Chavez not in coma, responding well to treatment: brother

CARACAS Ailing Venezuelan President Hugo Chavez is not in a coma and is responding well to cancer treatment in Cuba, making daily progress, his brother said Saturday.

"Reports that the president is in a coma and that the family is discussing ending life support, are totally false," Adan Chavez, governor of the state of Barinas, said in a statement.

He "continues to respond well to his medical care and to make daily progress in his recovery."

Chavez has been out of public sight since undergoing surgery in Havana on December 11, the fourth such operation in the 18 months since his condition was made public.

Officials have said the fiery leftist leader is suffering from a severe pulmonary infection that has resulted in a "respiratory insufficiency," fueling speculation about his prospects for a full recovery -- and his political future.

The uncertainty surrounding Chavez's condition has rattled Venezuela, the nation with the world's largest proven oil reserves.

The government was forced to postpone the president's scheduled inauguration Thursday, as it became clear that he could not attend. Authorities insist the country's constitution allows Chavez to take the oath of office later on.

But the opposition has cried foul, calling for a medical board to review the absent leader's health -- a demand rejected by the Supreme Court, which said the delayed swearing-in was constitutional.

In Cuba on Saturday, President Raul Castro voiced his support for the Venezuelan leadership, his government's closest and most critical economic and political ally.

Castro made the comments during a meeting with Venezuelan Vice President Nicolas Maduro, who arrived in the Cuban capital late Friday to check on his ailing boss, who had a difficult fourth round of cancer surgery last month.

Raul Castro "expressed his confidence in the ability of the Venezuelan people and their institutions to address and overcome any challenge," a government statement said.

"Raul and Maduro shared their mutual satisfaction with the emotional demonstration of support for Venezuela and President Chavez on January 10 in Caracas," it added.

Two Chavez allies, Argentine President Cristina Kirchner and Peruvian President Ollanta Humala, also arrived in Havana on Friday.

"We all hope for a quick recovery," Humala said.

Kirchner refused to comment on Chavez's health when asked by reporters, saying it should be left to his family. She did, however, thank retired revolutionary icon Fidel Castro, 86, for hosting a luncheon for her in his home Friday.

Like Chavez, Castro has been sidelined by health problems and rarely appears in public since stepping aside as president of the communist country in 2006.

Throughout his illness, first detected in June 2011, Chavez -- in power for 14 years -- has refused to relinquish the powers of the presidency, even when leaving for Cuba for his latest surgery.

The Venezuelan constitution says new elections must be held within 30 days if the president-elect or president dies or is permanently incapacitated, either before he takes office or in the first four years of his six-year term.

-AFP/ac

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Punjab family ravaged by Alzheimer’s banks on gene test

NEW DELHI: A curious case from Punjab has rattled not just Kuldeep Kaur and her family but even the experts who have been striving for over a year to solve her case. Kaur, a 32-year-old mother of two, was living a healthy life till September 2011 when she suddenly developed memory loss. She stopped recognizing people, forgot meals and became urinary incontinent — a pattern observed in her family including her father, grandfather, great grandmother and several other blood relatives.

Kaur had been suffering from an extremely rare disease called familial Alzheimer's that runs into families. This was declared two days ago in a genetic test conducted by a research group based in France.

"This is the first time we have come across any such patient. Her 26-year-old brother had approached us two years ago for genetic testing, fearing that he might also suffer from the same fate as his family members. We did some testing but the mutation in gene could not be identified. Finally, a research group in France offered to do the genetic testing for free and the results came in," said Dr Sunita Bijarniya Mahay, metabolic physician and geneticist at the Center of Genetic Medicine, Ganga Ram Hospital.

Now they will do predicting testing on the brother and Kuldeep's blood relatives, Dr Sunita said, to rule out or confirm the possibility of mutation of the same gene in them. "Though there is no cure for familial Alzheimer's, the tests would help them beat the angst. We can also try to manage the positive cases using best post possible medical intervention," she added.

According to Harmohan Singh, Kuldeep's brother, most of their family members could not survive beyond 50 years. "We always thought it was a family curse and would lead to the extermination of our whole generation. But the finding of the gene responsible for the deaths has given us new hope," he said. Singh was eight when his father passed away due to the same disease.

"Kuldeep's condition is also worsening each day. She has developed urinary incontinent and has become very weak. Her children have been the worst sufferers of the tragedy and no one knows what future they have. We are poor and it is really difficult for us to even think of getting the tests done on each family member," he said.

According to Dr I C Verma, director of the center of genetic medicine at Ganga Ram Hospital, India has the largest number of patients having genetic disorders because of large number of births (27 million per year), consanguineous marriages (within relations), high frequency thalessemia and sickle cell disease.

"Prenatal genetic testing, which can help in timely identification of these risk factors, is available at most centers in India. We are now trying to acquire high-end services like Microarray Analysis that can analyse the minutest change in chromosome and next generation sequencing to multiple genes for possible mutation in one go.

"These new technologies will lead to the identification of the cause of intellectual disability, muscle weakness , brain disorders and many other genetic disorders. This will also lead to the development of newer therapies," he said.

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Poisoned Lottery Winner's Kin Were Suspicious

Urooj Khan had just brought home his $425,000 lottery check when he unexpectedly died the following day. Now, certain members of Khan's family are speaking publicly about the mystery -- and his nephew told ABC News they knew something was not right.

"He was a healthy guy, you know?" said the nephew, Minhaj Khan. "He worked so hard. He was always going about his business and, the thing is: After he won the lottery and the next day later he passes away -- it's awkward. It raises some eyebrows."

The medical examiner initially ruled Urooj Khan, 46, an immigrant from India who owned dry-cleaning businesses in Chicago, died July 20, 2012, of natural causes. But after a family member demanded more tests, authorities in November found a lethal amount of cyanide in his blood, turning the case into a homicide investigation.

"When we found out there was cyanide in his blood after the extensive toxicology reports, we had to believe that ... somebody had to kill him," Minhaj Khan said. "It had to happen, because where can you get cyanide?"

In Photos: Biggest Lotto Jackpot Winners

Authorities could be one step closer to learning what happened to Urooj Khan. A judge Friday approved an order to exhume his body at Rosehill Cemetery in Chicago as early as Thursday to perform further tests.

Lottery Winner Murdered: Widow Questioned By Police Watch Video

Moments after the court hearing, Urooj Khan's sister, Meraj Khan, remembered her brother as the kind of person who would've shared his jackpot with anyone. Speaking at the Cook County Courthouse, she hoped the exhumation would help the investigation.

"It's very hard because I wanted my brother to rest in peace, but then we have to have justice served," she said, according to ABC News station WLS in Chicago. "So if that's what it takes for him to bring justice and peace, then that's what needs to be done."

Khan reportedly did not have a will. With the investigation moving forward, his family is waging a legal fight against his widow, Shabana Ansari, 32, over more than $1 million, including Urooj Khan's lottery winnings, as well as his business and real estate holdings.

Khan's brother filed a petition Wednesday to a judge asking Citibank to release information about Khan's assets to "ultimately ensure" that [Khan's] minor daughter from a prior marriage "receives her proper share."

Ansari may have tried to cash the jackpot check after Khan's death, according to court documents, which also showed Urooj Khan's family is questioning if the couple was ever even legally married.

Ansari, Urooj Khan's second wife, who still works at the couple's dry cleaning business, has insisted they were married legally.

She has told reporters the night before her husband died, she cooked a traditional Indian meal for him and their family, including Khan's daughter and Ansari's father. Not feeling well, Khan retired early, Ansari told the Chicago Sun-Times, falling asleep in a chair, waking up in agony, then collapsing in the middle of the night. She said she called 911.

"It has been an incredibly hard time," she told ABC News earlier this week. "We went from being the happiest the day we got the check. It was the best sleep I've had. And then the next day, everything was gone.

"I am cooperating with the investigation," Ansari told ABC News. "I want the truth to come out."

Ansari has not been named a suspect, but her attorney, Steven Kozicki, said investigators did question her for more than four hours.

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Flu season puts businesses and employees in a bind

WASHINGTON (AP) — Nearly half the 70 employees at a Ford dealership in Clarksville, Ind., have been out sick at some point in the past month. It didn't have to be that way, the boss says.

"If people had stayed home in the first place, a lot of times that spread wouldn't have happened," says Marty Book, a vice president at Carriage Ford. "But people really want to get out and do their jobs, and sometimes that's a detriment."

The flu season that has struck early and hard across the U.S. is putting businesses and employees alike in a bind. In this shaky economy, many Americans are reluctant to call in sick, something that can backfire for their employers.

Flu was widespread in 47 states last week, up from 41 the week before, the Centers for Disease Control and Prevention said Friday. The only states without widespread flu were California, Mississippi and Hawaii. And the main strain of the virus circulating tends to make people sicker than usual.

Blake Fleetwood, president of Cook Travel in New York, says his agency is operating with less than 40 percent of its staff of 35 because of the flu and other ailments.

"The people here are working longer hours and it puts a lot of strain on everyone," Fleetwood says. "You don't know whether to ask people with the flu to come in or not." He says the flu is also taking its toll on business as customers cancel their travel plans: "People are getting the flu and they're reduced to a shriveling little mess and don't feel like going anywhere."

Many workers go to the office even when they're sick because they are worried about losing their jobs, says John Challenger, CEO of Challenger, Gray & Christmas, an employer consulting firm. Other employees report for work out of financial necessity, since roughly 40 percent of U.S. workers don't get paid if they are out sick. Some simply have a strong work ethic and feel obligated to show up.

Flu season typically costs employers $10.4 billion for hospitalization and doctor's office visits, according to the CDC. That does not include the costs of lost productivity from absences.

At Carriage Ford, Book says the company plans to make flu shots mandatory for all employees.

Linda Doyle, CEO of the Northcrest Community retirement home in Ames, Iowa, says the company took that step this year for its 120 employees, providing the shots at no cost. It is also supplying face masks for all staff.

And no one is expected to come into work if sick, she says.

So far, the company hasn't seen an outbreak of flu cases.

"You keep your fingers crossed and hope it continues this way," Doyle says. "You see the news and it's frightening. We just want to make sure that we're doing everything possible to keep everyone healthy. Cleanliness is really the key to it. Washing your hands. Wash, wash, wash."

Among other steps employers can take to reduce the spread of the flu on the job: holding meetings via conference calls, staggering shifts so that fewer people are on the job at the same time, and avoiding handshaking.

Newspaper editor Rob Blackwell says he had taken only two sick days in the last two years before coming down with the flu and then pneumonia in the past two weeks. He missed several days the first week of January and has been working from home the past week.

"I kept trying to push myself to get back to work because, generally speaking, when I'm sick I just push through it," says Blackwell, the Washington bureau chief for the daily trade paper American Banker.

Connecticut is the only state that requires some businesses to pay employees when they are out sick. Cities such as San Francisco and Washington have similar laws.

Challenger and others say attitudes are changing, and many companies are rethinking their sick policies to avoid officewide outbreaks of the flu and other infectious diseases.

"I think companies are waking up to the fact right now that you might get a little bit of gain from a person coming into work sick, but especially when you have an epidemic, if 10 or 20 people then get sick, in fact you've lost productivity," Challenger says.

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Associated Press writers Mike Stobbe in Atlanta, Eileen A.J. Connelly in New York, Paul Wiseman in Washington, Barbara Rodriguez in Des Moines, Iowa, and Jim Salter in St. Louis contributed to this report.

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Obama, Karzai accelerate end of U.S. combat role in Afghanistan

WASHINGTON (Reuters) - President Barack Obama and Afghan President Hamid Karzai agreed on Friday to speed up the handover of combat operations in Afghanistan to Afghan forces, raising the prospect of an accelerated U.S. withdrawal from the country and underscoring Obama's determination to wind down a long, unpopular war.

Signaling a narrowing of differences, Karzai appeared to give ground in talks at the White House on U.S. demands for immunity from prosecution for any American troops who stay in Afghanistan beyond 2014, a concession that could allow Obama to keep at least a small residual force there.

Both leaders also threw their support behind tentative Afghan reconciliation efforts with Taliban insurgents, endorsing the establishment of a Taliban political office in Qatar in hopes of bringing insurgents to inter-Afghan talks.

Outwardly, at least, the meeting appeared to be something of a success for both men, who need to show their vastly different publics they are making progress in their goals for Afghanistan. There were no signs of the friction that has frequently marked Obama's relations with Karzai.

Karzai's visit came amid stepped-up deliberations in Washington over the size and scope of the U.S. military role in Afghanistan once the NATO-led combat mission concludes at the end of 2014.

"By the end of next year, 2014, the transition will be complete," Obama said at a news conference with Karzai standing at his side. "Afghans will have full responsibility for their security, and this war will come to a responsible end."

The Obama administration has been considering a residual force of between 3,000 and 9,000 troops - far fewer than some U.S. commanders propose - to conduct counterterrorism operations and to train and assist Afghan forces.

A top Obama aide said this week that the administration does not rule out a complete withdrawal after 2014, a move that some experts say would be disastrous for the weak Afghan central government and its fledgling security apparatus.

Obama on Friday left open the possibility of that so-called "zero option" when he several times used the word "if" to suggest that a post-2014 U.S. presence was far from guaranteed.

Insisting that Afghan forces were "stepping up" faster than expected, Obama said Afghan troops would take over the lead in combat missions across the country this spring, rather than waiting until the summer as originally planned. NATO troops will then assume a "support role," he said.

"It will be a historic moment and another step toward full Afghan sovereignty," Obama said.

Obama said final decisions on this year's troop cuts and the post-2014 U.S. military role were still months away, but his comments suggested he favors a stepped-up withdrawal timetable.

There are some 66,000 U.S. troops currently in Afghanistan. Washington's NATO allies have been steadily reducing their troop numbers as well despite doubts about the ability of Afghan forces to shoulder full responsibility for security.

'WAR OF NECESSITY'

Karzai voiced satisfaction over Obama's agreement to turn over control of detention centers to Afghan authorities, a source of dispute between their countries, although the White House released no details of the accord on that subject.

Obama once called Afghanistan a "war of necessity." But he is heading into a second term looking for an orderly way out of the conflict, which was sparked by the September 11, 2001, attacks on the United States by an al Qaeda network harbored by Afghanistan's Taliban rulers.

He faces the challenge of pressing ahead with his re-election pledge to continue winding down the war while preparing the Afghan government to prevent a slide into chaos and a Taliban resurgence once most NATO forces are gone.

Former Senator Chuck Hagel, Obama's nominee to become defense secretary, is likely to favor a sizable troop reduction.

Karzai, meanwhile, is eager to show he is working to ensure Afghans regain full control of their territory after a foreign military presence of more than 11 years.

Asked whether the cost of the war in lives and money was worth it, Obama said: "We achieved our central goal ... or have come very close to achieving our central goal, which is to de-capacitate al Qaeda, to dismantle them, to make sure that they can't attack us again."

He added: "Have we achieved everything that some might have imagined us achieving in the best of scenarios? Probably not. This is a human enterprise, and you fall short of the ideal."

Obama made clear that unless the Afghan government agrees to legal immunity for U.S. troops, he would withdraw them all after 2014 - as happened in Iraq at the end of 2011.

Karzai, who criticized NATO over civilian deaths, said that with Obama's agreement to transfer detention centers and the planned withdrawal of U.S. forces from Afghan villages, "I can go to the Afghan people and argue for immunity" in a bilateral security pact being negotiated.

Addressing students at Georgetown University later in the day, the Afghan leader predicted with certainty that the United States would keep a limited number of troops in Afghanistan after 2014, in part to battle al Qaeda and its affiliates.

"One of the reasons the United States will continue a limited presence in Afghanistan after 2014 in certain facilities in Afghanistan is because we have decided together to continue to fight against al Qaeda," Karzai said. "So there will be no respite in that."

Many of Obama's Republican opponents have criticized him for setting a withdrawal timetable and accuse him of undercutting the U.S. mission by reducing troop numbers too quickly.

Karzai and his U.S. partners have not always seen eye to eye, even though the American military has been crucial to preventing insurgent attempts to oust him.

In October, Karzai accused Washington of playing a double game by fighting the war in Afghan villages instead of going after insurgents who cross the border from neighboring Pakistan.

In Friday's news conference, Karzai did not back down from his previous comments that foreigners were responsible for some of the official corruption critics say is rampant in Afghanistan. But he acknowledged: "There is corruption in the Afghan government that we are fighting against."

Adding to tensions has been a rash of deadly "insider" attacks by Afghan soldiers and police against NATO-led troops training or working with them. U.S. forces have also been involved in a series of incidents that enraged Afghans, including burning Korans, which touched off days of rioting.

(Additional reporting by Roberta Rampton, Mark Felsenthal, Jeff Mason, Phil Stewart, Tabassum Zakaria, David Alexander; Editing by Warren Strobel and Will Dunham)

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US mulls aid to French in Mali, including drones

WASHINGTON: The US military is weighing support for French forces in Mali including surveillance drones, a US official said Friday, as Washington backed moves to deny safe haven to extremists in the country.

US commanders were looking at providing intelligence and aerial refueling tankers among a range of options, such as logistical backup and boosting intelligence sharing, which would involve surveillance drones, the official, who spoke on condition of anonymity, told AFP.

Backed by French air power, Mali on Friday unleashed an offensive against Islamist rebels who have seized control of the north of the West African country and are now threatening to push south.

Senior US officials held talks with their counterparts in the French capital and other allies on drawing up an action plan, the official said.

President Francois Hollande confirmed in Paris that French forces were supporting an attack aimed at repelling the Al-Qaeda-linked radicals who have triggered international alarm with moves towards the capital Bamako.

The United States said Friday it shared France's goal of denying the extremists safe haven in Mali.

"We are monitoring the situation closely," National Security Council spokesman Tommy Vietor told AFP.

"We have noted that the government of Mali has asked for support, and we share the French goal of denying terrorists a safe haven in the region."

Hollande gave no indication of the scale of French involvement, but said it would last "for as long as is necessary."

The American military has a network of air bases in Italy, Spain and elsewhere in the region that could provide refueling tankers and other assistance to the French.

Former colonial power France has warned that the Islamist rebels were seeking to transform the vast nation into a "terrorist state."

State Department spokesman Victoria Nuland meanwhile said Washington was "consulting very closely" with the French government on the fighting.

"Obviously we remain deeply concerned by the recent events in Mali. We echo the international community's condemnation of these recent aggressive acts."

Earlier Friday, French Defense Minister Jean-Yves Le Drian briefed his US counterpart Leon Panetta about the situation.

-AFP/ac

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Stop show on Nirbhaya: Bombay HC

NAGPUR: The Bombay high court's Nagpur bench has stayed the telecast of Sony TV's 'Crime Patrol' episode on the Nirbhaya gang-rape case till further orders.

The telecast was slated for Friday and Saturday. Social organization Bharatiya Stree Sangh had moved the high court challenging the telecast. Its counsel Harshada Kurhekar contended that the telecast of this episode might affect the judicial outcome of the case. She pointed out that the case was sub judice. The BSS contented that the episode was commercialization of the tragedy that had shocked the nation. It said it would "increase the misery of the victim's family as well as hurt the feelings of women in general".

The division bench of justices AP Lavande and Arun Chaudhari issued the order and sent notices to Sony Entertainment Pvt Ltd, Information and Broadcasting Ministry and Indian Broadcasting Foundation. The show was expected to reconstruct the December 16 brutal gang-rape and torture of a 23-year-old physiotherapist trainee by six men in south Delhi. She died in a Singapore hospital on December 29 because of grievous injuries. tnn

A social organization said that the episode was an attempt to commercialize the tragedy that had shocked the nation.

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Obama Promises Faster Transition in Afghanistan

President Obama and Afghan President Hamid Karzai said today that most U.S. combat operations in Afghanistan would end this spring, signaling a quickening troop drawdown that will bring the decade-long war to a close at the end of 2014.

"Our troops will continue to fight alongside Afghans when needed, but let me say it as plainly as I can: Starting this spring, our troops will have a different mission -- training, advising, assisting Afghan forces," Obama announced at an East Room news conference in Washington.

"It will be a historic moment and another step toward full Afghan sovereignty, something I know that President Karzai cares deeply about, as do the Afghan people," he said.

Administration officials said Afghan forces were "exceeding initial expectations" in their capabilities. Afghan security forces are expected to lead 90 percent of security operations across the country in February.

"By the end of next year -- 2014 -- the transition will be complete," Obama said. "Afghans will have full responsibility for their security, and this war will come to a responsible end."

The rosy assessments belied the serious political, economic and security challenges that remain.

Left unanswered by Obama and Karzai: How many U.S. troops might stay after 2014; what their mission would be and whether they could be effective; and whether the forces would have immunity from prosecution in Afghan courts.

Charles Dharapak/AP Photo

President Hamid Karzai Addresses Afghan Sovereignty at White House Watch Video

Afghanistan: Insider Attacks Mark War's 11th Anniversary Watch Video

Afghanistan Troop Surge Ends at Tumultuous Point Watch Video

Obama said he was still reviewing recommendations from the Pentagon and will make an announcement in the coming weeks after penning an anticipated bilateral security agreement with Afghanistan. Karzai said the exact number would be up to the United States to decide.

Both leaders confirmed in a statement that the United States "does not seek permanent bases in Afghanistan."

They also agreed today to turn over battlefield combatants held by the U.S. military in Afghanistan to Afghan government control, which has been long-sought by Karzai.

Roughly 66,000 U.S. troops are serving in Afghanistan. The military has proposed keeping several thousand troops in the country after 2014 as advisers, trainers and logistical support for Afghan forces; the White House has said it remains open to pulling out all troops entirely.

Obama's visit with Karzai was the first face-to-face encounter since the November election and since last year's dramatic increase in so-called green-on-blue attacks, when U.S. and NATO soldiers have been killed by the Afghans they are training or working alongside.

There were 45 insider attacks in 2012 that resulted in 62 deaths among coalition forces, including 35 Americans. There has been one attack already in the first 11 days of 2013.

The White House summit included a private Oval Office meeting between Obama, Karzai and Vice President Joe Biden. The trio also attended a private lunch in the Old Family Dining Room.

Karzai Thursday attended meetings with Defense Secretary Leon Panetta and top military brass at the Pentagon, where he was afforded all the pomp and circumstance accorded a head of state: a 21-gun salute, and marching bands and honor guards from the Army, Navy, Air Force, Marines and Coast Guard.

Karzai's relationship with the United States has at times been a rocky one as he has sometimes made critical statements about the allied troop presence in his country. U.S. officials believe he has made those comments out of political expediency to improve his standing with Afghans and show his independence.

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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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String of bombings kill 101, injure 200 in Pakistan

QUETTA, Pakistan (Reuters) - At least 101 people were killed in bombings in two Pakistani cities on Thursday in one of the country's bloodiest days in recent years, officials said, with most casualties caused by sectarian attacks in Quetta.

The bombings underscored the myriad threats Pakistani security forces face from homegrown Sunni extremist groups, the Taliban insurgency in the northwest and the less well-known Baloch insurgency in the southwest.

On Thursday evening, two coordinated explosions killed at least 69 people and injured more than 100 in Quetta, the provincial capital of Balochistan, said Deputy Inspector of Police Hamid Shakil.

The first attack, in a crowded snooker hall, was a suicide bombing, local residents said. About ten minutes later, a car bomb exploded, they said. Five policemen and a cameraman were among the dead from that blast.

The attacks happened in a predominately Shia neighborhood and banned sectarian group Lashkar-e-Jhangvi claimed responsibility. The extremist Sunni group targets Shias, who make up about 20 percent of Pakistani's population.

Targeted killings and bombings of Shia communities are common in Pakistan, and rights groups say hundreds of Shia were killed last year. Militant groups in Balochistan frequently bomb or shoot Shia passengers on buses travelling to neighboring Iran.

The killers are rarely caught and some Shia activists say militants work alongside elements of Pakistan's security forces, who see them as a potential bulwark against neighboring India.

Many Pakistanis fear their nation could become the site of a regional power struggle between Saudi Arabia, source of funding for Sunni extremist groups, and Iran, which is largely Shia.

But sectarian tensions are not the only source of violence.

The United Baloch Army claimed responsibility for a blast in Quetta's market earlier in the day. It killed 11 people and injured more than 40, mostly vegetable sellers and secondhand clothes dealers, police officer Zubair Mehmood said. A child was also killed.

The group is one of several fighting for independence for Balochistan, an arid, impoverished region with substantial gas, copper and gold reserves, which constitutes just under half of Pakistan's territory and is home to about 8 million of the country's population of 180 million.

SWAT BOMBING

In another incident Thursday, 21 were killed and more than 60 injured in a bombing when people gathered to hear a religious leader speak in Mingora, the largest city in the northwestern province of Swat, police and officials at the Saidu Sharif hospital said.

"The death toll may rise as some of the injured are in critical condition and we are receiving more and more injured people," said Dr. Niaz Mohammad.

It has been more than two years since a militant attack has claimed that many lives in Swat.

The mountainous region, formerly a tourist destination, has been administered by the Pakistani army since their 2009 offensive drove out Taliban militants who had taken control.

But Talibans retain the ability to attack in Swat and shot schoolgirl campaigner Malala Yousufzai in Mingora last October.

A Taliban spokesman said they were not responsible for Thursday's bombing.

(Additional reporting by Jibran Ahmad in Peshawar, Pakistan; Writing by Katharine Houreld; Editing by Mark Heinrich and Jason Webb)

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