Global & Disaster Medicine

Archive for May, 2016

The blaze, which has scorched more than 602 square miles and ravaged Fort McMurray, is approaching the neighboring province of Saskatchewan

CNN

Fire Danger

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Fires Continue in Fort McMurray


Control of Canine Rabies in Ethiopia, 2015: Challenges Galore!

CDC

 

 

Notes from the Field: Assessment of Health Facilities for Control of Canine Rabies — Gondar City, Amhara Region, Ethiopia, 2015

Emily G. Pieracci, DVM1,2; Betsy Schroeder, MPH3; Araya Mengistu, DVM, PhD4; Achenef Melaku, DVM4; Miriam Shiferaw, MD5; Jesse D. Blanton, MPH5; Ryan Wallace, DVM5

Rabies is an encephalitic disease that is nearly always fatal after onset of illness. Worldwide, rabies kills an estimated 59,000 humans each year (95% confidence interval [CI] = 25,000–159,000); the majority of the deaths are caused by the rabies virus variant that circulates in dogs (1,2). Canine rabies is endemic in Ethiopia, with an estimated 2,771 human deaths annually (CI = 1,116–12,660) (13). Annual rabies-associated livestock losses are estimated at >$50 million (USD), making rabies important to both human and animal health (1).

Human health care delivery in Ethiopia occurs through hospitals, health centers, and health posts. The Ethiopian government runs veterinary clinics, and some private veterinarians operate in large cities; however, human and animal health providers do not routinely collaborate to control zoonotic diseases. The World Organisation for Animal Health’s Tool for the Evaluation of Performance of Veterinary Services identified a need to improve animal disease surveillance as well as collaboration on zoonotic diseases between the Ministry of Health and veterinary services in Ethiopia (4).

Dog bites are nationally notifiable in Ethiopia and bite victims are referred to health centers for rabies postexposure prophylaxis (PEP). No additional public health interventions occur at the community level. In an integrated bite-case management (IBCM) program, animal health workers would investigate biting dogs to provide the health sector with information for rabies risk assessments. Studies have shown that IBCM can increase bite detection rates by up to 30% and decrease unnecessary PEP by 60% (5). Because IBCM represents integration of both human and animal health, it offers an opportunity to prevent human rabies deaths as well as decrease the high costs of unnecessary PEP.

In January 2015, CDC, in collaboration with Ohio State University, the University of Gondar (Amhara Region, Ethiopia), and the Ethiopian Public Health Institute developed an IBCM pilot program in the city of Gondar. Bite events are reported from human health sectors to animal health workers, who conduct animal rabies assessments to guide management decisions for exposed persons. Program goals include recording dog bites, testing suspected rabid dogs, and reducing community rabies exposures.

In September 2015, a CDC team evaluated the IBCM pilot program and assessed the feasibility of program expansion. The evaluation included informal interviews with animal health workers, laboratorians, and program supervisors, and field observation of animal health workers. The feasibility assessment included semi-structured interviews with key stakeholders at human and animal health facilities and evaluation of infrastructural requirements necessary for IBCM program expansion (i.e., cold-chain capacity, sample transportation, and access to rabies vaccines).

Delays in the distribution of funds and shortages of PEP slowed program implementation during the first 9 months. In addition, the preference of community members to seek bite-wound treatment from traditional healers rather than health professionals resulted in a low dog-bite reporting rate. Rabies diagnostic testing capacity was lacking, related to delays in construction of a regional animal disease diagnostic center. Quarantine facilities for suspected rabid dogs did not adhere to international animal welfare regulations; therefore, most suspected rabid animals were quarantined within owners’ homes. Inconsistencies in animal health workers’ handling of animals, including euthanasia practices and sample collection, also hampered implementation. Resource gaps included inadequate access to PEP and canine vaccines and a lack of cold-chain capacity.

Despite the implementation challenges, efforts were undertaken to enhance IBCM capacity in Gondar through training of additional animal health workers, laboratorians, and program supervisors. Ethiopia has regional and national plans to increase access to PEP and canine rabies vaccine during the next year. A national animal rabies surveillance system, based on IBCM, is being jointly developed by human and animal health agencies with CDC support, and will be implemented in the Amhara Region during 2016. Construction of the rabies laboratory is under way, and temporary diagnostic laboratory space has been identified. Construction of regional quarantine facilities is expected to begin in 2016. During the feasibility assessments, the IBCM program was introduced to clinicians unaware of this activity.

Further work is needed to increase community reporting of suspected rabid dogs through improved awareness of the IBCM program. Expanded access to WHO-approved PEP is needed, but distribution of vaccine should be limited to facilities with stable cold-chain capacity. Traditional healers should be encouraged to refer dog-bite victims for PEP, and health clinics and veterinary facilities should coordinate IBCM investigations. Enhancement of the IBCM program is anticipated to continue as the program is introduced in new areas.

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Corresponding author: Emily G. Pieracci, epieracci@cdc.gov, 404-639-2603.

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1Epidemic Intelligence Service, CDC; 2Division of Vector-Borne Diseases, National Center for Emerging Zoonotic Infectious Diseases, CDC; 3Virginia-Maryland College of Veterinary Medicine; 4University of Gondar, Amhara Region, Ethiopia; 5Division of High-Consequence Pathogens and Pathology, National Center for Emerging Zoonotic Infectious Diseases, CDC.

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References

  1. Hampson K, Coudeville L, Lembo T, et al. . Estimating the global burden of endemic canine rabies. PLoS Negl Trop Dis 2015;9:e0003709. CrossRef PubMed
  2. Jemberu WT, Molla W, Almaw G, Alemu S. Incidence of rabies in humans and domestic animals and people’s awareness in North Gondar Zone, Ethiopia. PLoS Negl Trop Dis 2013;7:e2216.CrossRef PubMed
  3. Paulos A, Eshetu Y, Bethelhem N, et al. A study on the prevalence of animal rabies in Addis Ababa during 1999–2002. Ethiopian Veterinary Journal 2002;7:69–77.
  4. World Organisation for Animal Health (OIE). OIE tool for the evaluation of performance of veterinary services. 6th ed. Paris, France: World Organisation for Animal Health; 2013.http://www.oie.int/fileadmin/Home/eng/Support_to_OIE_Members/pdf/PVS_A_Tool_Final_Edition_2013.pdf
  5. Wallace RM, Reses H, Franka R, et al. Establishment of a high canine rabies burden in Haiti through the implementation of a novel surveillance program. PLoS Negl Trop Dis 2015;9:e0004245.CrossRef PubMed

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Suggested citation for this article: Pieracci EG, Schroeder B, Mengistu A, et al. Notes from the Field. Assessment of Health Facilities for Control of Canine Rabies — Gondar City, Amhara Region, Ethiopia, 2015. MMWR Morb Mortal Wkly Rep 2016;65:456–457. DOI: http://dx.doi.org/10.15585/mmwr.mm6517a4.


Volcanic Lahars

Lahar devastation after the eruption of Mount Pinatubo, Philippines. 
 (Click image to view full size.)

 


It’s alive! In the past eight weeks, more than 130 small earthquakes have trembled beneath the surface of Mount St. Helens.

CNN

 

Location: Washington, Skamania County
Latitude: 46.2° N
Longitude: 122.18° W
Elevation: 2,549 (m) 8,363 (f)
Volcano type: Stratovolcano
Composition: Basalt to Rhyodacite
Most recent eruption: 1980, 2004-2008
Nearby towns: Castle Rock, WA; Olympia, WA; Vancouver, WA; Yakima, WA; Portland, OR
Threat Potential: High *

Prior to 1980, Mount St. Helens had the shape of a conical, youthful volcano sometimes referred to as the Mount Fuji of America. During the 1980 eruption the upper 400 m (1,300 ft) of the summit was removed by a huge debris avalanche, leaving a 2 x 3.5 km (1.2 x 2.2 mi) horseshoe-shaped crater now partially filled by a lava dome and a glacier. It is primarily an explosive dacite volcano with a complex magmatic system.

Digital Elevation Map of Mount St. Helens with annotation of pre-1980 topography and deposits from 1980 - 2008.
 (Click image to view full size.)

Mount St. Helens was formed during four eruptive stages beginning about 275,000 years ago and has been the most active volcano in the Cascade Range during the Holocene. Prior to about 12,800 years ago, tephra, lava domes, and pyroclastic flows were erupted, forming the older St. Helens edifice, but a few lava flows extended beyond the base of the volcano. The bulk of the modern edifice (above the 1980 crater floor) was constructed during the last 3,000 years, when the volcano erupted a wide variety of products from summit and flank vents. Historical eruptions in the 19th century originated from the Goat Rocks area on the north flank, and were witnessed by early settlers. New unpublished data on the timing for Mount St. Helens eruptive activity have been analyzed, which improves some of the eruption dates cited in published literature. This website contains the most up to date information.

Location of magma formation, accumulation, and storage beneath Mount St. Helens (locations are inferred from scientific data). 
 (Click image to view full size.)

Mount St. Helens, Washington simplified hazards map showing potential impact area for ground-based hazards during a volcanic event.
 (Click image to view full size.)


Fort McMurray: A family watches as their living room goes up in flames on a security camera they had installed in their home.

https://www.youtube.com/watch?v=bD5FHqtFO1Y

Heat Fuels Fire at Fort McMurray

NASA:   “….Winds gusted over 20 miles (32 kilometers) per hour, fanning the flames in an area where rainfall totals have been well below normal in 2016. Ground-based measurements showed that the temperature soared to 32 degrees Celsius (90 degrees Fahrenheit) on May 3 as the fire spread.

Satellite observations also detected the unusual heat. The map above shows land surface temperature from April 26 to May 3, 2016, compared to the 2000–2010 average for the same one-week period. Red areas were hotter than the long-term average; blue areas were below average. White pixels had normal temperatures, and gray pixels did not have enough data, most likely due to cloud cover…..”

 


Alberta’s Fort McMurray Wildfire Update and Resources as of May 5, 2016

Alberta Agriculture and Forestry

Fort McMurray Wildfire Updates

Recent Critical Updates

May 5, 9:20 p.m. Official update:

  • Anzac/Gregoire Lake Estates remains an active zone. Further details won’t be available until the morning.
  • The Stone Creek Area remains an active fire zone.
  • The Birchwood Trails remains a priority from a strategic firefighting standpoint. Crews are working hard to protect this area.
  • Gusting winds have been extremely challenging for fire crews.
  • Properties near green areas remain an issue due to sparks and high winds creating spot fires among housing.
  • A plan is being developed for northern evacuees
  • Wildfire Emergency Resources

Regional Municipality of Wood Buffalo

The RMWB is sharing information on the wildfire, the status of evacuations and the status of neighbourhoods as quickly as possible. Follow our social media resources for up-to-date information:

RMWB on Twitter
RMWB on Facebook

RCMP

If you are in Wood Buffalo and need immediate assistance, call 911.
Safety concerns only: 780-788-4000

Wildfire Information Line

310-4455
Open daily from 7 a.m. to 10 p.m.

Alberta Government Emergency Information

http://www.alberta.ca/emergency.cfm

Red Cross

Redcross.ca
Registration: 1-888-350-6070
Twitter: @RedCrossAB

Insurance inquiries

Contact your insurance provider, or call the Insurance Bureau of Canada’s consumer information line: 1-844-227-5422 or FortMacFire@ibc.ca

SPCA

Animal Assistance Form
Fort McMurray SPCA Facebook Page

Emergency Income Support

24 hours
1-866-644-5135
780-644-5135 Edmonton
Government of Canada EI Claims notice for affected workers

 

Calgary Evacuee Reception Centre

With Fort McMurray and Wood Buffalo evacuees arriving in Calgary, a reception centre has been established at:

Southern Alberta Institute of Technology [Map]
Residence Tower
151 Doctor Carpenter Circle NW
Calgary

Edmonton Hotels Offering “Compassionate Rates”

As of Thursday afternoon. (Rates vary by hotel and are available on an “asked-for” basis.)

0 = Sold Out
NR = No Response
NO = Not Open
Rooms Available
May May May May May May
Company 5th 6th 7th 8th 9th 10th
West End Hotels
Best Western Plus Westwood Inn 0 42 76 105 110 110
Chateau Nova Yellowhead 0 15 17 53 54 44
Comfort Inn West NR NR NR NR NR NR
Continental Inn 0 0 0 0 0 0
Courtyard by Marriott Edm West 33 19 27 83 63 46
Days Inn & Suites West NR NR NR NR NR NR
DoubleTree by Hilton West Edmonton 0 0 0 0 0 0
Edmonton Marriott River Cree 50 80 80 80 80 80
Executive Royal Inn 0 100 149 179 186 195
Hampton Inn & Suites 0 0 0 50 30 25
Hilton Garden Inn West NR NR NR NR NR NR
Holiday Inn Express West 0 0 0 75 75 75
Holiday Inn & Suites 0 0 17 40 26 42
Home2 Suites by Hilton 0 0 0 0 0 0
Travelodge Hotel West 15 72 91 144 176 176
Staybridge Suites West Edmonton 0 0 1 29 5 3
Quality Inn West Edmonton (formerly West Harvest Inn) 0 0 30 50 70 75
Nova Acheson 4 17 47 48 51 58
Wingate Inn 0 0 12 45 65 64
Southside Hotels
Best Western Cedar Park Inn 0 0 54 142 157 153
Campus Tower Suites Hotel 0 0 0 9 9 6
Days Inn Edmonton South 0 0 40 75 85 85
Delta Edmonton South Hotel 0 0 38 150 122 68
Four Points Sheraton 0 0 0 0 0 0
Four Points Sheraton Edmonton Gateway 0 0 0 50 45 45
Holiday Inn Conference Centre Edmonton South 9 29 34 141 168 154
Hampton Inn Edmonton South NR NR NR NR NR NR
Lister Hall at U of A 0 0 0 0 0 0
Metterra Hotel 0 42 34 50 26 19
Radisson Hotel Edmonton South 0 0 0 115 130 95
Renaissance Edmonton Airport Hotel 0 35 35 35 35 35
Sawridge Inn Edmonton 0 0 0 70 40 15
Selkirk at Fort Edmonton Park NO NO NO NO NO NO
Super 8 Edmonton South NR NR NR NR NR NR
Travelodge Edmonton South 0 20 20 20 20 20
Varscona Hotel 0 18 26 56 57 42
Downtown Hotels
Chateau Nova Kingsway 0 0 10 10 10 15
Chateau Lacombe 5 10 10 85 85 35
Coast Edmonton Plaza 50 50 50 50 50 50
Courtyard by Marriott 0 27 58 98 90 0
Days Inn Downtown 0 50 50 50 50 50
Delta Edmonton Centre Suites 70 80 62 82 20 20
Fairmont Hotel Macdonald 16 0 47 91 58 0
Holiday Inn Express 0 13 23 50 80 47
MacEwan University Residences NR NR NR NR NR NR
Matrix 15 30 29 100 40 20
Ramada Inn & Conference Centre 0 14 60 157 224 168
Sutton Place Hotel 25 75 60 160 156 139
Union Bank Inn 10 10 10 10 10 0
Westin Hotel 50 50 50 50 50 0
Total Rooms 352 898 1347 2887 2808 2274

 

Calgary Hotels Reporting Available Accommodations

The City of Calgary, in conjunction with the Calgary Hotel Association, has compiled a list of hotels that indicated availability as of 5 p.m. on Thursday.

Name Street Phone
Acclaim Hotel 123 Freeport Boulevard NE 403-291-8000
Aloft Calgary University 2359 Banff Trail NW 403-338-4401
Best Western Airport Inn 1947 – 18 Avenue NE 403-250-5015
Best Western PLUS Calgary Centre Inn 3630 Macleod Trail South 403-287-3900
Best Western PLUS Suites Downtown 1330 – 8 Street SW 403-209-3444
Best Western Port O’Call Hotel 1935 McKnight Boulevard NE 403-291-4600
Best Western Village Park Inn 1804 Crowchild Trail NW 403-220-1813
Calgary Marriott Downtown Hotel 110 – 9 Avenue SE 403-231-4520
Carriage House Inn 9030 Macleod Trail South 403-640-7504
Centro Motel 4540 – 16 Avenue NW 403-968-3799
Clarion Hotel & Conference Centre, Calgary Airport 2120 – 16 Avenue NE 403-250-6050
Coast Plaza Hotel & Conference Centre 1316 – 33 Street NE 403-207-8119
Country Inn & Suites By Carlson, Calgary Airport 2481 – 39 Avenue NE 403-250-1800
Courtyard By Marriott Calgary Airport 2500 – 48 Avenue NE 403-613-7006
Courtyard By Marriott Calgary South 3750 Market Street SE 403.463.0945
Days Inn Calgary Airport 2799 Sunridge Way NE 403-250-3297
Days Inn Calgary Northwest 4420 – 16 Avenue NW 403-288-7115
Days Inn Calgary South 3828 Macleod Trail South 403-243-5531
Deerfoot Inn & Casino 1000, 11500 – 35 Street SE 403-236-7529
Delta Calgary Airport 2001 Airport Road NE 403-250-6027
Delta Calgary Downtown. 209 – 4 Avenue SE 403-205-5409
Delta Calgary South 135 Southland Drive SE 403-225-5808
EconoLodge Inn & Suites University 2231 Banff Trail NW 403-220-9286
Executive Royal Hotel 2828 – 23 Street NE 403-219-7483
Fairfield Inn & Suites 239 – 12 Ave SW 403-351-6500
Fairmont Palliser, The 133 – 9 Avenue SW 403-260-1202
Four Points By Sheraton Calgary Airport 2875 Sunridge Way NE 403-648-3180
Four Points By Sheraton Calgary West 8220 Bowridge Crescent NW 403-681-4822
Glenmore Inn & Convention Centre 2770 Glenmore Trail SE 403-720-5280
Grey Eagle Resort & Casino 3779 Grey Eagle Dr 587-390-6935
Hampton Inn & Suites Airport 2000 2021 100 Ave (403) 250-4667
Hilton Garden Inn Calgary Airport 2335 Pegasus Road NE 403-717-0150
Holiday Inn Calgary Airport 1250 McKinnon Drive NE 403-313-3384
Holiday Inn Calgary Macleod Trail South 4206 Macleod Trail South 403-287-1435
Homewood Inn & Suites Airport 2000 2021 100 Ave 403-230 7881
Hotel Alma 169 University Gate NW 403-220-7472
Hotel Arts 119 – 12 Avenue SW 403-266-7677
Hotel Blackfoot 5940 Blackfoot Trail SE 403-212-1732
Hotel Elan 1122 – 16 Avenue SW 403-826-1352
Hotel Le Germain 899 Centre Street South 403-444-1371
Hyatt Regency Calgary 700 Centre Street South 403-537-4400
International Hotel Suites Calgary 220 – 4 Avenue SW 403-290-7870
Kensington Riverside Inn 1126 Memorial Drive NW 403-228-4442
Lakeview Signature Inn, Calgary Airport 2622 39 Ave NE 403-735-3230 #4011
O Hotel Suites 346 23 Ave SW
Radisson Hotel Calgary Airport 6620 36 Street NE 403-475-1111
Ramada Hotel Downtown Calgary 708 – 8 Avenue SW 403-218-3026
Ramada PLAZA Calgary Airport Hotel & Conference Centre 3515 – 26 Street NE 403-250 8855
Regency Suites 610 – 4 Avenue SW 403-231-1000
Residence Inn By Marriott Calgary Airport 2530 – 48 Avenue NE 403-613-7006
Residence Inn By Marriott Calgary South 3750 Market Street SE 403.463.0945
Sandman Hotel Calgary Airport 25 Hopewell Way NE 403-219-2478
Sandman Hotel Calgary City Centre 888 – 7 Avenue SW 403-513-2526
Sandman Hotel Calgary South 8001 – 11th Street SE 403-252 7263
Sandman Hotel Calgary West 125 Bowridge Drive NW 403-202-6503
Service Plus Inn & Suites 3503 – 114 Avenue SE 403-203-4311
Sheraton Cavalier 2620 – 32 Avenue NE 403-291-0107
Sheraton Suites Calgary Eau Claire 255 Barclay Parade SW 403-517-6623
Travelodge Hotel Calgary Airport 2750 Sunridge Boulevard NE 403-291 4375
Travelodge Hotel Calgary Macleod Trail 9206 Macleod Trail South 403-255 6740 / 587-432-0356 (m)
Travelodge Calgary University 2227 Banff Trail NW 403 879 1543
Thriftlodge Calgary North 2304 – 16 Avenue NW 403 289 0211
Westin Calgary 320 – 4 Avenue SW 403-508-5200
Wingate by Wyndham Calgary Airport 57 Freeport Crescent NE 587-393-0700
Wingate by Wyndham Calgary South 400 Midpark Way SE 403-254-3554
Wyndham Garden Calgary Airport 11 Freeport Crescent NE 403-516-2266

The 328 square-mile fire at Fort McMurray has forced 88,000 people to evacuate

NBC News

**  “….More than 1,110 firefighters, 145 helicopters and 22 air tankers are fighting the fires…..”

Wildfire in Fort McMurray

Acquired May 3

 

Wildfire Spreads in Fort McMurray

Acquired May 4

References

NASA Earth Observatory image by Joshua Stevens, using Landsat data from the U.S. Geological Survey. Caption by Kathryn Hansen.

Instrument(s):
Landsat 8 – OLI

Elizabethkingia anophelis

Wisconsin

Wisconsin 2016 Elizabethkingia anophelis outbreak

The Wisconsin Department of Health Services (DHS), Division of Public Health (DPH) is currently investigating an outbreak of bacterial infections caused by Elizabethkingia anophelis.

The majority of patients acquiring these infections are over 65 years old, and all patients have a history of at least one underlying serious illness.

The Department quickly identified effective antibiotic treatment for Elizabethkingia, and has alerted health care providers, infection preventionists and laboratories statewide. Since the initial guidance was sent on January 15, there has been a rapid identification of cases and healthcare providers have been able to treat and improve outcomes for patients. DHS continues to provide updates of outbreak-related information that includes laboratory testing, infection control and treatment guidance.

At this time, the source of these infections is still unknown, and the Department continues to work diligently to control this outbreak.  Disease detectives from the Department and the Centers for Disease Control and Prevention (CDC) are conducting a comprehensive investigation which includes:

  • Interviewing patients with Elizabethkingia anophelis infection and/or their families to gather information about activities and exposures related to healthcare products, food, water, restaurants, and other community settings.
  • Obtaining environmental and product samples from facilities that have treated patients with Elizabethkingia anophelis infections. To date, these samples have tested negative and there is no indication the bacteria was spread by a single healthcare facility.
  • Conducting a review of medical records.
  • Obtaining nose and throat swabs from individuals receiving care on the same units in health care facilities as a patient with a confirmed Elizabethkingia anophelis to determine if they are carrying the bacteria.  To date, all of these specimens tested negative, which suggests the bacteria is not spreading from person to person in healthcare settings.
  • Obtaining nose and throat swabs from household contacts of patients with confirmed cases to identify if there may have been exposure in their household environment.
  • Performing a “social network” analysis to examine any commonalities shared between patients including healthcare facilities or shared locations or activities in the community.
Type of Cases Number of Cases
Wisconsin 2016 Elizabethkingia anophelis Outbreak:
Elizabethkingia infections believed to be associated with this outbreak reported to DPH*
Case counts between November 1, 2015 and May 3, 2016
Confirmed 60
Under investigation 0
Possible cases** 4
Total cases reported to Wisconsin DPH 64

Affected counties include Columbia, Dane, Dodge, Fond du Lac, Jefferson, Milwaukee, Ozaukee, Racine, Sheboygan, Washington, Waukesha and Winnebago.

There have been 18 deaths among individuals with confirmed Elizabethkingia anophelis infections and an additional 1 death among possible cases for a total of 19 deaths. It has not been determined if these deaths were caused by the infection or other serious pre-existing health problems. Counties where these deaths occurred are: Columbia, Dodge, Fond du lac, Milwaukee, Ozaukee, Racine, Sheboygan, Washington and Waukesha.

*This investigation is ongoing. Case counts may change as additional illnesses are identified and more cases are laboratory confirmed.
**These are cases that tested positive for Elizabethkingia, but will never be confirmed as the same strain of Elizabethkingia anophelis because the outbreak specimens are no longer available to test.


At least 137 people have gotten seriously ill after they consumed toxic milk from a shop in Muradabad, Pakistan

News Pakistan

 


Singapore: As of May 3, a total of 183 people have come down with food poisoning after eating durian pastries

Channel News Asia

durian

durian fruits

 


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