Mar 22, 2022 · Meningitis in children. Meningitis becomes more common in children as they grow older and reach high school and college ages. Symptoms of viral and bacterial meningitis in children are similar to ... Protecting newborns Seeing a doctor Meningitis is a condition that causes inflammation in the meninges, which protect the brain and spinal cord. Meningitis is most often caused by a virus or...Meningitis is an infection of the protective membranes that surround the brain and spinal cord (meninges). It can affect anyone, but is most common in babies, young children, teenagers and young adults. Meningitis can be very serious if not treated quickly. It can cause life-threatening blood poisoning ( sepsis) and result in permanent damage ... Stiff neck. Other symptoms that can occur with this disease: Agitation. Bulging fontanelles in babies. Decreased alertness. Poor feeding or irritability in children. Rapid breathing. Unusual posture, with the head and neck arched backward (opisthotonos) You cannot tell if you have bacterial or viral meningitis by how you feel.Abstract. Group B streptococcus (GBS) infection remains a leading cause of sepsis, pneumonia, and meningitis in infants. Rates of GBS early onset disease have declined following the widcespread use of intrapartum antibiotic prophylaxis; hence, late-onset infections (LOGBS) are currently a common presentation of neonatal GBS dicsease.The MMR vaccine is very safe. Most side effects are mild and do not last long, such as: the area where the needle goes in looking red, swollen and feeling sore for 2 to 3 days; around 7 to 11 days after the injection, babies or young children may feel a bit unwell or develop a high temperature for about 2 or 3 daysSeizures. Sleepiness or trouble waking. Sensitivity to light. No appetite or thirst. Skin rash in some cases, such as in meningococcal meningitis. Signs in newborns Newborns and infants may show these signs: High fever.Protecting newborns Seeing a doctor Meningitis is a condition that causes inflammation in the meninges, which protect the brain and spinal cord. Meningitis is most often caused by a virus or...Babies who get group B strep a week or so after birth may have signs such as: Decreased movement of an arm or leg. Pain with movement of an arm or leg. Breathing problems. Fever. Red area on the face or other part of the body. Pregnant women may have group B strep without symptoms. When they have symptoms, these may include: Having to urinate ...Meningitis during the neonatal period is a potentially devastating condition with dire long-term consequences. Despite advances in preventive and critical care medicine, bacterial meningitis continues to have an adverse outcome rate of 20 to 60% among its survivors.[1] Although the incidence and mortality have declined over the past few decades, it remains challenging to diagnose due to ...Babies who get group B strep a week or so after birth may have signs such as: Decreased movement of an arm or leg. Pain with movement of an arm or leg. Breathing problems. Fever. Red area on the face or other part of the body. Pregnant women may have group B strep without symptoms. When they have symptoms, these may include: Having to urinate ... Oct 19, 2021 · sensitivity to light. confusion. seizures, or fits. Although fever is one of the most telling signs of meningitis, it is often absent in babies younger than 3 months old. Babies and toddlers may ... Sep 2, 2022 · Meningitis is a serious illness that causes inflammation of the membranes around the spinal cord and neck. It can be fatal without prompt treatment. The meningitis vaccine is one of the best ways ... Feb 8, 2011 · Newborn babies are immune to some diseases because they have antibodies they get from their mothers, usually before they are born. However, this immunity lasts a few months. Most babies do not get protective antibodies against diphtheria, whooping cough, polio, tetanus, hepatitis B, or Hib from their mothers. Neonatal meningitis is a serious medical condition in infants that is rapidly fatal if untreated. Meningitis is an inflammation of the meninges , the protective membranes of the central nervous system , is more common in the neonatal period (infants less than 44 days old) than any other time in life, and is an important cause of morbidity and ...Enterovirus encephalitis (EVE) can present as meningoencephalitis (where it results in both inflammation of the brain and its lining), an illness similar to herpes simplex encephalitis, or a severe brainstem encephalitis. Symptoms can include lethargy, somnolence, altered consciousness, personality change, hallucinations, stiff neck, ataxia ...Older children and adolescents have a stiff neck with a fever, headache, and confusion, and newborns and young infants are usually irritable, stop eating, vomit, or have other symptoms. The diagnosis is based on the results of a spinal tap and blood and urine tests. Some children die of meningitis even after receiving appropriate treatment.Meningitis is an infection of the protective membranes that surround the brain and spinal cord (meninges). It can affect anyone, but is most common in babies, young children, teenagers and young adults. Meningitis can be very serious if not treated quickly. It can cause life-threatening blood poisoning ( sepsis) and result in permanent damage ... Oct 13, 2021 · Herpes meningitis is a type of viral meningitis resulting from infection with a herpes virus. Three types of herpes virus can cause HM: herpes simplex virus 1, herpes simplex virus 2, and ... Jun 15, 2022 · Meningitis can occur in people of all ages, but babies, children, and those with a weakened immune system are at the highest risk. Babies between birth and 1 month of age are more likely to ... Meningitis is when the membranes that surround and protect the brain and spinal cord become inflamed and swollen. This usually happens because the membranes, called the meninges, have become infected from bacteria or a virus. The inflammation can then cause damage to the brain or nerves.Your baby can get meningitis when bacteria, viruses, or a fungus infecting another part of their body travels in the bloodstream to their brain and spinal cord. Out of 1,000 live births,...Apr 27, 2023 · Child and Adolescent Immunization Schedule by Age. Recommendations for Ages 18 Years or Younger, United States, 2023. Print. Please see the most up-to-date COVID-19 vaccine recommendations and new or updated recommendations for RSV , Influenza, pneumococcal, polio, and Mpox vaccines. These have been adopted by the CDC Director and are official. Extreme fatigue. Irritability. Blue color to the skin. Babies with group B strep bacteria could get serious complications like these: Pneumonia -- a lung infection. Meningitis -- inflammation in ...Neonatal meningitis is a serious medical condition in infants that is rapidly fatal if untreated. Meningitis is an inflammation of the meninges , the protective membranes of the central nervous system , is more common in the neonatal period (infants less than 44 days old) than any other time in life, and is an important cause of morbidity and ...Prevention. Treatment. Bacterial meningitis is inflammation of the layers of tissue surrounding the brain and spinal cord (meninges) caused by bacteria . Newborns with bacterial meningitis are usually irritable, vomit, or may have seizures. The diagnosis is based on the results of a spinal tap and blood tests.Child and Adolescent Immunization Schedule by Age. Recommendations for Ages 18 Years or Younger, United States, 2023. Print. Please see the most up-to-date COVID-19 vaccine recommendations and new or updated recommendations for RSV , Influenza, pneumococcal, polio, and Mpox vaccines. These have been adopted by the CDC Director and are official.Meningococcal bacteria. Meningococcal disease is caused by the bacterium Neisseria meningitidis. There are several different groups of meningococcal bacteria including groups A, B, C, Y and W (previously called W135). These groups of bacteria can be further divided into specific strains. Most cases in New Zealand are caused by group B. Meningitis is when the membranes that surround and protect the brain and spinal cord become inflamed and swollen. This usually happens because the membranes, called the meninges, have become infected from bacteria or a virus. The inflammation can then cause damage to the brain or nerves.Meningitis during the neonatal period is a potentially devastating condition with dire long-term consequences. Despite advances in preventive and critical care medicine, bacterial meningitis continues to have an adverse outcome rate of 20 to 60% among its survivors.[1] Although the incidence and mortality have declined over the past few decades, it remains challenging to diagnose due to ...May 1, 2003 · Neonatal meningitis is an uncommon but serious disease, with an incidence of 0.1–0.4 per 1000 live births. 1, 2 It can have severe long term sequelae in 12–29% of survivors, 2– 8 and milder impairment of neurological function occurs in another 15–38%. 3– 5, 8 Cognitive impairment has been shown in some follow up studies of neonatal ... Oct 19, 2021 · sensitivity to light. confusion. seizures, or fits. Although fever is one of the most telling signs of meningitis, it is often absent in babies younger than 3 months old. Babies and toddlers may ... Babies who get group B strep a week or so after birth may have signs such as: Decreased movement of an arm or leg. Pain with movement of an arm or leg. Breathing problems. Fever. Red area on the face or other part of the body. Pregnant women may have group B strep without symptoms. When they have symptoms, these may include: Having to urinate ... Meningitis during the neonatal period is a potentially devastating condition with dire long-term consequences. Despite advances in preventive and critical care medicine, bacterial meningitis continues to have an adverse outcome rate of 20 to 60% among its survivors.[1] Although the incidence and mortality have declined over the past few decades, it remains challenging to diagnose due to ...Side effects linked to the vaccines are usually mild and tend to go away within a few days. Herd immunity is unlikely to prevent meningitis, so it is essential that people get vaccinated and have ...purple-red skin rash or bruising. pale or blotchy skin. seizures (fits) The most common symptoms of meningitis in older children and adults are: fever. sensitivity to light. very bad headache and stiff or sore neck. nausea or vomiting and loss of appetite. tiredness and drowsiness. In infants, illness caused by group B strep can be within six hours of birth (early onset) — or weeks or months after birth (late onset). Signs and symptoms might include: Fever. Low body temperature. Difficulty feeding. Sluggishness, limpness or weak muscle tone. Difficulty breathing. Irritability. Jitteriness.The most common causes of bacterial meningitis among babies younger than 2 months of age are group B Streptococcus, Streptococcus pneumoniae, Listeria monocytogenes, and Escherichia coli .Meningitis is an infection of the membranes that cover the brain and spinal cord. While meningitis affects people in all age groups, children 2 and younger are most at risk. Without prompt treatment, infants with meningitis can suffer permanent brain damage or even death. Learn more about the causes, symptoms, and treatment of this dangerous ...Prevention. Treatment. Bacterial meningitis is inflammation of the layers of tissue surrounding the brain and spinal cord (meninges) caused by bacteria . Newborns with bacterial meningitis are usually irritable, vomit, or may have seizures. The diagnosis is based on the results of a spinal tap and blood tests.Infant development milestones for a 7- to 9-month-old include sitting, standing and laughing. By Mayo Clinic Staff. As your baby becomes more mobile and curious, infant development takes off. It might seem that your baby learns something new every day. Understand these next milestones and what you can do to promote your baby's growth.Babies who get group B strep a week or so after birth may have signs such as: Decreased movement of an arm or leg. Pain with movement of an arm or leg. Breathing problems. Fever. Red area on the face or other part of the body. Pregnant women may have group B strep without symptoms. When they have symptoms, these may include: Having to urinate ...Apr 27, 2023 · Child and Adolescent Immunization Schedule by Age. Recommendations for Ages 18 Years or Younger, United States, 2023. Print. Please see the most up-to-date COVID-19 vaccine recommendations and new or updated recommendations for RSV , Influenza, pneumococcal, polio, and Mpox vaccines. These have been adopted by the CDC Director and are official. Almost half of neonatal sepsis survivors return to the hospital at least once after recovery. Some babies develop an infection of the membranes surrounding their brain called meningitis. Newborns who have this condition may develop serious symptoms and side effects, including: Extreme sluggishness (lethargy).Meningococcal bacteria. Meningococcal disease is caused by the bacterium Neisseria meningitidis. There are several different groups of meningococcal bacteria including groups A, B, C, Y and W (previously called W135). These groups of bacteria can be further divided into specific strains. Most cases in New Zealand are caused by group B.Side effects linked to the vaccines are usually mild and tend to go away within a few days. Herd immunity is unlikely to prevent meningitis, so it is essential that people get vaccinated and have ...Having convulsions (seizure) Babies who get group B strep a week or so after birth may have signs such as: Decreased movement of an arm or leg. Pain with movement of an arm or leg. Breathing problems. Fever. Red area on the face or other part of the body. Pregnant women may have group B strep without symptoms. Viral meningitis is the most common type, but it’s not usually life-threatening. The enteroviruses that cause meningitis can spread through direct contact with saliva, nasal mucus, or feces ...May 18, 2023 · In many cases, they are harmless. Bacterial meningitis occurs when these bacteria get in your bloodstream and travel to your brain and spinal cord to start an infection. Most bacteria that cause ... Email Meningitis Infections in Infants and Children Meningitis is a swelling (inflammation) of the tissues that cover the brain and spinal cord. Sometimes, the swelling affects the brain. Meningitis can be caused by medications, injuries, and conditions such as cancer and lupus, but the most common cause is infection.Dec 30, 2022 · Specific Immunization Reactions. Pain or swelling at the shot site for 1 to 2 days. (20% of children) Mild fever lasting 1 to 3 days begins 14 to 28 days after the shot (10%). Give acetaminophen or ibuprofen for fever over 102° F (39°C). Never give aspirin for fever, pain or within 6 weeks of getting the shot. Signs and symptoms of meningitis include: fever. a severe headache. nausea. stiff neck. sensitivity to light. Meningitis often occurs due to pathogens such as viruses, bacteria, and fungi, and so ...Meningitis is an infection of the membranes that cover the brain and spinal cord. While meningitis affects people in all age groups, children 2 and younger are most at risk. Without prompt treatment, infants with meningitis can suffer permanent brain damage or even death. Learn more about the causes, symptoms, and treatment of this dangerous ...Meningitis is a disease caused by an inflammation of the meninges, the membranes that surround the brain and spinal cord. It's usually caused by a virus, although it can be caused by bacteria, a fungus, or tuberculosis. Treatment for meningitis depends on the specific cause of the disease. Vaccinations can prevent or minimize the incidence of ... Meningitis is an inflammation of the meninges (meh-NIN-jeez), the membranes that cover the brain and spinal cord. Some types of meningitis (meh-nen-JYE-tis) can be dangerous and even life-threatening. Routine vaccinations can help prevent it. Quick treatment of meningitis usually is successful. So it's important to know what symptoms it can ...Meningococcal bacteria. Meningococcal disease is caused by the bacterium Neisseria meningitidis. There are several different groups of meningococcal bacteria including groups A, B, C, Y and W (previously called W135). These groups of bacteria can be further divided into specific strains. Most cases in New Zealand are caused by group B.The MenB vaccine will protect your baby against infection by meningococcal group B bacteria. These bacteria are responsible for about 9 in every 10 meningococcal infections in young children. Meningococcal infections can be very serious, causing meningitis and sepsis. This can lead to severe brain damage, amputations and, sometimes, death.Sep 17, 2019 · Summary. Meningitis is inflammation of the thin tissue that surrounds the brain and spinal cord, called the meninges. There are several types of meningitis. The most common is viral meningitis. You get it when a virus enters the body through the nose or mouth and travels to the brain. Bacterial meningitis is rare, but can be deadly. Older children and adolescents have a stiff neck with a fever, headache, and confusion, and newborns and young infants are usually irritable, stop eating, vomit, or have other symptoms. The diagnosis is based on the results of a spinal tap and blood and urine tests. Some children die of meningitis even after receiving appropriate treatment.purple-red skin rash or bruising. pale or blotchy skin. seizures (fits) The most common symptoms of meningitis in older children and adults are: fever. sensitivity to light. very bad headache and stiff or sore neck. nausea or vomiting and loss of appetite. tiredness and drowsiness. Extreme fatigue. Irritability. Blue color to the skin. Babies with group B strep bacteria could get serious complications like these: Pneumonia -- a lung infection. Meningitis -- inflammation in ... Older children and adolescents have a stiff neck with a fever, headache, and confusion, and newborns and young infants are usually irritable, stop eating, vomit, or have other symptoms. The diagnosis is based on the results of a spinal tap and blood and urine tests. Some children die of meningitis even after receiving appropriate treatment.Jun 26, 2023 · Babies are at high risk of bacterial meningitis and often have symptoms that mimic other illnesses. Parents should be on the lookout for meningitis symptoms such as high fever, stiff neck, rigid extremities, vomiting, diarrhea, or a skin rash with lots of pinpoint-sized dots ( petechiae ) that are associated with invasive meningococcal disease . How meningitis is spread. The viruses and bacteria that cause meningitis can be spread through: sneezing. coughing. kissing. The infection is usually spread by people who carry these viruses or bacteria in their nose or throat, but are not ill themselves. The infection can also be spread by someone with meningitis, although this is less common.Meningitis In Babies. Meningitis is an inflammation of the meninges, which is the tissue that surrounds and protects the brain and spinal cord. It’s most commonly caused by viral or bacterial infections. Meningitis is a serious condition that, left untreated, can be fatal in a short period of time and can cause life-altering complications in ... Signs and symptoms in people over the age of 2 may include: High fever that comes on suddenly. Stiff neck. Severe headache that seems unusual. Headache with nausea or vomiting. Confusion or ...Dec 30, 2022 · Specific Immunization Reactions. Pain or swelling at the shot site for 1 to 2 days. (20% of children) Mild fever lasting 1 to 3 days begins 14 to 28 days after the shot (10%). Give acetaminophen or ibuprofen for fever over 102° F (39°C). Never give aspirin for fever, pain or within 6 weeks of getting the shot. Meningitis is acute or chronic inflammation of the protective membranes covering the brain and spinal cord, collectively called the meninges. The most common symptoms are fever, headache, and neck stiffness. Other symptoms include confusion or altered consciousness, nausea, vomiting, and an inability to tolerate light or loud noises.Jun 15, 2023 · Meningitis is an infection of the protective membranes that surround the brain and spinal cord (meninges). It can affect anyone, but is most common in babies, young children, teenagers and young adults. Meningitis can be very serious if not treated quickly. It can cause life-threatening blood poisoning (septicaemia) and result in permanent ... Newborn babies are immune to some diseases because they have antibodies they get from their mothers, usually before they are born. However, this immunity lasts a few months. Most babies do not get protective antibodies against diphtheria, whooping cough, polio, tetanus, hepatitis B, or Hib from their mothers.To help comfort your baby, you can: give them a cuddle; offer them extra cool drinks (if you're breastfeeding, your child may feed more often) take them for a walk in the fresh air; If the injection site is red, swollen or tender, put a clean cold cloth to the area for about 5 to 10 minutes – this may help to soothe your baby. After the MMR ...Spread to others. People spread meningococcal bacteria to other people by sharing respiratory and throat secretions (saliva or spit). Generally, it takes close (for example, coughing or kissing) or lengthy contact to spread these bacteria. Fortunately, they are not as contagious as germs that cause the common cold or the flu.Meningitis is an infection that causes inflammation of the membranes (the meninges) covering the brain and spinal cord. Bacterial meningitis is a true medical emergency that may result in death or brain injury even if treated. Bacterial strains that cause meningitis include Streptococcus pneumoniae, Haemophilus influenza, Neisseria meningitides ... Sep 17, 2019 · Summary. Meningitis is inflammation of the thin tissue that surrounds the brain and spinal cord, called the meninges. There are several types of meningitis. The most common is viral meningitis. You get it when a virus enters the body through the nose or mouth and travels to the brain. Bacterial meningitis is rare, but can be deadly. Meningitis in children. Meningitis becomes more common in children as they grow older and reach high school and college ages. Symptoms of viral and bacterial meningitis in children are similar to ...Feb 26, 2018 · Protecting newborns Seeing a doctor Meningitis is a condition that causes inflammation in the meninges, which protect the brain and spinal cord. Meningitis is most often caused by a virus or... Having convulsions (seizure) Babies who get group B strep a week or so after birth may have signs such as: Decreased movement of an arm or leg. Pain with movement of an arm or leg. Breathing problems. Fever. Red area on the face or other part of the body. Pregnant women may have group B strep without symptoms. Your baby can get meningitis when bacteria, viruses, or a fungus infecting another part of their body travels in the bloodstream to their brain and spinal cord. Out of 1,000 live births,...Dec 30, 2022 · Specific Immunization Reactions. Pain or swelling at the shot site for 1 to 2 days. (20% of children) Mild fever lasting 1 to 3 days begins 14 to 28 days after the shot (10%). Give acetaminophen or ibuprofen for fever over 102° F (39°C). Never give aspirin for fever, pain or within 6 weeks of getting the shot. Meningitis is an infection of the protective membranes that surround the brain and spinal cord (meninges). It can affect anyone, but is most common in babies, young children, teenagers and young adults. Meningitis can be very serious if not treated quickly. It can cause life-threatening blood poisoning ( sepsis) and result in permanent damage ...Bacterial meningitis is a devastating infection associated with high mortality and morbidity in the neonatal population. Prompt diagnosis and treatment are essential to achieving good outcomes in affected infants. While overall incidence and mortality have declined over the last several decades, morbidity associated with neonatal meningitis ...Spread to others. People spread meningococcal bacteria to other people by sharing respiratory and throat secretions (saliva or spit). Generally, it takes close (for example, coughing or kissing) or lengthy contact to spread these bacteria. Fortunately, they are not as contagious as germs that cause the common cold or the flu. Protects your child from Hib disease, which can cause lifelong disability and be deadly. Protects your child from the most common type of Hib disease, meningitis (an infection of the lining of the brain and spinal cord). Keeps your child from missing school or child care, and you from missing work.Older children and adolescents have a stiff neck with a fever, headache, and confusion, and newborns and young infants are usually irritable, stop eating, vomit, or have other symptoms. The diagnosis is based on the results of a spinal tap and blood and urine tests. Some children die of meningitis even after receiving appropriate treatment.
An overview of immunizations for kids ages 4 to 6 years old. DTaP – The fifth and final diphtheria, tetanus and pertussis vaccine is recommended when your child is between 4 and 6 years old. IPV – The poliovirus vaccine is another four-dose series. The dosing schedule for the polio vaccine recommends the first shots at 2 months, 4 months .... Dollar299 down car lots near me
Meningitis is when the membranes that surround and protect the brain and spinal cord become inflamed and swollen. This usually happens because the membranes, called the meninges, have become infected from bacteria or a virus. The inflammation can then cause damage to the brain or nerves.Meningitis is an infection of the protective membranes that surround the brain and spinal cord (meninges). It can affect anyone, but is most common in babies, young children, teenagers and young adults. Meningitis can be very serious if not treated quickly. It can cause life-threatening blood poisoning ( sepsis) and result in permanent damage ... Meningitis in children. Meningitis becomes more common in children as they grow older and reach high school and college ages. Symptoms of viral and bacterial meningitis in children are similar to ...Feb 26, 2018 · Protecting newborns Seeing a doctor Meningitis is a condition that causes inflammation in the meninges, which protect the brain and spinal cord. Meningitis is most often caused by a virus or... The most common causes of bacterial meningitis among babies younger than 2 months of age are group B Streptococcus, Streptococcus pneumoniae, Listeria monocytogenes, and Escherichia coli .Meningococcal bacteria. Meningococcal disease is caused by the bacterium Neisseria meningitidis. There are several different groups of meningococcal bacteria including groups A, B, C, Y and W (previously called W135). These groups of bacteria can be further divided into specific strains. Most cases in New Zealand are caused by group B. Trust your instincts and do not wait for all the symptoms to appear or until a rash develops. Symptoms of meningitis and sepsis include: a high temperature. cold hands and feet. vomiting. confusion. breathing quickly. muscle and joint pain. pale, mottled or blotchy skin (this may be harder to see on brown or black skin) Meningitis is when the membranes that surround and protect the brain and spinal cord become inflamed and swollen. This usually happens because the membranes, called the meninges, have become infected from bacteria or a virus. The inflammation can then cause damage to the brain or nerves.Bacterial meningitis, which took the life of famed guitar player Jeff Beck, is a potentially deadly infection that can strike quickly. Learn about the causes, what puts you at risk, and how to ...Meningitis is an inflammation of the meninges (meh-NIN-jeez), the membranes that cover the brain and spinal cord. Some types of meningitis (meh-nen-JYE-tis) can be dangerous and even life-threatening. Routine vaccinations can help prevent it. Quick treatment of meningitis usually is successful. So it's important to know what symptoms it can ... Meningitis can occur in people of all ages, but babies, children, and those with a weakened immune system are at the highest risk. Babies between birth and 1 month of age are more likely to ...Oct 19, 2021 · sensitivity to light. confusion. seizures, or fits. Although fever is one of the most telling signs of meningitis, it is often absent in babies younger than 3 months old. Babies and toddlers may ... Signs and symptoms of meningitis include: fever. a severe headache. nausea. stiff neck. sensitivity to light. Meningitis often occurs due to pathogens such as viruses, bacteria, and fungi, and so ...Meningitis is an infection that causes inflammation of the membranes (the meninges) covering the brain and spinal cord. Bacterial meningitis is a true medical emergency that may result in death or brain injury even if treated. Bacterial strains that cause meningitis include Streptococcus pneumoniae, Haemophilus influenza, Neisseria meningitides ...Feb 26, 2018 · Protecting newborns Seeing a doctor Meningitis is a condition that causes inflammation in the meninges, which protect the brain and spinal cord. Meningitis is most often caused by a virus or... Herpes meningoencephalitis is an infection of the brain and brain covering (meninges) caused by the herpes simplex virus. It is a medical emergency that requires treatment right away. Symptoms can include headache, fever, changes in consciousness, confusion, neck stiffness, sensitivity to light, seizures, and changes in mood, personality, or ... .