CDC: Flu Outbreak Could Be Waning

The flu season appears to be waning in some parts of the country, but that doesn't mean it won't make a comeback in the next few weeks, according to the Centers for Disease Control and Prevention.

Five fewer states reported high flu activity levels in the first week of January than the 29 that reported high activity levels in the last week of December, according to the CDC's weekly flu report. This week, 24 states reported high illness levels, 16 reported moderate levels, five reported low levels and one reported minimal levels, suggesting that the flu season peaked in the last week of December.

"It may be decreasing in some areas, but that's hard to predict," CDC Director Dr. Thomas Frieden said in a Friday morning teleconference. "Trends only in the next week or two will show whether we have in fact crossed the peak."

The flu season usually peaks in February or March, not December, said Dr. Jon Abramson, who specializes in pediatric infectious diseases at Wake Forest Baptist Health in North Carolina. He said the season started early with a dominant H3N2 strain, which was last seen a decade ago, in 2002-03. That year, the flu season also ended early.

Click here to see how this flu season stacks up against other years.

Cheryl Evans/The Arizona Republic/AP Photo

Increasing Flu Cases: Best Measures to Ensure Your Family's Health Watch Video

Because of the holiday season, Frieden said the data may have been skewed.

For instance, Connecticut appeared to be having a lighter flu season than other northeastern states at the end of December, but the state said it could have been a result of college winter break. College student health centers account for a large percentage of flu reports in Connecticut, but they've been closed since the fall semester ended, said William Gerrish, a spokesman for the state's department of public health.

The flu season arrived about a month early this year in parts of the South and the East, but it may only just be starting to take hold of states in the West, Frieden said. California is still showing "minimal" flu on the CDC's map, but that doesn't mean it will stay that way.

Click here to read about how flu has little to do with cold weather.

"It's not surprising. Influenza ebbs and flows during the flu season," Frieden said. "The only thing predictable about the flu is that it is unpredictable."

Dr. William Schaffner, chair of preventive medicine at Vanderbilt University Medical Center in Nashville, Tenn., said he was expecting California's seeming good luck with the flu to be over this week.

"Flu is fickle, we say," Schaffner said. "Influenza can be spotty. It can be more severe in one community than another for reasons incompletely understood."

Early CDC estimates indicate that this year's flu vaccine is 62 percent effective, meaning people who have been vaccinated are 62 percent less likely to need to see a doctor for flu treatment, Frieden said.

Although the shot has been generally believed to be more effective for children than adults, there's not enough data this year to draw conclusions yet.

"The flu vaccine is far from perfect, but it's still by far the best tool we have to prevent flu," Frieden said, adding that most of the 130 million vaccine doses have already been administered. "We're hearing of shortages of the vaccine, so if you haven't been vaccinated and want to be, it's better late than never."

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Rights group warns of worsening Pakistani sectarian violence

QUETTA, Pakistan (Reuters) - Violence against Pakistani Shi'ite Muslims is rising and some communities are living in a state of siege, a human rights group said on Friday, warning that sectarian violence will only get worse a day after 114 people were killed in bombings.

Most of the deaths were caused by twin attacks aimed at members of the Muslim Shi'ite sect in the southwestern city of Quetta, near the Afghan border.

"Last year was the bloodiest year for Shias in living memory," said Ali Dayan Hasan of Human Rights Watch. "More than 400 were killed and if yesterday's attack is any indication, it's just going to get worse."

A suicide bomber first targeted a snooker club in Quetta. A car bomb blew up nearby 10 minutes later after police and rescuers had arrived.

In all, 82 people were killed and 121 wounded. Nine police and 20 rescue workers were among the dead.

"It was like doomsday. Bodies were lying everywhere," said police officer Mir Zubair Mehmood.

The banned Sunni group Lashkar-e-Jangvi (LeJ) claimed responsibility for the attack in a predominantly Shi'ite neighborhood where the residents are ethnic Hazaras, Shi'ites who first migrated from Afghanistan in the nineteenth century.

The bombings underscored the myriad threats security forces face from homegrown Sunni extremist groups, the Pakistani Taliban insurgency in the northwest and from nationalist groups in resource-rich Baluchistan province, of which Quetta is capital.

Shi'ite leaders said they wanted the military to take control of Quetta to protect them and they would not allow the 82 victims of the twin bomb attacks to be buried until their demands were met.

The burials had been scheduled to take place after Friday prayers but the bodies would remain in the mosque until the Shi'ites had received promises of protection.

"We won't let them be buried unless the army comes into Quetta," said Maulana Amin Shaheedi, who heads the Shi'ite Majlis-e-Wahdatul Muslameen, an umbrella organization formed in 2008 to unite Shiite organizations and clerics.

The paramilitary Frontier Corps is largely responsible for security in Baluchistan province but Shi'ites say it is unable or unwilling to protect them from the LeJ.

"STATE OF SIEGE"

The LeJ wants to impose a Sunni theocracy in U.S.-allied Pakistan by stoking Sunni-Shi'ite violence. It bombs religious processions and shoots civilians in the type of attacks that pushed countries like Iraq close to civil war.

LeJ leader Malik Ishaq was released last year after spending 14 years in jail in connection with dozens of murder and terrorism cases.

The roughly 500,000-strong Hazara people in Quetta, who speak a Persian dialect, have distinct features and are an easy target, said Dayan of Human Rights Watch.

"They live in a state of siege. Stepping out of the ghetto means risking death," said Dayan. "Everyone has failed them - the security services, the government, the judiciary."

Earlier on Thursday, a separate bomb killed 11 people in Quetta's main market.

The United Baloch Army claimed responsibility for that blast. The group is one of several fighting for independence for Baluchistan, an arid, impoverished region with substantial gas, copper and gold reserves.

Baluchistan constitutes just less than half of Pakistan's territory and is home to about 8 million of the country's population of 180 million.

In a separate attack on Thursday, in Mingora, the largest city in the Swat valley in the northwest, at least 21 people were killed when an explosion targeted a public gathering of residents who had come to listen to a religious leader.

No one claimed responsibility for that bombing. Swat has been under army rule since a military offensive expelled Pakistani Taliban militants in 2009.

Sectarian attacks in Pakistan have risen even as overall deaths from militant violence have fallen over the past two years. But Pakistan's security forces and its overburdened justice system are struggling to cope.

Human rights groups say the government must investigate whether some of the groups have links to elements within Pakistan's security services.

The LeJ has had historically close ties to elements in the security forces, who see the group as an ally in any potential war with neighboring India.

The security forces deny any such links.

(Reporting by Katharine Houreld; Editing by Robert Birsel)

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Malaysia prepares for joint opposition mega-rally

KUALA LUMPUR: Malaysia is preparing for a big rally on Saturday - what organisers are calling the People's Uprising rally.

It is the first of its kind, bringing together opposition parties and non-governmental organisations.

Dubbed the KL112, the mega rally this Saturday promises to be a historic event for the country.

The rally venue, Merdeka stadium, is a heritage site and the management has limited its capacity to no more than 30,000, even though organisers are expecting a million people.

Once the stadium reaches its saturation point, the crowd will have to gather outside the stadium at the parking lot as well as the adjacent Victoria field.

The organisers have paid US$30,000 to the management as deposit to use the venue and signed an agreement with the police to gather peacefully.

Rally goers must not bring children or they can be arrested and prosecuted.

Meanwhile, the Education Ministry has warned teachers and students not to participate in the so-called politically motivated rally.

Chief secretary to the government Ali Hamsa also advised civil servants not to be involved in the rally.

Parents were told to discourage their children from attending.

Still, thousands of university and college students have confirmed their attendance.

In fact, they will be going for a pre-rally countdown on Friday evening at Kampong Baru, not too far from here.

On Saturday, they will be joining others at eight main gathering points in the city before making their way to Merdeka stadium for the People's Uprising rally, that is scheduled to go on between 2 and 5pm local time.

- CNA/xq

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Fire at ONGC, two dead

SIBSAGAR: (Assam) A massive fire swept through an unit of the ONGC at upper Assam's Sibsagar district killing two persons and destroying property worth lakhs of rupees, ONGC officials said.

The fire started from a part of the Group Gathering Stations (GGS) number 3 of ONGC's Assam Asset at Geleki in Sibsagar around midnight.

The fire rapidly spread through the entire GGS burning thousands of tonnes of oil.

It took many hours for the ONGC's fire department to douse the flame.

Bodies of two workers were found from the spot, though their names have not been disclosed so far.

The exact quantum of loss or the reason for the fire are yet to be ascertained.

Senior officials have rushed to the spot.

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Flu season strikes early and, in some places, hard

NEW YORK (AP) — From the Rocky Mountains to New England, hospitals are swamped with people with flu symptoms. Some medical centers are turning away visitors or making them wear face masks, and one Pennsylvania hospital set up a tent outside its ER to deal with the feverish patients.

Flu season in the U.S. has struck early and, in many places, hard.

While flu normally doesn't blanket the country until late January or February, it is already widespread in more than 40 states, with about 30 of them reporting some major hot spots. On Thursday, health officials blamed the flu for the deaths of 20 children so far.

Whether this will be considered a bad season by the time it has run its course in the spring remains to be seen.

"Those of us with gray hair have seen worse," said Dr. William Schaffner, a flu expert at Vanderbilt University in Nashville.

The evidence so far points to a moderate season, Schaffner and others say. It looks bad in part because last year was unusually mild and because the main strain of influenza circulating this year tends to make people sicker and really lay them low.

David Smythe of New York City saw it happen to his 50-year-old girlfriend, who has been knocked out for about two weeks. "She's been in bed. She can't even get up," he said.

Also, the flu's early arrival coincided with spikes in a variety of other viruses, including a childhood malady that mimics flu and a new norovirus that causes vomiting and diarrhea, or what is commonly known as "stomach flu." So what people are calling the flu may, in fact, be something else.

"There may be more of an overlap than we normally see," said Dr. Joseph Bresee, who tracks the flu for the Centers for Disease Control and Prevention.

Most people don't undergo lab tests to confirm flu, and the symptoms are so similar that it can be hard to distinguish flu from other viruses, or even a cold. Over the holidays, 250 people were sickened at a Mormon missionary training center in Utah, but the culprit turned out to be a norovirus, not the flu.

Flu is a major contributor, though, to what's going on.

"I'd say 75 percent," said Dr. Dan Surdam, head of the emergency department at Cheyenne Regional Medical Center, Wyoming's largest hospital. The 17-bed emergency room saw its busiest day ever last week, with 166 visitors.

The early onslaught has resulted in a spike in hospitalizations. To deal with the influx and protect other patients from getting sick, hospitals are restricting visits from children, requiring family members to wear masks and banning anyone with flu symptoms from maternity wards.

One hospital in Allentown, Pa., set up a tent this week for a steady stream of patients with flu symptoms. But so far "what we're seeing is a typical flu season," said Terry Burger, director of infection control and prevention for the hospital, Lehigh Valley Hospital-Cedar Crest.

On Wednesday, Boston declared a public health emergency, with the city's hospitals counting about 1,500 emergency room visits since December by people with flu-like symptoms.

All the flu activity has led some to question whether this year's flu shot is working. While health officials are still analyzing the vaccine, early indications are that it's about 60 percent effective, which is in line with what's been seen in other years.

The vaccine is reformulated each year, based on experts' best guess of which strains of the virus will predominate. This year's vaccine is well-matched to what's going around. The government estimates that between a third and half of Americans have gotten the vaccine.

In New York City, 57-year-old Judith Quinones skipped getting a flu shot this season and suffered her worst case of flu-like illness in years. She was laid up for nearly a month with fever and body aches. "I just couldn't function," she said.

But her daughter got the vaccine. "And she got sick twice," Quinones said.

Europe is also suffering an early flu season, though a milder strain predominates there. Flu reports are up, too, in China, Japan, the West Bank, the Gaza Strip, Algeria and the Republic of Congo. Britain has seen a surge in cases of norovirus.

On average, about 24,000 Americans die each flu season, according to the CDC. That's an estimate — the agency does not keep a running tally of adult flu deaths each year, only for children. Some state health departments do keep count, and they've reported dozens of flu deaths so far.

Flu usually peaks in midwinter. Symptoms can include fever, cough, runny nose, head and body aches and fatigue. Some people also suffer vomiting and diarrhea, and some develop pneumonia or other severe complications.

Most people with flu have a mild illness and can help themselves and protect others by staying home and resting. But people with severe symptoms should see a doctor. They may be given antiviral drugs or other medications to ease symptoms.

Flu vaccinations are recommended for everyone 6 months or older. Of the 20 children killed by the flu this season, only two were fully vaccinated.

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AP Medical Writer Maria Cheng in London contributed to this report.

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Online:

CDC flu: http://www.cdc.gov/flu/index.htm

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Judge: Holmes Can Face Trial for Aurora Shooting

Jan 10, 2013 8:45pm

(Arapahoe County Sheriff/AP Photo)

In a ruling that comes as little surprise, the judge overseeing the Aurora, Colo., theater massacre has ordered that there is enough evidence against James Holmes to proceed to a trial.

In an order posted late Thursday, Judge William Sylvester wrote that “the People have carried their burden of proof and have established that there is probable cause to believe that Defendant committed the crimes charged.”

The ruling came after a three-day preliminary hearing this week that revealed new details about how Holmes allegedly planned for and carried out the movie theater shooting, including how investigators say he amassed an arsenal of guns and ammunition, how he booby-trapped his apartment to explode, and his bizarre behavior after his arrest.

PHOTOS: Colorado ‘Dark Knight Rises’ Theater Shooting

Holmes is charged with 166 counts, including murder, attempted murder and other charges related to the July 20 shooting that left 12 people dead and 58 wounded by gunfire. An additional 12 people suffered non-gunshot injuries.

One of the next legal steps is an arraignment, at which Holmes will enter a plea. The arraignment was originally expected to take place Friday morning.

Judge Sylvester indicated through a court spokesman that he would allow television and still cameras into the courtroom, providing the outside world the first images of Holmes since a July 23 hearing. Plans for cameras in court, however, were put on hold Thursday afternoon.

“The defense has notified the district attorney that it is not prepared to proceed to arraignment in this case by Friday,” wrote public defenders Daniel King, Tamara Brady and Kristen Nelson Thursday afternoon in a document objecting to cameras in court.

A hearing in the case will still take place Friday morning. In his order, Judge Sylvester said it should technically be considered an arraignment, but noted the defense has requested a continuance.  Legal experts expect the judge will grant the continuance, delaying the arraignment and keeping cameras out of court for now.

Sylvester also ordered that Holmes be held without bail.

Holmes’ attorneys have said in court that the former University of Colorado neuroscience student is mentally ill. The district attorney overseeing the case has not yet announced whether Holmes, now 25, can face the death penalty.

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Swiss trains collide, 17 injured

NEUHAUSEN, Switzerland (Reuters) - Two Swiss trains collided on Thursday, injuring 17 people, none of them seriously, and closing the line near the German border, police said.

The two local trains, one travelling from Winterthur and the other from Schaffhausen, crashed just outside the Neuhausen station in northern Switzerland, not far from the German border.

Swiss railways said the line was closed and buses were carrying local passengers, while those travelling from Zurich to Stuttgart in Germany would be diverted via Basel.

Police spokeswoman Anja Schudel said 17 people had been injured and nine of them taken to hospital, but nobody was badly hurt. Everybody had been evacuated from the trains, which were carrying a total of 280 passengers, she said.

Swiss trains have a reputation for punctuality and safety, and fatal train accidents are rare.

The last major accident was in 2010. One passenger was killed and 42 were injured when one of the country's best-known tourist trains, the Glacier Express, derailed at the height of the summer holiday season.

(Reporting by Arnd Wiegmann and Emma Thomasson; Editing by Louise Ireland)

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India's Kingfisher airline boss promises restart

MUMBAI: The boss of India's troubled Kingfisher airline has sought to allay fears about jobs in a rare communication to staff, which outlines plans to restart limited operations and win a foreign investment deal.

Kingfisher, whose operations have been grounded since October, lost permission to fly after a deadline to renew its suspended licence with the aviation regulator expired at the start of the new year.

Vijay Mallya's email, sent late Wednesday, expressed hopes for a limited re-start of flights from March this year, requiring funding of 6.5 billion rupees (US$118 million) which would be provided by the airline's parent UB Group.

The airline has submitted a detailed restart plan to the regulator, he said, also reiterating that there were "discussions with multiple investors", including Abu Dhabi-based Etihad Airways, to sell a stake in the airline.

"We remain confident that we will secure a deal," he wrote in the email seen by AFP.

The firm's shares jumped 9.96 per cent to 14.79 rupees on the Bombay Stock Exchange on Thursday.

Many staff are owed months of pay. Some of them have threatened to approach a court seeking formal closure of the airline if they are unconvinced about the management's revival plan and its ability to pay pending salaries.

Mallya said Kingfisher "was on safe ground" to renew its flying licence with the regulator, which can be applied for within two years after the date of expiry.

"We need to single-mindedly focus on being back in the air and to win back the confidence of our loyal guests," he wrote.

The Centre for Aviation, a Sydney-based consultancy, said in a recent report Kingfisher had accumulated losses of US$1.9 billion and debts of US$2.49 billion, including bank debts of US$1.1 billion.

- AFP/xq

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LeT chief Hafiz Saeed was present in PoK: Shinde

NEW DELHI: Union home minister Sushilkumar Shinde has said that visa agreement between India and Pakistan will be carried out as per schedule.

There will be no change in visa policy for Pakistan in view of the Tuesday's incident on Line of Control (LoC) in which two Indian soldiers were killed by Pakistan army with the body of one being badly mutilated.

Lashkar-e-Taiba founder Hafeez Saeed was present in Pakistan-occupied Kashmir some days before the Tuesday's LoC encounter, Shinde said. Shinde was speaking to mediapersons in New Delhi.

Earlier, India on Thursday outright rejected Pakistan's proposal for UN investigation into Tuesday's incident on Line of Control (LoC) in which two Indian soldiers were killed with the body of one being badly mutilated.

The issue figured at a meeting of the Cabinet Committee on Security (CCS) which was briefed by defence minister A K Antony on the incident in Jammu and Kashmir's Poonch sector on January eight and subsequent developments.

"We are certainly not going to agree to internationalise the issue or allow the United Nations to hold an inquiry. That demand is obviously rejected out of hand," finance minister P Chidambaram told a press conference after the meetings of the Union Cabinet and CCS here.

(With inputs from PTI)

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Retooling Pap test to spot more kinds of cancer

WASHINGTON (AP) — For years, doctors have lamented that there's no Pap test for deadly ovarian cancer. Wednesday, scientists reported encouraging signs that one day, there might be.

Researchers are trying to retool the Pap, a test for cervical cancer that millions of women get, so that it could spot early signs of other gynecologic cancers, too.

How? It turns out that cells can flake off of tumors in the ovaries or the lining of the uterus, and float down to rest in the cervix, where Pap tests are performed. These cells are too rare to recognize under the microscope. But researchers from Johns Hopkins University used some sophisticated DNA testing on the Pap samples to uncover the evidence — gene mutations that show cancer is present.

In a pilot study, they analyzed Pap smears from 46 women who already were diagnosed with either ovarian or endometrial cancer. The new technique found all the endometrial cancers and 41 percent of the ovarian tumors, the team reported Wednesday in the journal Science Translational Medicine.

This is very early-stage research, and women shouldn't expect any change in their routine Paps. It will take years of additional testing to prove if the so-called PapGene technique really could work as a screening tool, used to spot cancer in women who thought they were healthy.

"Now the hard work begins," said Hopkins oncologist Dr. Luis Diaz, whose team is collecting hundreds of additional Pap samples for more study and is exploring ways to enhance the detection of ovarian cancer.

But if it ultimately pans out, "the neat part about this is, the patient won't feel anything different," and the Pap wouldn't be performed differently, Diaz added. The extra work would come in a lab.

The gene-based technique marks a new approach toward cancer screening, and specialists are watching closely.

"This is very encouraging, and it shows great potential," said American Cancer Society genetics expert Michael Melner.

"We are a long way from being able to see any impact on our patients," cautioned Dr. Shannon Westin of the University of Texas MD Anderson Cancer Center. She reviewed the research in an accompanying editorial, and said the ovarian cancer detection would need improvement if the test is to work.

But she noted that ovarian cancer has poor survival rates because it's rarely caught early. "If this screening test could identify ovarian cancer at an early stage, there would be a profound impact on patient outcomes and mortality," Westin said.

More than 22,000 U.S. women are diagnosed with ovarian cancer each year, and more than 15,000 die. Symptoms such as pain and bloating seldom are obvious until the cancer is more advanced, and numerous attempts at screening tests have failed.

Endometrial cancer affects about 47,000 women a year, and kills about 8,000. There is no screening test for it either, but most women are diagnosed early because of postmenopausal bleeding.

The Hopkins research piggybacks on one of the most successful cancer screening tools, the Pap, and a newer technology used along with it. With a standard Pap, a little brush scrapes off cells from the cervix, which are stored in a vial to examine for signs of cervical cancer. Today, many women's Paps undergo an additional DNA-based test to see if they harbor the HPV virus, which can spur cervical cancer.

So the Hopkins team, funded largely by cancer advocacy groups, decided to look for DNA evidence of other gynecologic tumors. It developed a method to rapidly screen the Pap samples for those mutations using standard genetics equipment that Diaz said wouldn't add much to the cost of a Pap-plus-HPV test. He said the technique could detect both early-stage and more advanced tumors. Importantly, tests of Paps from 14 healthy women turned up no false alarms.

The endometrial cancers may have been easier to find because cells from those tumors don't have as far to travel as ovarian cancer cells, Diaz said. Researchers will study whether inserting the Pap brush deeper, testing during different times of the menstrual cycle, or other factors might improve detection of ovarian cancer.

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