kampot province.

The case of the girl above the house next to the case of a 21-year-old woman who issued a press release on November 24, 2023, which was found through an active search in the village by the National Emergency Response Team. And the sub-national level of the Ministry of Health, the Ministry of Agriculture, Forestry and Fisheries, and the Ministry of Environment, local authorities at all levels, and the police.

According to inquiries, she was carrying a dead chicken and began to get sick on November 23, 2023, with respiratory symptoms including fever, cough and rash. The child was treated with Tamiflu and was Sent for treatment and care at Kampot Provincial Hospital on November 25, 2023. The patient is currently receiving intensive care by a team of doctors.

National and sub-national emergency response teams of the Ministry of Health have been cooperating With the working group of the Ministry of Agriculture, Forestry and Fisheries and the Ministry of Environment, local authorities at all levels, the police and partner organizations continue to actively investigate the occurrence of the two types of bird flu that have occurred and respond to Methods and technical protocols Continue to search for sources of transmission in both animals and humans, and continue to search for suspected and affected cases to prevent transmission to others in the community, as well as distribute Tamiflu to close contacts and Conduct a health education campaign for the people in the village where the incident occurred.

The Ministry of Health would like to remind all citizens to always pay attention to avian influenza because avian influenza (SN) continues to pose a threat.

To the health of our people, and also please tell you if you have a fever, cough, runny nose or difficulty breathing and have a history of contact with chickens, ducks, sick or dead during the 14 days before the onset of symptoms, please do not go to the meeting or go Cities that are crowded and need to seek consultation and treatment at the nearest health center as soon as possible.

Transmission: H5N1 bird flu is a flu virus that is usually transmitted from sick birds to other birds, but can sometimes be transmitted from birds to humans through close contact with sick or dead birds. Avian influenza in humans is a serious disease that requires timely hospitalization. Although it is not easily transmitted from person to person, if it can metabolize it can be as contagious as the seasonal flu.

Preventive measures: The government's educational message includes: Wash your hands often with soap and water before eating and after contact with birds, keep children away from birds and keep birds away from living, do not eat birds. Sick or dead and all birds made for eating must be well cooked.

The Ministry of Health will continue to inform the public about information related to public health issues through the Telegram Channel and the official Facebook page of the Ministry of Health, as well as the official Facebook page of the Department of Infectious Diseases and the website www.cdcmoh.gov.kh, which has Health education materials that can be downloaded, viewed and used. For more information, please contact the Ministry of Health Hotline 115 for free.

Saturday, the 13th day of the lunar month of Thao Panchasak, BE 2567, Phnom Penh, November 25, 2023​

Although we aren't seeing any evidence of sustained or efficient human-to-human transmission of H5N1, this recent uptick warrants our attention. The more times the virus spills over into humans, the more opportunities it will have to `figure us out', and better adapt to a human host.

Obviously, with two cases reported in two days, we'll be watching this part of the world closely for the next couple of weeks.​

Stay tuned.

https://afludiary.blogspot.com/2023/11/cambodian-moh-announces-another-h5n1.html



​

 

[sharon sanders]

Erik Karlsson
@E_A_Karlsson
Sequences from the first case of #H5N1 #avianflu from Kampot are available on
@GISAID
(EPI_ISL_18540514). As always, this has been an incredible effort by a number of people:
6:36 AM · Nov 25, 2023
​

 

[sharon sanders]

Please see:

Updated - FluTrackers 2016+ Global H5N1 Human Cases List​

 

[Pathfinder]

Translation Google

Nearly 100 chickens killed after villagers contracted bird flu in Dang Tong district

NOV 25, 2023

By: Bokor / Kampot: Throughout the day of November 24, 2023, professional officers educated and killed nearly 100 chickens in Trapeang Russey village, Damnak Sokrom commune, Dong Tong district after a citizen became infected with bird flu.

Mr. Meng Santepheap, Director of Production and Veterinary Office of Kampot Provincial Department of Agriculture, said that after receiving information from local officials on the incident of chickens and ducks and the press release of the Ministry of Health about the case of people living in Trapeang Russey village, Damnak Sokrom commune, Dang Tong district. On the morning of November 24, he led his subordinates to the target immediately. Throughout the day, professional officials, in cooperation with local authorities, educated, instructed and disseminated to the people, as well as sprayed disinfectants to prevent the spread of the disease.

The head of the office said that with this, the team also killed 91 diseased chickens and dug and buried very carefully. Those benefits will be offset by the return of poultry after the bird flu situation has calmed down.

According to the villagers, about a week ago, in Trapeang Russey village, Damnak Sokrom commune, Dong Tong district, chickens and ducks started to get sick and died until almost every family was out of cages. With that, a woman over 20 years old took a dead chicken to cook and then feeling unwell went to buy medicine. The same source continued that because the situation did not improve, the villagers also advised to see a doctor in Chhouk district and was sent to Phnom Penh. Later, the news that this woman was infected with bird flu shocked and frightened the villagers.

https://www.rasmeinews.com/archives/874373

-----------------------------------------------

​Another bird flu was found in a 4-year-old girl living in Trapeang Russey village, Damnak Sokrom commune, Dang Tong district, Kampot province.

NOV 25, 2023

By: Tep Mongkul / Phnom Penh: The Ministry of Health issued a press release on November 25, 2023 on the case of bird flu in a 4-year-old girl living in the village. Trapeang Russey, Damnak Sokrom Commune, Dang Tong District, Kampot Province.

The Ministry of Health of the Kingdom of Cambodia would like to inform the public that there is another case of bird flu in a 4-year-old girl. And confirmed that the H5N1 bird flu virus is positive from the National Institute of Public Health and the Institut Pasteur du Cambodge on November 24, 2023. Residing in Trapeang Russey village, Damnak Sokrom commune, Dang Tong district, Kampot province.

The case of the above girl has a house next to the case of a 21-year-old woman who issued a press release on November 24, 2023, which was found through Active search in the village was carried out by a joint emergency response team from the national and sub-national levels of the Ministry of Health, the Ministry of Agriculture, Forestry and Fisheries and the Ministry of Environment, local authorities at all levels. Class and Police. According to interrogation, she was holding a dead chicken and started to get sick on November 23, 2023 with respiratory symptoms including fever, cough and rash. Received treatment with Tamiflu and was sent to Kampot Provincial Hospital for examination and care on 25 November. 2023. The patient is currently receiving intensive care from a team of doctors.
...

https://www.rasmeinews.com/archives/874561

 

[Shiloh]

Source: https://www.khmertimeskh.com/501398...sts-positive-for-bird-flu-in-kampot-province/

November 26, 2023
Ministry of Health confirms girl, 4, tests positive for bird flu in Kampot province
Nang Veasna / Khmer Times​

The Ministry of Health of the Cambodia confirmed today that a four-year-old girl from Kampot province has been tested positive for H5N1 bird flu virus.

The girl hails from Trapeang Russey village of Damnak Sokrom commune in the Dong Tong district of Kampot province.

According to authorities, the girl fell ill after carrying a dead chicken on her hands and is suffering from fever and cough, the initial symptoms of bird flu.

She was shifted to Kampot Provincial Hospital yesterday and has been receiving treatment since then under the care of a team of doctors. The girl’s mother was allowed to accompany her to the hospital.

The Ministry of Health at the national and sub-national levels is cooperating with the working groups of the Ministry of Agriculture, Forestry and Fisheries and the Ministry of Environment, and local authorities to find suspected cases of bird flu in the province.

The health authorities have also distributed Tamiflu to close the close contacts of the girl and her family and conducting health education campaigns in the affected villages...


​

 

[Shiloh]

Source: https://www.postkhmer.com/national/2023-11-26-1534-256315

Another case of bird flu in a girl was found in Kampot province
National News
Release Date: November 26, 2023 | 15:27
Reporter: Phnom Penh Post


Phnom Penh: The Ministry of Health on November 25 announced that there is another case of bird flu in a 4-year-old girl and confirmed that the virus is positive H5N1 bird flu from the National Institute of Public Health and the Institut Pasteur du Cambodge on November 24, 2023 in Trapeang village or Ssey, Damnak Sokrom commune, Dang Tong district, Kampot province.

The Ministry confirmed that the case of the girl above the house next to the case of a 21-year-old woman who issued a press release on November 24. 2023, discovered through active search in the village, triggered by a joint national and sub-national emergency response team of the Ministry of Health, Ministry of Agriculture and Forestry And the Ministry of Fisheries and the Ministry of Environment, local authorities at all levels, and the police.

According to inquiries, she was carrying a dead chicken and started to get sick on November 23, 2023, with respiratory symptoms including fever, cough and rash. Red children receive treatment with Tamiflu and are sent to Kampot Provincial Hospital for further treatment and care. November 25, 2023 The patient is currently receiving intensive care from a team of doctors.​

 

[Michael Coston]

WHO DON Update On 2 Cambodian H5N1 Cases

#17,789

Last Friday and Saturday the Cambodian MOH announced their 5th and 6th human H5N1 infections of 2023 - all of which come after 9 years without reporting a single case. Other than their ages, and gender (female), and the fact that they lived in close proximity to each other, we haven't had much in the way of details.

Today we learn that the first case - a 20-25 year old woman - has died, while the 4 year-old neighbor remains hospitalized. The virus - as expected - belongs to H5N1 clade 2.3.2.1c - an older lineage of avian flu which predates our current clade 2.3.4.4b epizootic​

While human-to-human transmission cannot be ruled out, it is likely both shared a common exposure to infected poultry. So far, most of the nearly 900 cases of H5N1 in humans over the past 20 years appears to have come from direct or indirect contact with infected bids.

Excerpts from the WHO DON report follow:

Avian Influenza A (H5N1) - Cambodia
29 November 2023

Situation at a Glance​

Between 24 and 25 November 2023, the Ministry of Health of Cambodia notified WHO of two confirmed cases of human infection with influenza A(H5N1) from the same village in Kampot Province. Both cases were female, one in the 20-25 years age group and the other less than five years old. The first reported case visited a public hospital four days after having symptoms of fever, shortness of breath and cough. Samples were collected, which tested positive for H5N1, and the case died while in hospital. The second reported case was detected during enhanced surveillance by the public health authorities in response to the confirmation of the first reported case. The case had fever, cough and rash and is currently being treated in hospital. Epidemiological investigation shows both cases had exposure to backyard birds, which were reported to be sick, with some having died, over the prior month. The Ministry of Health's national and sub-national rapid response teams are investigating the source of the infection and coordinating response activities, including but not limited to active surveillance for additional cases, identifying close contacts for monitoring, and conducting health education campaigns to prevent transmission in the community. In total, six cases of influenza A(H5N1) have been reported from Cambodia this year. Influenza A(H5N1) infection in humans can cause severe disease, has a high mortality rate, and is notifiable under the International Health Regulations (2005).​

Description of the Situation

The Ministry of Health of Cambodia notified WHO of two confirmed human cases of influenza A (H5N1) between 24 and 25 November 2023. The cases resided in the same village in Kampot Province. Both cases were females, one in the age group of 20-25 years and the other less than 5 years old.

The first reported case developed fever, cough and shortness of breath on 19 November 2023, was treated at home for several days, and then visited a hospital on 23 November. At the hospital, samples were collected and transported to the National Institute of Public Health for testing and was subsequently confirmed as influenza A(H5N1) by RT-qPCR assays at the National Laboratory at National Institute of Public Health and reconfirmed by Institute Pasteur du Cambodge. The case was admitted and in intensive care at the hospital and passed away on 26 November 2023.​

The second reported case was detected during active surveillance in response to the first reported case, for additional cases with clinical presentation including fever, cough and rash. The case was transported to hospital on 25 November 2023 for testing with samples returning positive for influenza A(H5N1) by RT-qPCR assays at the National Laboratory at National Institute of Public Health and reconfirmed by at the Institute Pasteur du Cambodge. The case is currently admitted in an isolation room in the respiratory ward of the hospital and undergoing treatment. Epidemiological investigation shows both cases had exposure to backyard birds which were reported to be sick and dead, over the past month. No epidemiological linkage of these cases has yet been confirmed other than that they both resided in the same village.

Laboratory investigation shows the viruses, as indicated by phylogenetic analysis, fall within the H5 clade 2.3.2.1c with close similarity to the viruses that have been circulating in Cambodia and Southeast Asia since 2013-2014. The sequences cluster most closely with the viruses from the two human cases reported in October 2023.​

(SNIP)​

WHO Risk Assessment

From 2003 to 27 November 2023, a total of 882 human cases of infection with influenza A(H5N1), including 461 deaths, have been reported globally from 23 countries. Almost all cases of human infection with avian influenza A(H5N1) have been linked to close contact with infected live or dead birds, or influenza A(H5N1)-contaminated environments. Based on evidence so far, the virus does not infect humans easily and spread from person-to-person appears to be unusual. Human infection can cause severe disease and has a high mortality rate. Since the virus continues to circulate in poultry, particularly in rural areas in Cambodia, the potential for further sporadic human cases can be expected.

In these two cases, while human-to-human transmission cannot be ruled out, it is likely there were separate exposures to the viruses from sick and dead chickens.

In the past, small clusters of A(H5) virus infections were reported, including those involving health care workers, but without evidence of sustained human-to-human transmission. Available epidemiological and virological evidence suggests that A(H5N1) viruses have not acquired the ability to sustain transmission among humans. Therefore, the likelihood of sustained human-to-human spread is low. Based on available information so far, WHO assesses the risk to the general population posed by this virus to be low. The risk assessment will be reviewed as needed if additional information becomes available.

Close analysis of the epidemiological situation, further characterization of the most recent influenza A(H5N1) viruses in both human and poultry populations, and serological investigations are critical to assess associated risks to public health and promptly adjust risk management measures.

There are no specific vaccines for influenza A(H5N1) in humans. However, candidate vaccines to prevent influenza A(H5) infection in humans have been developed for pandemic preparedness in some countries. WHO continues to update the list of zoonotic influenza candidate vaccine viruses (CVV) selected twice a year at the WHO consultation on influenza virus vaccine composition. The list of such CVV is available on WHO website. In addition, the genetic and antigenic characterization of contemporary zoonotic influenza viruses are published on the Global influenza programme, human-animal interface website.​

WHO Advice

This event does not change the current WHO recommendations on influenza surveillance and public health measures.

Given reports of sporadic influenza A (H5N1) cases in humans, outbreaks in mammals, the widespread circulation in birds and the constantly evolving nature of influenza viruses, WHO continues to stress the importance of global surveillance to detect and monitor virological, epidemiological, and clinical changes associated with emerging or circulating influenza viruses that may affect human (or animal) health and timely virus sharing for risk assessment.

The public should avoid contact with high-risk environments such as live animal markets/farms and live poultry, or surfaces that might be contaminated by poultry droppings. Additionally, it is recommended to maintain good hand hygiene with frequent washing or the use of alcohol-based hand sanitizer.

The general public and at-risk individuals should immediately report instances of sick or unexpected deaths in animals to veterinary authorities. Consumption of poultry or wild birds that are sick or have died unexpectedly should be avoided.

Any person who has had exposure to potentially infected birds or contaminated environments and feels unwell, should seek health care promptly and inform their healthcare provider of their possible exposure.

WHO advises against implementing any travel or trade restrictions based on the current information available on this event. WHO does not advise special traveler screening at points of entry or other restrictions due to the current situation of influenza viruses at the human-animal interface.

State Parties to the International Health Regulations (2005) are required to immediately notify WHO of any laboratory-confirmed case of a recent human infection caused by a new subtype of influenza virus. Evidence of illness is not required for this notification.​

​

https://afludiary.blogspot.com/2023/11/who-don-update-on-2-cambodian-h5n1-cases.html

 

[Shiloh]

Source: https://www.khmertimeskh.com/501399369/bird-flu-alert-in-kampot/

November 30, 2023
Bird flu alert in Kampot
Hang Punreay / Khmer Times​

Authorities have stepped up the search for bird flu cases in Kampot province following two recent infections in Dang Tong district.

The latest victims were a 21-year-old woman, who subsequently died, and a four-year-old girl from Trapaing Russey village in Damnak Sokrom commune.

The Ministry of Health announced on Saturday that national and sub-national authorities are working with the Ministry of Agriculture, Forestry and Fisheries, Ministry of Environment, local authorities at all levels, the police and partner organisations to investigate the two cases of bird flu in Kampot province to find the sources of transmission and continue searching for suspected cases and prevent further spread of the disease.​..

 

[Shiloh]

Source: https://www.telegraph.co.uk/global-...se/cambodian-woman-death-bird-avian-flu-h5n1/


How a 21-year-old Cambodian became the world’s latest bird flu victim
Woman dies within a week of falling sick, as Cambodia faces a spike in avian influenza in humans after an eight year hiatus
Sarah Newey, Global Health Security Correspondent, in Bangkok and Mech Dara in Phnom Penh 21 December 2023 • 12:41pm

​
Chem Seavmey’s family are still in shock. One Sunday morning, the 21-year-old woke up slightly breathless, struggling with a fever and cough. A week later, she was dead.

“I did not expect this, it was so quick,” Chem’s brother-in-law, Sok Reth, told the Telegraph. “She just got worse and worse … Although the doctors tried to help, she still passed away. I am very, very regretful and sad … it was too quick for us.”

On November 26, at a hospital in the capital city three hours from home, Chem became the third person to die from bird flu in Cambodia this year. The country has seen a spike of infections after an eight year hiatus, with six of the 12 human H5N1 cases detected in 2023 reported here, according to the World Health Organization.

“Southeast Asia has always been a bit of a hotspot… but it’s hard to say why Cambodia has seen cases this year,” said Dr Bolortuya Purevsuren, an avian influenza expert at the World Organisation for Animal Health in Bangkok. “Any new human case is always a concern, wherever it unfolds.”

These cases hold crucial clues for scientists and health officials analysing pandemic threats. Tracing how Chem caught H5N1 can help sculpt strategies to reduce the likelihood of future spillovers, while scrutinising samples of the virus that killed her allows virologists to track how the pathogen is changing – and whether the threat to humans has risen.

“Will bird flu cause the next pandemic? Who knows,” said Dr Purevsuren. “But it’s critical to have strong surveillance to monitor trends in wild birds and poultry, quickly identify signals of cases in humans, and then investigate every one that is detected.”

It was infected poultry that passed H5N1 to Chem – a “gentle, quiet” person who loved reading and playing with her nieces and nephews – according to interviews with her family, local officials and epidemiologists.

The 21-year-old, who was also a keen cook, lived with her sister’s family in Dang Tong district in southern Cambodia, some 80 miles south of the capital Phnom Penh and close to the border with Vietnam.

In early November, ducks and chickens in Chem’s village suddenly started to drop dead. Unaware it was bird flu which killed them, eight of the families which lost poultry shared the carcuses with their neighbours to eat.​..

​