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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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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WP says its focus is to offer choice to Punggol East voters

SINGAPORE: The Workers' Party (WP) has stated categorically that its focus continues to be fulfilling its promise to offer a choice to voters in Punggol East.

The party made this point in response to a question from Channel NewsAsia with regards to its response to the latest proposal from the secretary-general of the Singapore Democratic Party (SDP).

At a news conference on Friday night, Dr Chee Soon Juan had proposed to the WP to run a joint campaign in the Punggol East by-election.

Dr Chee said he wants to field a candidate from the SDP in the joint campaign and explained that if the opposition wins the by-election, the SDP gets to enter Parliament and the WP will run the Punggol East Town Council.

Both the WP and the SDP have yet to name their candidates for the by-election for which Nomination Day falls on Wednesday 16 January.

If there is a contest, Polling Day will be on Saturday 26 January. - CNA/ir

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High alert, reports of troop build-up on both sides of Indo-Pak border

JAMMU: Tension continued to prevail along the Line of Control (LoC) between India and Pakistan on Saturday, a day after cross-LoC firing was reported on at least eight border posts.

There are also reports of a troop build-up on both sides of the border.

Pakistan has so far not responded to requests from India and its army for a flag meeting at the brigade level to de-escalate tension along the LoC.

Indian intelligence intercepts reveal that the Pakistan Army has cancelled all leaves and ordered its troops to report for duty.

According to sources, defence secretary Shashi Kant Sharma and the three service chiefs are likely to brief defence minister AK Antony on Saturday on the latest situation prevailing along the LoC.

The Indian side has been bolstered with the presence of additional Border Action Task Force personnel. Surveillance has been heightened with both the Army and Air Force deploying unmanned aerial vehicles in areas over Poonch and Rajouri sectors.

Sources said Pakistani troops fired intermittently at eight Indian border posts on the LoC in Krishna Ghati and Sonagali around Mendhar sector and Poonch on Friday.

The firing lasted for 20 minutes.

On Friday, India confirmed that Pakistan has suspended cross-border trade.

"As per our understanding, because of some circumstances in one sector, neither trucks nor buses could go," said Syed Akbaruddin, a spokesperson for the Ministry of External Affairs, according to ANI.

Also, Pakistan's foreign secretary Jalil Abbas Jilani summoned India's high commissioner Sharat Sabharwal to protest against "repeated", "unacceptable" and "unprovoked" attacks by the Indian Army which led to the death of a Pakistani soldier on Thursday.

Jilani asked India to "investigate violations of ceasefire by Indian troops" and "emphasised that such unprovoked attacks were against the spirit of the ongoing peace process".

Sabharwal said India's troops undertook "controlled retaliation" in the face of "unprovoked firing".

Pakistan also reiterated its demand for a United Nations Military Observers Group for India and Pakistan (UNMOGIP) probe, but India maintains that that following the Shimla agreement in 1972 and the establishment of the LoC, the UNMOGIP has no relevance or role to play whatsoever.

Prime Minister Manmohan Singh has also been briefed on the tense border situation by National Security Advisor Shiv Shankar Menon.

(Inputs from ANI)

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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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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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Afghan troop levels top agenda for Obama-Karzai talks

WASHINGTON (Reuters) - President Barack Obama and Afghan President Hamid Karzai will hold a critical round of talks on Friday that could help determine how fast the United States withdraws troops from Afghanistan and whether it leaves a residual force after 2014.

Hosting Karzai at the White House, Obama faces the challenge of pressing ahead with his re-election pledge to continue winding down the long war in Afghanistan while preparing the Afghan government to prevent a slide back into chaos and a Taliban resurgence once most NATO forces are gone.

Karzai's visit, which follows a year of growing strains in U.S.-Afghan ties, comes 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 next year.

White House officials have left open the possibility of a complete U.S. withdrawal after 2014 - as happened in Iraq in 2011 - an option that conflicts with the Pentagon's view that thousands of troops will be needed to bolster and train still-fragile Afghan security forces.

But talk of this "zero option" may actually be a gambit to squeeze concessions from Karzai, who has yet to agree on immunity from prosecution for any U.S. forces that stay behind under a bilateral security pact being negotiated. It could also send a message to the Pentagon to scale back expectations of future troop levels.

The White House believes Obama and Karzai, despite a history of sometimes tense relations, can narrow their differences. But Obama aides expect no breakthroughs or concrete agreements and say it will be months before Obama decides how many troops - if any - he wants to keep in Afghanistan.

U.S. officials have said privately that the White House is asking for options to be developed for keeping between 3,000 and 9,000 troops in the country. General John Allen, the top U.S. and NATO commander in Afghanistan, had initially suggested that as many as 15,000 troops should remain.

With some 66,000 U.S. troops currently in Afghanistan, Obama is also deciding on the pace of this year's troop reductions. Afghan forces are due to take the lead role in security across the country in 2013.

"WAR OF NECESSITY"

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

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

Deliberations between Obama and his aides on winding down the unpopular war will have to compete with other priorities dominating his agenda, including the next round of U.S. fiscal showdowns and an intensifying push for gun-control measures.

Many of Obama's Republican opponents have criticized him for setting a timetable for withdrawal from Afghanistan and accuse him of undercutting the U.S. mission by reducing the size of the U.S. force there too quickly.

Karzai's talks with Obama - together with a working lunch and joint news conference - will cap a series of meetings this week with Defense Secretary Leon Panetta, Secretary of State Hillary Clinton and top lawmakers.

"After a long and difficult past, we finally are, I believe, at the last chapter of establishing ... a sovereign Afghanistan that can govern and secure itself for the future," Panetta told Karzai at the start of talks at the Pentagon on Thursday.

Clinton and Karzai met at the State Department on Thursday evening and were to have a working dinner.

Also on the agenda for the Obama-Karzai talks are tentative reconciliation efforts involving Taliban insurgents. Those efforts have shown flickers of life after nearly 10 months of limbo.

Karzai and his U.S. partners have not always seen eye to eye, even though the American military has been seen as crucial to securing his tenure from insurgents' attempts to oust him.

In October, Karzai accused the United States of playing a double game by fighting the war in Afghan villages instead of going after those in Pakistan who support insurgents.

(Additional reporting by David Alexander and Warren Strobel; Editing by David Brunnstrom)

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India's industrial output dips 0.1% in November

MUMBAI: India's industrial output dipped marginally by 0.1 percent in November from a year ago, data showed on Friday, raising hopes that the central bank will soon cut interest rates to boost sluggish growth.

The figure matched market expectations but was well below the previous month's 8.3 percent growth figure and underlines the challenges the government faces as it seeks to kickstart the economy.

Manufacturing output, which accounts for three-quarters of the index of industrial production, rose just 0.3 percent, while capital goods -- such as factory plant equipment -- plunged by 7.7 percent, the data showed.

"The numbers were not a surprise," said Siddhartha Sanyal, chief India economist with Barclays Capital, who expects India's industrial output to grow in low single digits until March.

The once-booming South Asian economy has been hit by continuing high interest rates in the face of strong inflation, sluggish exports and slow investment.

India last month cut its growth forecast for the current fiscal year ending March to between 5.7 and 5.9 percent, putting it on track for its worst annual performance in a decade.

Prime Minister Manmohan Singh, who with general elections due in 2014 is keen to revive the economy, announced a string of reforms in September, opening up retail and other sectors to wider foreign investment.

The government has also vowed to clamp down on tax evasion to help to lower the country's wide fiscal deficit.

India's output dip comes as industrial output in fellow Asian giant China has been growing much faster, rising 10.1 percent in November from a year earlier.

- AFP/al

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Pakistan suspends Poonch-Rawalakot bus service

JAMMU: In yet another setback to cross-LoC travel, Pakistan today decided to suspend 'Paigam-e-Aman' bus service between Pakistan-Occupied Kashmir (PoK) and Jammu and Kashmir.

There would be no bus service on Monday. "Pakistan has suspended the cross-LoC bus service between Chakan-Da-Bagh (J and K) and Rawalakote (PoK) for the time being," Trade Facilitation Officer (TFO), Poonch, Abdul Hamid Sheikh told PTI.

"There would be no cross-LoC bus service on Monday," the TFO said, adding, "No time frame was conveyed to us for re-starting the cross-LoC trade and bus service."

Sheikh said that he contacted Director General, Trade and Travel, PoK for clarifying the situation on LoC trade and travel and he conveyed that there was firing going on and in this situation, no travel can be carried out till further orders.

Pakistan Army had yesterday refused to open the gates for allowing cross-LoC trade in Chakan-Da-Bagh crossing point in Poonch district of Jammu and Kashmir. 25 J and K trucks carrying goods mostly vegetables for traders in PoK were stranded at the checkpoint.

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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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