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Seasonal Influenza Outbreaks 2008 (excluding Hong Kong)

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Re: Seasonal Influenza Outbreaks 2008 (excluding Hong Kong)

German isolates this season:

Virusisolat,Entnahme,A/NewCaledonia/20/99-IS,A/SolomonIslands/3/2006-IS
---------------------------------------------------
A/Berlin/98/07,19.12.2007,10,160
A/Rheinland-Pfalz/63/07,19.12.2007,20,320
A/Brandenburg/29/07,19.12.2007,80,320
A/Niedersachsen/63/07,20.12.2007,80,640
A/Baden-W?rttemberg/1/08,02.01.2008,80,640
A/Th?ringen/1/08,02.01.2008,80,640
A/Baden-W?rttemberg/5/08,09.01.2008,40,320
A/Berlin/2/08,14.01.2008,40,320
A/Sachsen/3/08,15.01.2008,40,320
A/Nordrhein-Westfahlen/1/08,15.01.2008,40,320


...waiting for the final report from this season...
They are all Brisbane/59.
 
Re: Seasonal Influenza Outbreaks 2008 (excluding Hong Kong)

Flu surge prompts warning

July 19, 2008 04:50pm
A JUMP in flu cases across the country has sparked an urgent "get vaccinated" warning, particularly aimed at the over 65s.

The number of people struck down by the potentially deadly disease has risen 25 per cent since last year and doctors fear the worst is still to come.

Queenslanders are faring the worst, accounting for 47 per cent of flu cases.

The figures have prompted a push from both doctors and politicians for more people are vaccinated.


National Notifiable Diseases Surveillance System records show that during January 1 to July 18 this year there were 1237 cases of laboratory-confirmed flu.

In a similar period last year the figure was 912.


Minister for Ageing Justine Elliot urged the 2.7 million people over 65 to have a free influenza shot.

"As the flu season generally lasts until late August or September, many people can still be protected by having the vaccine now," Mrs Elliot said.

Australian Medical Association Queensland president and geriatrician Dr Chris Davis urged people over 65 to get vaccinated, warning the worst was to come.

"Late August and September is where we see a lot of cases," Dr Davis said.

"All the evidence suggests that once people are over 65 there is a greater risk of health complications resulting from influenza.

"Immune systems get less effective as we age, so it's very important to take the opportunity to get vaccinated now."

Over the past five years, influenza and pneumonia were responsible for 2.5 per cent of all deaths in Australia and in 2006, resulted in 2725 deaths.

The illness is the 12th highest cause of death for Australians.

http://www.news.com.au/story/0,23599,24045108-29277,00.html
 
Re: Seasonal Influenza Outbreaks 2008 (excluding Hong Kong)

[see post #37. From 42 to 70 pilgrims in isolation]

Pilgrim flu outbreak spreads

An investigation has begun into two new flu cases among World Youth Day pilgrims at Marist College in Parramatta, west of Sydney.

A total of 150 other pilgrims have been diagnosed with the flu at various locations around Sydney.

Seventy pilgrims are in isolation at Oakhill College at Castle Hill where eight of them tested positive for influenza B.

There have also been confirmed cases of flu among pilgrims staying in the Sydney suburbs of Forestville, Campelltown, Gladesville and Homebush.

New South Wales Health says a outbreak of viral gastroenteritis, affecting 23 pilgrims at St Therese's school in Denistone, north-west of the city, has been resolved.

http://www.abc.net.au/news/stories/2008/07/19/2308534.htm
 
Re: Seasonal Influenza Outbreaks 2008 (excluding Hong Kong)

Pilgrim health woes
Updated: 20:18, Saturday July 19, 2008
An increasing number of World Youth Day pilgrims are being struck down by illness and injury, the Ambulance Service of NSW says.

Chief executive Greg Rochford said the number of pilgrims suffering from influenza-like symptoms had reached 143 on Saturday morning.

'That's a steady increase on the 104 we reported yesterday,' he said.

'It's in line with the expected progress of an infections disease of that nature and in fact is perhaps slower than what otherwise could have been anticipated.'

In terms of medical emergencies, 84 people who identified themselves as WYD pilgrims presented to hospital emergency departments in the 24 hours to 10am (AEST) on Saturday.

This brings the total of injured pilgrims to 326 since July 9.

'That's a respectable trickle and they cover a full range of misfortunes that people tend to present to ED departments,' Mr Rochford said.

But alcohol was not a major factor in their injuries, he said.

'(It is) much less than one would expect from a large gathering,' he said.

The most serious injuries included a fractured femur in an elderly pilgrim, a fractured nose and a number of ankle and leg related injuries.

Meanwhile, an outbreak of gastroenteritis among 23 pilgrims at St Therese's School, in Denistone, in Sydney's northwest, has now been contained.

Mr Rochford told reporters there had been no further notifications and those that had had the condition were 'well and truly on the mend'.

http://www.skynews.com.au/health/article.aspx?id=250847
 
Re: Seasonal Influenza Outbreaks 2008 (excluding Hong Kong)

July 15th:
Three of the sick pilgrims may be taken to hospital,


July 16th:
Forty-two people are being treated and assessed at Oakhill College at Castle Hill in the city's north-west and other pilgrims are being treated at Olympic Park in Homebush.

July 19th:
Seventy pilgrims are in isolation at Oakhill College at Castle Hill where eight of them tested positive for influenza B.
 
Re: Seasonal Influenza Outbreaks 2008 (excluding Hong Kong)

More pilgrims getting sick in Sydney

18th July 2008, 14:09 WST
Sickness and injury are continuing to afflict pilgrims visiting Sydney for World Youth Day (WYD).
More pilgrims have fallen ill with influenza and gastroenteritis, and almost 250 have received emergency treatment for injuries suffered at WYD event sites.

Almost 120 pilgrims had been diagnosed with influenza or were showing flu-like symptoms as of 10am (AEST) Friday, NSW Health said in a statement.

Affected pilgrims have been staying at schools, a church hall and Sydney's Olympic Park at Homebush.

"Since yesterday morning there has been a steady increase in the incidence of influenza among pilgrims," NSW Ambulance Service chief executive Greg Rochford told reporters in Sydney.
-snip-
http://www.thewest.com.au/aapstory.aspx?StoryName=498820
 
Re: Seasonal Influenza Outbreaks 2008 (excluding Hong Kong)

Pilgrim flu 'no threat' to Sydney

HEALTH authorities have urged the public to remain calm - saying an outbreak of influenza among the visiting World Youth Day pilgrims is no real threat to Sydney's population.

Influenza outbreaks have been detected at five of the pilgrim accommodation sites across Sydney.

So far there are 57 confirmed cases of influenza among the pilgrims.

And almost 80 World Youth Day pilgrims have been isolated in two centres in Sydney to try and contain the spread of the virus.
-snip-
http://www.news.com.au/dailytelegraph/story/0,22049,24039505-5001021,00.html
 
Re: Seasonal Influenza Outbreaks 2008 (excluding Hong Kong)

18 July 2008

World Youth Day - Public Health Update

Acting Deputy Chief Health Officer for NSW Health, Dr Jeremy McAnulty confirmed there have been no further reports of public health outbreaks involving World Youth Day pilgrims in Sydney.

Dr McAnulty also stated the numbers of WYD pilgrims affected by influenza, gastroenteritis and chicken pox has not changed since this mornings update.

As reported at 10am today, details remain as follows:

Our Lady of Good Counsel School in Forestville
Six pilgrims have been diagnosed with Influenza
One of these pilgrims has tested positive for Influenza A
One other pilgrim has tested positive for Influenza B

Thomas Moore School in Campbelltown
20 pilgrims have been diagnosed with Influenza
Two of these people have tested positive to Influenza B

Our Lady of the Peace in Gladesville
12 pilgrims have been diagnosed with Influenza
Three of these pilgrims have tested positive for Influenza A

Oakhill College at Castle Hill
70 pilgrims have been isolated with flu-like symptoms
Eight people from this group have tested positive for Influenza B

Sydney Olympic Park at Homebush
11 pilgrims have been diagnosed with Influenza
Three of these pilgrims have tested positive for Influenza B
Two pilgrims have tested positive for Influenza A
One pilgrim is also suspected to have chicken pox

St Therese's Primary School at Denistone
Viral gastroenteritis has affected a group of 23 pilgrims

http://www.health.nsw.gov.au/news/2008/20080718_09.html
 
Re: Seasonal Influenza Outbreaks 2008 (excluding Hong Kong)

Flu outbreak worse than last year
LOUISE HALL
20/07/2008 12:00:01 AM
THE number of people struck down by influenza is up by one-third compared to this time last year, leading governments to urge people to protect themselves from the highly contagious infection.

More than 1230 flu cases have been confirmed nationally since January, up from 912 in a similar period in 2007, the National Notifiable Diseases Surveillance System shows.

The federal Minister for Ageing, Justine Elliot, urged any of the 2.7 million Australians aged over 65 who have not been vaccinated to protect themselves from the potentially life-threatening illness with a free influenza vaccination.

"As the flu season generally lasts until late August or September, many people can still be protected by having the vaccine now," Ms Elliot said.

The increase in cases of influenza is associated with World Youth Day. NSW Health says 153 pilgrims have been diagnosed with influenza A or B.
-snip-
http://hawkesbury.yourguide.com.au/...lu-outbreak-worse-than-last-year/1060536.aspx
 
Re: Seasonal Influenza Outbreaks 2008 (excluding Hong Kong)

hat-tip: Treyfish
Opinion Piece

Contagion risk of huddled masses

The news that about 120 pilgrims were struck down by highly contagious strains of influenza and gastroenteritis said to be sweeping World Youth Day accommodation sites is disturbing evidence of how infections travel across time and space, and how this type of event increases the risk of exposure to common illnesses.

Religious gatherings are no strangers to infectious disease. Each year approximately 2 million Muslims make the haj pilgrimage to Mecca and, while detailed information is lacking, it would seem that possibly between 30 per cent and 40 per cent regularly contract influenza or some other infectious disease.

In 2007, more than 600 pilgrims died during the course of the haj, many from pneumonia and heart attacks, possibly exacerbated by the extremely cold weather. There have been serious outbreaks of meningitis at Mecca, and returning pilgrims have transported dengue around the world.

Large gatherings of people from different places can be a potent force in the emergence and spread of disease, and a fertile environment for the exchange and spread of common infections.

The process by which infectious diseases emerge and diffuse is not simple. It requires a series of events to occur in concert. International travel plays an important role in transporting infections across time and space, allowing potentially pathogenic infections to be introduced into new environments. More than 1.5 billion people cross international borders by air every year in journeys that are considerably shorter than the incubation time of most infections. Remember SARS and bird flu? In an interconnected world we are all at risk.

In such times, and faced by such population movements, how do you control the spread of infectious diseases? Many World Youth Day pilgrims may have been incubating various infections when they arrived, but how would we know? The days of formal quarantine are long gone, and unless you look totally moribund as you cross the immigration line you are unlikely to be detained. Local GPs have been asked to keep an eye open for diseases, including measles, tuberculosis and dengue, but surely this is closing the stable door after the horse has bolted.

Should we be worried? Well, every couple of years there are outbreaks of dengue in parts of northern Queensland, caused by the disease being introduced by a local tourist or a visitor from overseas. Dengue is not endemic in Australia, but the mosquitoes that carry it are.

http://www.smh.com.au/news/opinion/contagion-risk-of-huddled-masses/2008/07/20/1216492247149.html
 
Re: Seasonal Influenza Outbreaks 2008 (excluding Hong Kong)

Australia

Pilgrims taken to hospital with flu-like illness

July 15, 2008

A FLU-LIKE illness has struck down eight World Youth Day (WYD) pilgrims staying at a Sydney school, the Ambulance Service of NSW says.

Three of the sick pilgrims may be taken to hospital, an ambulance spokeswoman said. The remainder were being assessed on-site.

A general practitioner is being arranged to visit Oakhill College on Old Northern Road in Castle Hill, where the WYD pilgrims are staying during the Catholic youth festival that officially began today.

Their nationality has not been confirmed and WYD organisers refused to comment on the matter.

A spokeswoman at the Catholic high school in Sydney's northwest said she had been directed to refer all inquiries to WYD.

http://www.theaustralian.news.com.au/story/0,25197,24023070-26103,00.html


16/07/2008 12:00:00 AM
Excerpt:
Two pilgrims staying at Oakhill College in Sydney's north-west were taken to hospital yesterday with a flu-like illness that also struck six of their companions.

The hospitalised pilgrims, believed to be from Solomon Islands, were discharged in a stable condition from Westmead Hospital after blood tests.

A hospital spokeswoman would not give any more information on their illness. The remaining six were assessed at the college by a GP.

http://www.canberratimes.com.au/new...cant-stop-sydneys-invasion-of-joy/811984.aspx
 
Re: Seasonal Influenza Outbreaks 2008 (excluding Hong Kong)

NSW Health says 153 pilgrims have been diagnosed with influenza A or B.

Wednesday, July 02, 2008 12:57 PM
Solomons Youths to Attend Australia Youth Meet
BY NINA TUHAIKA

More than 400 Solomon Islanders, who will be participating at the Australia for World Youth Day 2008 in Sydney, will gather this Friday in Honiara.
The Australian High Commission in a statement said that a briefing will take place with the participants at Don Bosco near Henderson airport before they leave for Australia.

Catholic Archbishop of Honiara, Adrian Smith was quoted as stating that with over 400 Solomon Islanders attending, this will be a huge event.

World Youth Day 2008 is a week of activities which will be held in Sydney from 15 - 20 July 2008.

The event will attract approximately 125-thousand international registered visitors, and approximately 500-thousand people to any of its major events.

http://www.solomontimes.com/news.aspx?nwid=2032
 
Re: Seasonal Influenza Outbreaks 2008 (excluding Hong Kong)

hat-tip Treyfish

DRY SPELL BRINGS HEALTH RISKS IN DUSTY HONIARA
Solomons Heat Triggers Flu Epidemic


By Joanna Sireheti

HONIARA, Solomon Islands (Solomon Times, July 15, 2008) - Breathing the dust is how most describe walking through the streets of Honiara during a dry spell of no rain.

"This is where you get summer all year round," one young student, Junior Kali joked.

The intense heat is the first greeting for visitors outside the Henderson International Airport tarmac upon arrival.

"Heat circulation around the city can be connected to continuous bouts of flu," a nurse, Jane Sade stated.

Another added factor to continuous flu in the city is the "very dusty air."

"Moving around Honiara is best in vehicles because walking to go places means breathing in the dust added with the intense heat," Ms. Sade added.

Young children are at higher risk of catching bad flu when exposed outdoors for a long period of time.

This however does not stop visitors from abroad who enjoy the laid back and friendly lifestyle of the Solomons.

http://pidp.eastwestcenter.org/pireport/2008/July/07-17-16.htm
 
Re: Seasonal Influenza Outbreaks 2008 (excluding Hong Kong)

Friday, July 18, 2008 5:02 PM
Need for Nurses to be Professional
BY GINA MAKA'A


Sick patients are complaining that nurses are not being professionals in their field.
As patients continue to flood the National Referral Hospital and clinics around Honiara following a flu outbreak, nurses particularly in smaller clinics are said to be unprofessional towards the sick.

Solomon Times took a visit to the Mataniko clinic this afternoon and spoke with a student who spoke under condition of anonymity revealing that "I was feeling really sick at school so I came here but when I approached the nurse on duty, I received a harsh response to go back outside and wait in line".

"I am feeling really sick here and all I want is professional medical assistance but instead, I got treated real badly," the student said.

He said there was no need for the nurse to be harsh "because she is paid to treat sick people".

The patient acknowledged that maybe it has been a hard week for the nurses with the outbreak in town "but they should always remain professional".

He questioned how the nurse would have reacted if something had happened to him outside the waiting room after such a harsh treatment given.

Asked how he dealt with the situation, the student said he was so disappointed with the nurse that he went to the police post near the clinic.

"I had to seek help elsewhere so the police called up the clinic and told them to deal with me as a matter of urgency because my condition was serious," the student said.

Meanwhile this morning at the Kukum Clinic, only one nurse turned up early to serve dozens of waiting sick people.

Waiting patients said medical service needs to improve and urge responsible authorities to deal with the issue.

http://www.solomontimes.com/news.aspx?nwID=2126
 
Re: Seasonal Influenza Outbreaks 2008 (excluding Hong Kong)

Sick pilgrims to walk in Pope's footsteps
Thirty luckless World Youth Day (WYD) pilgrims, struck down by illness last week, managed to get lost on their way to a free cruise today.

The pilgrims, visiting Australia from the Solomon Islands, had been scheduled to tour Sydney Harbour this afternoon, to help make up for their absence at the Pope's official arrival last Thursday.

But to the bemusement of NSW government WYD spokesperson Kristina Keneally, they managed to find themselves in Homebush at 2pm (AEST) - while their ferry was ready to depart at Circular Quay.

"We should have chartered a bus," she joked.

Ms Keneally said another ferry would be organised for the pilgrims.

She said a harbour cruise would be a chance for the pilgrims to enjoy Sydney before departing the country.

"It's a way that we can make up, in a very small way, we can make up for what they missed out on on Thursday," she told reporters in Sydney.

"How disappointing it must have been for some of our pilgrims who travelled all the way to see the Pope, and they missed that iconic arrival of Pope Benedict on Sydney Harbour.

"There's no better way to see Sydney's iconic Opera House and Harbour Bridge than by boat, so we expect the pilgrims will have a great time."

She said that most of the pilgrims who fell ill last week had recovered well.

"Fortunately, our pilgrims were on the whole young and healthy, so when they came down with influenza B or gastro ... they seemed to recover quite quickly," she said.

More than 200 pilgrims caught a bad flu or stomach bug during the six-day Catholic event, according to the latest figures.

NSW Health today said almost another 1,000 pilgrims needed medical treatment at hospitals or WYD's temporary medical centres.

"Clinicians and public health officers treated a total of 181 pilgrims for flu and flu-like illness," a NSW Health spokesman said.

"Public health officers also investigated 23 cases of viral gastroenteritis."

Pilgrims taken to hospital emergency departments numbered 480 since July 9.

Another 461 sick or injured pilgrims were treated at WYD sites including Randwick Racecourse and Barangaroo.

http://www.livenews.com.au/Articles/2008/07/21/Sick_pilgrims_to_walk_in_Popes_footsteps
 
Re: Seasonal Influenza Outbreaks 2008 (excluding Hong Kong)

[SEASONAL INFLUENZA, EISS, UPDATES] EISS - Inter-season Electronic Bulletin - Week 29 : 14/07/2008-20/07/2008 - 25 July 2008, Issue N? 268 - Single laboratory confirmed case of influenza in Europe in the last two weeks
Summary:
Influenza virus detections are currently very sporadic in Europe.
In week 28/2008 there was one detection and in week 29/2008 there were no detections.
Eight countries reported an assessment of the geographical spread of influenza activity in week 29/2008 and all reported no influenza activity.
In weeks 28-29/2008, only one influenza virus was detected in Europe: an influenza virus B detected in Poland in a sentinel specimen (see graph and table for further details).





Since week 21/2008 (i.e. 21/2008-29/2008), there have been a total of 101 influenza virus detections in Europe: 78 (77%) type B, 14 (14%) type A not subtyped, 7 (7%) type A subtype H3 and 2 (2%) type A subtype H1.
There have been no reports of unusual influenza activity in Europe at a community level (i.e. in a region or local area such as a city, county or district) since week 16/2008.
Background:
The Inter-season Electronic Bulletin presents and comments influenza activity based on virological data reported to EISS. In weeks 28/2008 and 29/2008, a total of 14 countries reported virological data to EISS. The Inter-season Electronic Bulletin will be published between week 21/2008 and week 39/2008.
The spread of influenza virus strains and their epidemiological impact in Europe are being monitored by EISS in collaboration with the WHO Collaborating Centre in London (United Kingdom) and the European Centre for Disease Prevention and Control in Stockholm (Sweden).
Graph
The graph presents the total number of specimens positive for influenza A and B viruses in Europe during the inter-season period.

europe_1_viro_2008_29_thumb%5B1%5D.png


Map
The map presents the geographical spread as assessed by each of the networks in EISS.

2008_29_v2_thumb%5B1%5D.png


A = Dominant virus A
H1N1 = Dominant virus A(H1N1)
H3N2 = Dominant virus A(H3N2)
H1N2 = Dominant virus A(H1N2)
B = Dominant virus B
A & B = Dominant virus A & B
= : stable clinical activity
+ : increasing clinical activity
- : decreasing clinical activity
No activity = no evidence of influenza virus activity (clinical activity remains at baseline levels)
Sporadic = isolated cases of laboratory confirmed influenza infection
Local outbreak = increased influenza activity in local areas (e.g. a city) within a region, or outbreaks in two or more institutions (e.g. schools) within a region. Laboratory confirmed.
Regional activity = influenza activity above baseline levels in one or more regions with a population comprising less than 50% of the country's total population. Laboratory confirmed.
Widespread = influenza activity above baseline levels in one or more regions with a population comprising 50% or more of the country's population. Laboratory confirmed.
-
---------
 
Re: Seasonal Influenza Outbreaks 2008 (excluding Hong Kong)

why no data from Australia about circulating strains,
no data at flunet ?
but New Zealand is available:

New Zealand , week 19-29:
------------------------------------------

activity:s,s,s,l,s,l,r,r,r,w,w
(s:sporadic,l:local,r:regional,w:widespread)
A (H1):0,0,0,0,0,0,0,0,0,0,0
A (H3):0,0,1,3,1,0,2,9,6,13,9
A (not subtyped):0,0,1,4,1,8,12,11,12,5,4
B (lineage not determined):1,0,1,0,0,3,6,5,3,7,7
B (Victoria lineage):0,0,0,0,0,0,0,0,0,0,0
B (Yamagata lineage):0,0,0,0,0,0,0,0,0,0,0
Other subtypes:0,0,0,0,0,0,3,0,0,0,0
Total A:0,0,2,7,2,8,14,20,18,18,13
Total A+B:1,0,3,7,2,11,20,25,21,25,20
Total B:1,0,1,0,0,3,6,5,3,7,7
Total:14,17,33,31,33,45,57,0,43,45,47

no H1 this season, so probably no Tamiflu-resistance


------edit-------
some other data for the Southern Hemisphere (+China):

weeks 19-29:
--------------
Argentina Total A : 0,1,2,2,2,4,14,27,33,36
Argentina Total B : 0,0,0,4,13,14,36,52,37,13

Brazil A (H1) : 4,4,0,4,10,0,0,0,0,0
Brazil A (H3) : 0,0,0,0,0,0,0,0,0,0
Brazil A (not suptyped) : 1,7,5,4,6,1,0,2,5,0
Bazil B (Lineage not determined) : 1,0,0,1,8,4,0,1,0,0
Brazil Total A+B : 6,11,5,9,24,5,0,3,5,0

China A (H1) : 0,3,7,5,5,4,12,22,25,31,66
China A (H3) : 0,13,23,12,7,15,15,24,34,27,69
China A (not suptyped) : 0,5,3,3,4,0,0,2,2,2,1
China B (Lineage not determined) : 0,1,2,0,1,0,2,1,0,0,1
China B (Victoria lineage) : 0,1,2,2,1,0,0,1,0,0
China B (Yamagata lineage) : 0,11,12,17,10,7,13,13,13,13,11
China Total A+B :0,34,48,39,29,27,42,62,75,73,148

South Africa A (H1) : 0,4,1,5,9,21,26,33,18,3,?
South Africa A (H3) : 0,0,0,0,1,0,1,0,1,0,?
South Africa A (not suptyped) : 0,0,0,1,0,0,0,3,17,41,?
South Africa Total A+B : 0,6,1,14,11,24,31,38,41,50,?

weeks 1-29:
-----------

China A (H1): 3,8,12,17,32,16,53,56,50,106,130,108,62,30,12,17,14,9,8,3,7,5,5,4,12,22,25,31,66
A(H3) : 39,58,51,32,38,7,35,82,62,111,102,99,52,58,12,22,21,28,18,13,23,12,7,15,15,24,34,27,69
Total B : 56,206,137,136,64,22,92,135,192,201,326,284,189,104,42,39,35,19,13,12,13,19,12,8,13,13,14,13,11

Argentina Total 19,21,27,25,26,25,27,25,20,28,54,41,58,57,57,55,77,381,684,667,850,767,959,1126,799,659,737,385,?
Brazil Total : 40,30,31,31,30,35,52,78,64,83,68,95,158,108,115,116,111,114, 149,79,93,123,115,141,70,93,80,74,?
China Total :594,1112,828,618,366,12,226,605,616,1020,985,863,604,506,0,0, ...
South Africa Total : 3,8,6,3,1,6,9,14,12,25,26,21,26, 24,36,23,58,12,30,32,32,43,64,72,72,99,117,136,?
Thailand Total : 112,98,268,171,174,113,138,121,129,83,86,85,135,100,73,20,70,87,48,72,59,30,127,...
 
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