Can You Get the Flu Twice in One Season?

There’s a lot of time during flu season to dodge germs. Influenza activity peaks from December to February, but it can easily stretch from November (or earlier) to March (or later). So if you had the flu already this year, you might feel like at least you got your turn out of the way.

Except it doesn’t exactly work that way. During these long flu season months, you could get the flu a second time. Yep, really.

RELATED: Why Do Some People Die From the Flu?

That’s because—stay with us here—there are four different types of the flu: influenza A, B, C, and D. Influenza A and influenza B cause the seasonal epidemics we’ve come to expect in the fall and winter, and there are different strains of each. When you get sick from one particular strain of flu virus, your body develops an immune response that will protect you from getting re-infected with the very same bug. “Your likelihood of getting the same flu again is lower,” explains Denise Pate, MD, internal medicine physician with Medical Offices of Manhattan. “However, you can become infected with a different strain, and the antibodies you formed from the first bout are not providing protection.”

RELATED: Why You Should Get the Flu Shot Every Year

As you’ve probably heard, this year’s particularly rough flu season is thought to be due to the fact that the 2018 flu shot is not all that effective against this year’s dominant strain of influenza A, H3N2. If you got the flu from this particular virus in, say, December, you could encounter another form of the bug—like H1N1 or influenza B—come February and get sick again. “It is not uncommon for there to be second waves of influenza B virus activity later in the flu season,” says Sonja Olsen, PhD, in the influenza division of the Centers for Disease Control and Prevention (CDC). “Right now, both the proportion of H1N1 and influenza B viruses in circulation is increasing.”

Cruel, isn’t it? At least getting the flu once doesn’t give you a higher risk of going in for a second round.

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We’ve said it before and we’ll say it again: It’s not too late to get your flu shot. That applies even if you already had the flu once this season. “Despite getting the flu, you are still eligible and should get the flu vaccine,” Dr. Pate says. “This will provide added protection against the strain of the flu you had, in addition to protecting you from the other strains of influenza that are circulating.”

Hopefully, we’re nearing the end of flu season 2018 and you won’t have to worry about any of this for much longer (until next year, of course). But we’re not out of the woods yet, according to Olsen: “There are still several weeks of flu activity to come.”

How to determine if you really have the flu

Dr. Marc Siegel explains on ‘Fox & Friends.’

Patients often ask me: Can I get the flu twice in one season? The answer, unfortunately, is that you can, though rarely. It’s much more common to mistakenly think you have the flu when in fact you’re suffering from another illness.

There are four main strains of the flu circulating this year, as in most years. If you catch one strain, you’ll develop an immunity to that, but can still get one of the other strains.

As the U.S. Centers for Disease Control explains: “There are four types of influenza viruses: A, B, C and D. Human influenza A and B viruses cause seasonal epidemics of disease almost every winter in the United States. The emergence of a new and very different influenza A virus to infect people can cause an influenza pandemic. Influenza type C infections generally cause a mild respiratory illness and are not thought to cause epidemics. Influenza D viruses primarily affect cattle and are not known to infect or cause illness in people.”

The influenza A virus originated with birds. A strain of influenza A called H3N2 has predominated so far this season and causes severe illness. But the H1N1 strain of influenza A and the two strains of influenza B are now starting to circulate more commonly.

Here’s one way you can tell if you likely have the flu: If you’re walking around one minute and have to lie down the next because of the rapid onset of fatigue or body aches and fever, that’s likely the flu, especially right now.

This year’s flu shot does a better job of matching up with the latter three strains, so it is still a very good idea to get vaccinated if you haven’t gotten a flu shot already. More on that below.

Surprisingly, you may think you’re coming down with the flu for the second time this season but be mistaken. That’s become some illnesses mimic some flu symptoms. It’s hard for the average person to tell the difference.

As a result, millions of Americans who think they had the flu this season really didn’t have it at all. How can you tell if you’re one of them?

For one thing, though the flu is a respiratory virus with symptoms that can vary from mild to severe, the trademark of the illness is a battle with the immune system causing inflammation.

This inflammation is characterized by rapidity of onset, fatigue, muscle aches and fever. Look for these symptoms before you announce that you have the flu. Yes, flu can also give you a sore throat, headache, cough, and a runny nose, but you can also have these symptoms with a cold, sinus infection or strep throat.

In fact, there are a lot of upper respiratory infections being passed around throughout the U.S. right now, some viral and some bacterial. Many concerned patients coming to see me in my office with a bad cough who are convinced they have the flu are actually suffering from bronchitis.

Of course, you can have both the flu and bronchitis at the same time, and your physician needs to be alert to this possibility. Even if your doctor performs a rapid flu test and it’s positive, you can also have a bacterial bronchitis, pneumonia, sinusitis or strep throat. Your doctor has to treat whatever combination has hit you.

The truth is, I don’t always perform a flu test on my patients, because it is only accurate 60 to 70 percent of the time. Luckily, I can often diagnose the flu just by talking to and examining a patient – and your doctor can likely do this as well.

Here’s one way you can tell if you likely have the flu: If you’re walking around one minute and have to lie down the next because of the rapid onset of fatigue or body aches and fever, that’s likely the flu, especially right now.

Patients commonly ask me if they should get a flu shot. I hope you’ve gotten one already, but if you haven’t, my advice is that you should do so now – it’s not too late.

We won’t know how effective the shot is until the flu season is complete, but early indications are that it will keep you from getting the flu about 30 percent of the time. We all wish the protection rate was higher – but 30 percent is better than having no protection at all.

There’s an additional benefit to having the flu shot. It may help decrease severity of the flu if you get sick and make it harder for you to spread the disease to others who may be a higher risk for complications – pregnant women, infants, the elderly and those with chronic diseases.

Believe it or not, most of our flu vaccine batch is still made by inoculating chicken eggs, a process that was first pioneered in the 1950s. In order to grow in an egg, which has an environment suited to bird flus, the flu virus often mutates.

Dr. Anthony Fauci, director of the National Institute of Allergies and Infectious Disease, recently told me that the flu virus unfortunately mutated this season in a way where the H3N2 antigens on its surface are less susceptible to the antibodies produced by the vaccine.

Hemagglutinin is the protein that attaches the flu virus to the surface of your cell, and Neuraminidase cleaves the flu virus (after it has reproduced inside) from your cell so it can jump to a neighboring cell.

Neuraminidase inhibitors (including Tamiflu) are effective anti-viral drugs that decrease the spread, severity and length of the illness once you have the flu. These drugs can also be used to protect high-risk patients from getting the flu in the first place.

Because of the hens’ eggs absurdity, the need for new flu shots every year and the relative ineffectiveness of the yearly shot, it has long been obvious to scientists that we desperately need a universal flu vaccine.

There are several candidates now entering clinical trials in humans. Dr. Fauci said he is excited by a new technique that targets the “stalk” of the hemagglutinin molecule, common to flu of all kinds.

It remains to be seen whether this process generates sufficient immunity to be useful in clinical practice, but it is certainly promising. Whichever universal influenza vaccine candidate is ultimately successful, one thing’s for sure: it will be produced using the cells of mammals rather than chicken eggs and will use modern recombinant genetic technology.

When the mass-produced universal flu vaccine arrives, it will be a great day for public health. The yearly flu epidemic that hits millions of us each year and that millions fear will be squashed and recede into history. That’s something we can all look forward to.

Catching the same cold twice: fact or myth?

We’ve probably all been in a position where, just as we start to feel better from a cold, our partner or colleague nearby suddenly starts to show symptoms – and then the panic sets in. After all, if you’ve just recovered, you probably don’t want to get ill all over again. But is that even possible?

The virus variations

Unfortunately for us, there are lots of different viruses which can all cause very similar common cold-like symptoms. These include viruses like parainfluenza virus, adenovirus and rhinovirus, all of which cause things like sneezing, headaches, coughs and a runny nose.

However, each of these viruses also have subcategories, called serotypes, or strains. For example, rhinovirus has over 100 different serotypes. Now, the good news is that you can’t get ill from the same virus serotype right after getting better, due to the fact that you’ll have developed antibodies which help to protect your immune system for a little while. The not so good news is that you can get another cold from a different virus, or a different virus strain.

Keep in mind that it’s rare that two virus serotypes that cause the common cold will be in circulation at the same time of year in one location. What this means is that if you get sick and then your partner does just after, you’ve probably both suffered due to the same dominant strain of virus – which you have now developed antibodies against. There are also some occasions where the antibodies you’ve developed against one strain will offer some protection against other closely related strains, but this is not guaranteed.

Wait to get well

One of the most common occurrences when people think that they’ve caught the same cold again, having only recently felt better, is that they actually hadn’t fully got over that first illness. If you’re feeling sick again it’s likely that your body is presenting some residual symptoms from the original virus, with one Dr saying that this can be for a few different reasons; perhaps you pushed yourself too hard without being fully recovered, or perhaps it was just a longer-lasting strain than you anticipated.

When it comes to antibodies, keep in mind that this protection may not last too long. Several viruses, including the influenza viruses, mutate at such a rate that it is possible to suffer from a cold due to the same virus strain during the next cold and flu season.

This rate of mutation is the reason why people are strongly advised to get a new flu vaccine every year. The annual vaccine has been designed to combat the most dominant flu viruses of that season, offering as much protection as possible from the strains most likely to cause illness at that time.

At FluCamp we’re working to understand more about the cold and flu viruses and how they work, in order to discover a way in which they can be treated, or eradicated for good. To find out how we use our clinical trials to conduct this research, head to our trials page, or contact our friendly team for more about how you can become an #EverydayHero and help us fight the flu.

But the good news is that it’s pretty rare to catch the flu twice in a single season. Having this happen would be “quite a stroke of bad luck,” Schaffner told Live Science.

Most people who get the flu this season are getting sick with the H3N2 strain. But a smaller portion of people (around 10 to 15 percent) are getting the H1N1 strain or the influenza B virus, according to data from the Centers for Disease Control and Prevention. (H3N2 and H1N1 are both strains of influenza A.)

Seasonal flu shots contain three to four strains of flu virus, because there isn’t much “cross protection” between strains, Schaffner said. It’s possible that getting sick with one type of influenza A virus would offer some modest protection against another type of influenza A, but it probably wouldn’t give you any protection against the influenza B virus, Schaffner said.

If you do catch the flu, and you haven’t received the flu vaccine for the season, doctors generally recommend that you still get a flu shot after you’re no longer sick, particularly if it’s early on in the flu season, Schaffner said. The CDC recommends the flu vaccine for everyone ages 6 months and older.

This flu season is turning out to be one of the worse since the 2009 “swine flu” epidemic, CDC officials said last week. Health officials are seeing “widespread’ flu activity across the entire country.

For the past five flu seasons, health officials found that flu activity was elevated for around 16 weeks. So far this season, flu activity has been elevated for nine weeks, meaning that the flu season may be only about halfway over, the CDC said.

Original article on Live Science.

Relapse of the Flu; Is That a Real thing?

March 5, 2017

After escaping flu during the 2015-2016 it has recently reminded many of us of the misery it can cause. The misery, however bad, is generally short lived for most; seven days being the typical course of illness, though in an unlucky few it can stretch to two weeks.

However, for medical providers it is less about the flu (no disrespect to all of you suffers), but the “relapse” which some have one to two weeks after they recover which is the big concern. That is likely not a relapse, but rather pneumonia.

Those at high risk for developing a post-influenza pneumonia are as follows: under age 2 or over 65, pregnant women or patients with underlying diabetes, heart disease or asthma.

By the time many patients are seen at Urgent Care, or by their doctor, it is too late to provide any effective treatment. The only treatment option, oseltamivir must be started within 48 hours to provide any effect and then on average it only speeds recovery by one day.

Armed with this, incomplete knowledge, some patients when they have what they believe to be a second round of flu simply stay home with their chicken soup, and over the counter meds. This unfortunately is a mistake. Typically pneumonia symptoms are fever, cough, body aches, headache, decrease appetite (sounds like flu!).

If you are not in a high risk group (see above) the first time you experience flu symptoms and wish to rely on home remedies that is great. The high risk patients with flu, should be seen as soon as possible after the onset of symptoms and certainly within the first 48 hours. Do not believe the myth of “flu relapse”, that unfortunately is not the way it usually works. For pneumonia, antibiotics have actually been shown to be better than chicken soup (sorry mom)!

David Gude, MD

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Can You Get The Flu Twice In One Season? This Is What The Experts Say

The two most prevalent strains of the flu this season are the H3N2 and the H1N1, which are both strains of influenza A, Schaffner said. Most flu vaccines offer protection against H1N1. However, there is also an influenza B virus, which means if you catch A, you can recover and still catch B, especially if you travel to a part of the country where you could be exposed to a different strain. And, flu season is only half over. “Flu activity has been elevated for consecutive weeks so far this season,” Dr. Brenda Fitzgerald said in a Q&A with the Centers for Disease Control.

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“To put that into perspective, the average duration of a flu season in the past seasons has been around 16 weeks, with the longest being 20 weeks. So, by this measure, we are about halfway there this season. That means we have several more weeks of flu to go.” What’s more, Dan Jernigan, director of the influenza division at the national Center for Immunization and Respiratory Diseases, told Fortune that this is the first year that flu activity has been rampant in every state in the continental U.S.

The flu vaccine is least effective against the H3N2 strain, which is one of the most severe strains of the flu you can catch. “We are always expecting there to be an unusual season,” Jernigan said. “We are rather humbled by this virus. We are always preparing for a severe season and welcome a less severe season, but it’s difficult to predict what will happen.” Basically, the flu is a zombie-like virus that is constantly mutating, and experts can’t always predict how it will manifest from season to season.

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If being able to catch eleventy million different strains of the flu isn’t bad enough, there is another virus called adenovirus that mimics the flu, but is actually more contagious and often delivers symptoms that are much more severe. The flu’s evil cousin can cause symptoms such as vomiting, diarrhea, bladder issues, neurological issues other than a headache (like a stiff neck), a barking cough and breathing distress, an earache, or pneumonia, according to the CDC. If you have these symptoms you should see your doctor ASAP.

The good news is that if your immune system is strong and healthy, you avoid sick people, and you are vigilant about keeping your hands and home clean, you’re less likely to come down with the flu and adenovirus. Practicing all three of these things is really important because you can actually catch the flu just by talking to someone who has it because new research says that the flu can be spread just by breathing. This is why you should never try to be a hero and go to work if you have the flu, unless your goal is to take out your entire workplace.

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If you are laid up with the flu, former Scream Queens star Lea Michele posted her go-to feel-better-fast flu remedies on her Instagram story last week, and they actually contain some things that experts say can strengthen your immune system. Things like apple cider vinegar, lemon, honey, mushrooms, and garlic — which are all included in Michele’s recipes — can keep help fight the virus.

If you’re not sick, it’s still worth trying these things to prevent the flu from taking you down in the first place. And, even though it’s not 100 percent effective, and it doesn’t protect you against all strains, experts still recommend that you get a flu shot. In some ways fighting off the flu is like fighting off zombies. So, be a zombie-fighting warrior and do everything you can — short of putting onions in your socks — to stay well.

Seriously, if there were ever a time to harness your inner introvert and stay home with your beloved two-dimensional friends on Netflix and Hulu, this is it. With a lot of vigilance, and a little common sense, we can just might get through this demonic-flu season in one piece.

Can You Get the Flu Twice In One Season?

For the first time in 13 years, there’s widespread flu activity in every single state in the continental U.S., according to the Centers for Disease Control and Prevention (CDC), and, sadly, even healthy people have died from the flu this winter. So, needless to say, you’re likely in one of three camps when it comes to the flu: You’re thanking yourself for rolling up your sleeve for the vaccine; wishing you had; or, if you’ve already fallen victim to the virus, you might be wondering: Can I get the flu again this winter?

The short answer is one you’re not going to like-that’s a yes, says Nicole Bouvier, M.D., an associate professor of infectious disease at the Icahn School of Medicine at Mount Sinai in New York.

“There are four different strains of the flu that could be circulating at any given time,” she explains. Right now, the main one in the U.S. is influenza A (H3N2). Docs have also seen cases of influenza B, but not nearly as many. And if you’ve suffered from one strain, you’re still susceptible to infection from another, says Dr. Bouvier. That’s because the different strains are different viruses-and they’re not neutralized by the same antibodies.

The good news is once you’ve been infected by a specific strain (say influenza A H3N2), your immune response is likely strong enough that you won’t get that same strain again (unless you’re severely immune suppressed). “The antibodies that your body makes (in defense of the infection) recognize the proteins on the flu virus’s surface,” explains Dr. Bouvier. You’re usually protected from that strain for a year or so. Over time, though, those proteins mutate and change and eventually, your body doesn’t recognize them, leaving you at risk for getting sick again. (Related: 5 Super-Germy Spots In the Gym That Might Make You Sick)

While you might be more worried about the flu this year, in particular, Dr. Bouvier says that this year’s flu season is not “completely out of the ordinary” … but that still doesn’t mean it’s not concerning. The number of people who are sick enough with the flu to go to the hospital is on par with the 2014–15 flu season, which was regarded as worse than usual, she notes.

So why the hype? Some of it has to do with data from the Australian flu season, which found the virus to be widespread and the vaccine to be not as effective as it’s been in years past. (Australia saw the same flu strains and used the same vaccine as the U.S., so it was easy to extrapolate data, says Dr. Bouvier.)

However, it’s too early for the CDC to *officially* issue an assessment of the efficacy of the vaccine this year. They’ll do that later in the season, usually post-peak season, she says.

For now? Your best bet is to get a flu shot-yes, this late in the season; yes, even if you’ve already had the flu; and yes, even if the shot is not as effective this year as it has been in years past.

“It’s entirely possible come February or March for another strain to start circulating-and those other strains are covered in the flu vaccine,” says Dr. Bouvier. Plus, even if the vaccine doesn’t prevent you from actually getting the flu, it can help prevent complications associated with the virus.

And make sure you keep an eye out for your flu symptoms if you do get hit with a virus once (or twice). Body aches, headaches, and fever tend to last anywhere from three to five days, says Dr. Bouvier, and respiratory symptoms like a cough can linger a week or two. But if you have trouble breathing or don’t feel like yourself (you feel confused, for example), it’s time to see a doc. Dr. Bouvier says the flu can progress into both viral or bacterial pneumonia.

Cold and Flu Prevention

Cold temperatures and low humidity, indoors and out, can irritate or damage your airways. Air pollution, indoor dust, and ash from fireplaces can also act as irritants, causing inflammation and making it easier for germs to enter your system, says Russell Robertson, chair of the department of family medicine at the Feinberg School of Medicine at Northwestern University, in Chicago.
Smoking can make you prone to bacterial and viral infections. “Smoking damages the linings of the nose and throat, which not only offer barrier protection but also have a coating of fine filaments, called cilia, on the surface,” says Neil Schachter, a professor of pulmonary and critical care at the Mount Sinai School of Medicine, in New York City. That’s why smokers tend to have more frequent and worse colds than nonsmokers. Exposure to secondhand smoke can also lower your natural defenses.
Stress, lack of sleep, and poor nourishment can also set you up for getting sick. Stress and fatigue can lower your resistance to infection and increase the intensity of illnesses you do get. (For more on how stress can make you sick, see Manage Your Stress.) But there may be a bit of a lag between a stressful event and when you become ill. “When you’re in a period of maximal stress, you’re releasing a lot of adrenaline, which keeps you going,” says Bruce Polsky, chief of the division of infectious diseases at St. Luke’s–Roosevelt Hospital Center, in New York City. “Once that stressful stimulus is over or removed, you crash.”
If you’re under long-term stress, you’re especially susceptible to illness, because chronically elevated stress hormones can suppress immune function and lower the activity of germ-fighting white blood cells. Researchers at Carnegie Mellon University found that severe chronic stress―from such things as conflicts with family or friends and unemployment―significantly increases a person’s risk of coming down with a cold.

What to do to keep from getting the flu again?

Anyone who has had the flu knows it’s not a pleasant experience. Fever, fatigue, runny nose, cough and muscle aches can make you feel pretty miserable. And once you get over the flu, you certainly won’t want to get sick again.

Well there’s good news and bad news on that front. I’ll start with the bad news. It is possible to get the flu twice during the same flu season. Since there are two types of flu strains – influenza A and influenza B – if you get influenza A, you can also get influenza B.

But there is some good news. If you get influenza A, your body will develop antibodies for influenza A that provide protection against it. Also, while the influenza A antibodies won’t protect you from getting influenza B, having influenza A doesn’t increase your risk of getting influenza B. Plus influenza B typically doesn’t cause as serious of an infection.

So if you’ve had the flu once, what can you do to keep from getting the flu again? The tried and true advice still applies.

1. Get an annual flu shot.

The best way to protect yourself and others is by getting the flu vaccine every year. It decreases the risk of acquiring the infection and it can decrease the severity if you do acquire it.

Flu viruses aren’t like other viruses where you get them once and you’re protected for life. Flu viruses changes from year to year. A lot of research goes into predicting the changes but it’s a prediction, so it’s not always 100 percent accurate. That’s what accounts for some of the variability and effectiveness of the vaccine.

2. Stay home when you’re sick and encourage others to do the same.

When you’re sick or a family member is sick, it’s really important to stay home until you’re better. For most people, it takes about a week to get over the flu. Staying home that long may be a hard pill to swallow in a culture of presentism, but it’s something you really should do.

People infected with the flu can shred the virus for five to seven days after developing it. The flu is typically spread through coughing. Cover your cough by coughing into your elbow and not into your hand.

To reduce the risk of infecting others, sleep in another room from other family members, don’t get really close and avoid high-risk populations such as infants, the elderly and people with compromised immune systems.

If you or a coworker returns to work or school early, you risk getting others sick.

3. Wash your hands.

All the time but especially during flu season, good hand hygiene is important. Wash your hands frequently with soap and water or use an alcohol-based hand sanitizer. Avoid touching your hands to your eyes and mouth.

4. Drink plenty of fluids and see if you’re a candidate for an antiviral medication.

One of the important things for treatment and overall wellness is hydration. When hydration is recommended, water is always ideal. There can be a lot of fluid loss with the fever caused by the flu. Medications like ibuprofen and acetaminophen can provide symptom relief.

If you can start the antiviral Tamiflu in the first 24 to 48 hours of symptom onset, it can decrease the symptom duration and viral shedding by about a day. It’s also likely can decrease the risk of severe complications.

Why is the flu so serious?

The flu is well known to predispose people to secondary bacterial infections such as pneumonia, bronchitis and ear infections, among others. It’s really important for people to know when they develop flu if they are getting better and then get worse again, they need to be evaluated for a secondary bacterial infection.

A significant number of deaths related to flu are attributed to the secondary infections people develop. These infections can happen at the same time patients have the flu, in that period right after they develop it or as they are recovering.

Shandra Day is an infectious disease physician at The Ohio State University Wexner Medical Center.

Yes, Your Kid Can Get the Flu Twice in One Season. Here’s Why

It’s bad enough when the flu bug strikes your family the first time—but when those same aches and high fevers strike more than once, you’ll be left wondering, can you get the flu twice? Sadly, the answer is yes.

As awful as it sounds, it is possible to get the flu twice in one season because there are two different types of the virus. “A child could be infected by both influenza A and influenza B in the same year,” Dr. Ian Tong, chief medical officer at Doctor on Demand told POPSUGAR.

#Parents: #Flu vaccination reduced the risk of flu-related death by half in children with high-risk medical conditions and 65% in healthy children from 2010 to 2014. #FightFlu this season with a flu vaccine, the best protection against flu. https://t.co/ttZcNp0Ejw pic.twitter.com/hJFiz3zqhw

— CDC Flu (@CDCFlu) October 22, 2018

While having the flu is miserable either way, the types can be different when it comes to symptoms and severity. “Influenza A subtype, or influenza A, is the more dangerous subtype of the flu,” Dr. Tong explained. While the symptoms tend to be more severe than those of influenza B, the good news is they don’t last quite as long. Influenza B on the other hand, is associated with milder symptoms, but tends to last longer.

Regardless of which type, the important thing to keep in mind is that treating any flu virus is the same. Dr. Tong advises, “Wash your hands, cover your mouth or your child’s mouth when he or she coughs, and isolate that person from other family members if possible, especially those who have weaker immune systems.”

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—Shahrzad Warkentin

Featured photo: Myriams Photos via

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