Q&A: Scramble for vaccine as flu season heats up

WASHINGTON (AP) — Missed flu-shot day at the office last fall? And all those "get vaccinated" ads? A scramble for shots is under way as late-comers seek protection from a miserable flu strain already spreading through much of the country.

Federal health officials said Friday that there is still some flu vaccine available and it's not too late to benefit from it. But people may have to call around to find a clinic with shots still on the shelf, or wait a few days for a new shipment.

"We're hearing of spot shortages," said Dr. Thomas Frieden, director of the Centers for Disease Control and Prevention.

Colorado offers an example. Kaiser Permanente, which has 535,000 members in the state, stopped giving flu shots this week. But it expected to resume vaccinations when new shipments arrive, expected this weekend.

Some questions and answers about flu vaccines:

Q: Are we running out of vaccine?

A: It's January — we shouldn't have a lot left. The traditional time to get vaccinated is in the fall, so that people are protected before influenza starts spreading.

Indeed, manufacturers already have shipped nearly 130 million doses to doctors' offices, drugstores and wholesalers, out of the 135 million doses they had planned to make for this year's flu season. At least 112 million have been used so far.

The nation's largest manufacturer, Sanofi Pasteur, said Friday that it still has supplies of two specialty vaccines, a high-dose shot for seniors, and an under-the-skin shot for certain adults, available for immediate shipment. But it also is working to eke out a limited supply of its traditional shots — some doses that it initially hadn't packaged into syringes, said spokesman Michael Szumera. They should be available late this month.

And MedImmune, the maker of the nasal spray vaccine FluMist, said it has 620,000 extra doses available.

Q: Can't they just make more?

A: No. Flu vaccine is complicated to brew, with supplies for each winter made months in advance and at the numbers expected to sell. Although health officials recommend a yearly flu vaccination for nearly everybody, last year 52 percent of children and just 39 percent of adults were immunized. Most years, leftover doses have to be thrown out.

Q: Should I still hunt for a vaccine?

A: It does take two weeks for full protection to kick in. Still, health officials say it's a good idea to be vaccinated even this late, especially for older people, young children and anyone with medical conditions such as heart or lung diseases that put them at high risk of dangerous flu complications. Flu season does tend to be worst in January and February, but it can run through March.

Q: I heard that a new flu strain is spreading. Does the vaccine really work?

A: Flu strains constantly evolve, the reason that people need an updated vaccine every year. But the CDC says this year's is a good match to the types that are circulating, including a new kind of the tough H3N2 strain. That family tends to be harsher than other flu types — and health officials warned last fall that it was coming, and meant this winter would likely be tougher than last year's flu season, the mildest on record.

Q: But don't some people get vaccinated and still get sick?

A: Flu vaccine never is 100 percent effective, and unfortunately it tends to protect younger people better than older ones. But the CDC released a study Friday showing that so far this year, the vaccine appears 62 percent effective, meaning it's working about as well as it has in past flu seasons.

While that may strike some people as low, Frieden said it's the best protection available. "It's a glass 62 percent full," he said. "It's well worth the effort."

Q: What else can I do?

A: Wash your hands often, and avoid touching your eyes, nose and mouth. Viruses can spread by hand, not just through the air. Also, cough in your elbow, not your hand. When you're sick, protect others by staying home.

And people who are in those high-risk groups should call a doctor if they develop symptoms, added CDC spokesman Tom Skinner. They might be prescribed antiviral medication, which works best if given within the first 48 hours of symptoms.

___

AP Medical Writers Lindsey Tanner and Mike Stobbe contributed to this report.

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American who fought with Taliban wins prayer ruling

SAN FRANCISCO — John Walker Lindh, the Marin County man imprisoned for fighting with the Taliban, has won the right to have daily communal Muslim prayer in the U.S. prison unit where he is incarcerated.

An Indiana judge, ruling in a lawsuit brought by Lindh, ordered a Terre Haute prison warden to end a ban on daily group prayer for Lindh and more than 40 other Muslim inmates. The judge said the ban violated a federal law that protects the religious rights of prison inmates.

Lindh, who converted to Islam while living with his family in San Anselmo, is serving a 20-year prison sentence. He was captured in Afghanistan and later pleaded guilty to supplying services to the Taliban and carrying an explosive.

Now housed in a prison unit for inmates whose communications are closely monitored, Lindh contended that the ban on daily group prayer violated his right to practice his religion. He said he adheres to the Hanbali school of Islam, which requires five communal prayers daily.

U.S. District Judge Jane Magnus-Stinson said in her ruling Friday that Lindh was now considered a low-risk inmate and had committed only minor, nonviolent infractions. Prisoners in his closely monitored unit are permitted to be out of their cells most of the day and can play cards, watch television and exercise, the judge said.

"While no disruptive episodes have occurred in the [unit] as a result of small group prayers, a fight has occurred over a remote control and one has occurred when the victim was reading," the judge said.

Lindh's prison infractions have included speaking Arabic to another inmate, participating in an unauthorized prayer meeting and ignoring an order to unfold his pants leg because he said that Islam prohibited wearing pants below the ankles, according to the judge's ruling.

Lindh is expected to be released in 2019.

maura.dolan@latimes.com

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Rebels Agree to Cease-Fire in Central African Republic

Joel Bouopda Tatou/Associated Press

President François Bozizé of Central African Republic, right, who will finish out his term, with Michel Djotodia, a rebel leader, after talks Friday in Gabon.

Bringing a tentative close to an uprising that brought the Central African Republic to the brink of civil war, the government and rebel fighters seeking to oust the president signed a deal on Friday for a weeklong cease-fire that could mature into a peace plan.

Under the agreement, President François Bozizé will not cede power, but a coalition government will be formed and an opposition leader will be named prime minister, according to participants in the negotiations, held in nearby Gabon. Those changes will come only after several other rebel demands have been met, including the release of political prisoners taken by the government during the uprising — their number is unclear — and the departure of soldiers from South Africa and Angola who were sent to bolster the tottering government.

The rebels, an alliance of several groups called the Seleka coalition, swept through the north of the country in December toward the capital city, Bangui. They are still not convinced of Mr. Bozizé’s good will. Should the coalition’s conditions not be met within one week, the cease-fire will not be honored, said Col. François Florian Njadder-Bedaya, a rebel spokesman.

“He’s quite cunning, Bozizé,” Colonel Njadder-Bedaya said. “We want to judge words, speech, with acts.”

A former military officer, Mr. Bozizé seized power in 2003 and has since been elected twice, though there are doubts about the legitimacy of his electoral success. The rebels say he has overseen torture and illegal executions, has not given the country’s north a voice in government and has failed to honor the terms of peace agreements signed with rebels beginning in 2007. Mr. Bozizé’s current term is set to end in 2016, and the agreement signed Friday will allow him to complete it.

Bangui was calm on Friday afternoon. Small groups of government soldiers remain posted in the city, but only at strategic locations; a nightly curfew is not strictly enforced.

In one month of fighting, the rebels seized control of several northern cities and swept south before being stopped at Damara, the final strategic city on the road to Bangui. Hundreds of soldiers from a multinational African peacekeeping force had massed there to prevent the rebels from reaching the capital.

The agreement signed Friday does not require the rebels to retreat from their current positions, and they will not, Colonel Njadder-Bedaya said. Rather, they will await the formation of the coalition government, and will be integrated into the national army, he said.

The coalition government, which participants in the peace talks called a “national unity” government, is to include representatives of Mr. Bozizé’s political group, the Kwa Na Kwa — “Work, Nothing but Work” in Sango, the national language — the opposition, armed groups and civil society.

The National Assembly, which Mr. Bozizé’s opponents dismiss as a corrupt mouthpiece for his government, will be dissolved and replaced by a transitional council. Legislative elections are to be held in 12 months, though the date could be later. Presidential elections will be held at the end of Mr. Bozizé’s term.

“This is a way to accompany Mr. Bozizé toward an honorable exit,” Colonel Njadder-Bedaya said.

The rebels had earlier insisted that there would be no cease-fire without the president’s immediate departure. That demand, however, was rejected early in talks as being unconstitutional.

“Within the constitutional framework, it wasn’t possible,” said Bruno Hyacinthe Gbiégba, a lawyer and the president of an antitorture group who served as an observer at the talks.

Should Mr. Bozizé fail to meet the agreed conditions, the rebels will call upon other nations to intervene, Colonel Njadder-Bedaya said, though this seems an unlikely outcome.

“We’re not in a military situation; we’re in a diplomatic situation,” the colonel said. Still, he added, “I admit to you, things might blow up.”

Christian Panika contributed reporting from Bangui, Central African Republic.

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In gun debate, video game industry defends itself

WASHINGTON (AP) — The video game industry, blamed by some for fostering a culture of violence, defended its practices Friday at a White House meeting exploring how to prevent horrific shootings like the recent Connecticut elementary school massacre.

Vice President Joe Biden, wrapping up three days of wide-ranging talks on gun violence prevention, said the meeting was an effort to understand whether the U.S. was undergoing a “coarsening of our culture.”

“I come to this meeting with no judgment. You all know the judgments other people have made,” Biden said at the opening of a two-hour discussion. “We’re looking for help.”

The gaming industry says that violent crime, particularly among the young, has fallen since the early 1990s while video games have increased in popularity.

There are conflicting studies on the impact of video games and other screen violence. Some conclude that video games can desensitize people to real-world violence or temporarily quiet part of the brain that governs impulse control. Other studies have concluded there is no lasting effect.

Cheryl Olson, a participant in Biden’s meeting and a researcher of the effect of violent video games, said there was concern among industry representatives that they would be made into a scapegoat in the wake of the Connecticut shooting.

“The vice president made clear that he did not want to do that,” Olson said.

Biden is expected to suggest ways to address violence in video games, movies and on television when he sends President Barack Obama a package of recommendations for curbing gun violence Tuesday. The proposals are expected to include calls for universal background checks and bans on assault weapons and high-capacity ammunition magazines.

Obama appointed Biden to lead a gun violence task force after last month’s shooting at a Newtown, Conn., elementary school that left 20 children and six educators dead.

Gun-safety activists were coalescing around expanded background checks as a key goal for the vice president’s task force. Some advocates said it may be more politically realistic — and even more effective as policy — than reinstating a ban on assault weapons.

The Brady Campaign to Prevent Gun Violence said some 40 percent of gun sales happen with no background checks, such as at gun shows and by private sellers over the Internet or through classified ads.

“Our top policy priority is closing the massive hole in the background check system,” the group said.

While not backing off support for an assault weapons ban, some advocates said there could be broader political support for increasing background checks, in part because that could actually increase business for retailers and licensed gun dealers who have access to the federal background check system.

“The truth is that an assault weapons ban is a very important part of the solution — and it is also much tougher to pass,” said Mark Glaze, director of Mayors Against Illegal Guns.

Restrictions on high-capacity ammunition magazines are also seen by some as an easier lift politically than banning assault weapons.

The National Rifle Association adamantly opposes universal background checks, as well as bans on assault weapons and high-capacity magazines — all measures that would require congressional approval. The NRA and other pro-gun groups contend that a culture that glamorizes violence bears more responsibility for mass shootings than access to a wide range of weapons and ammunition.

In a 2009 report, the American Academy of Pediatrics declared, “The evidence is now clear and convincing: Media violence is one of the causal factors of real-life violence and aggression.”

The report focused on all types of media violence. But for video games in particular, the pediatricians cited studies that found high exposure to violent ones increased physical aggression at least in the short term, and warned that they allow people to rehearse violent acts. On the other hand, it said friendly video games could promote good behavior.

A wide spectrum of the video game industry was represented at the meeting with the vice president, including the makers of violent war video games like “Call of Duty” and “Medal of Honor” and a representative from the Entertainment Software Ratings Board, which sets age ratings that on every video game package released in the United States.

The vice president met Thursday with representatives from the entertainment industry, including Motion Picture Association of America and the National Cable & Telecommunications Association. In a joint statement after the meeting, a half-dozen said they “look forward to doing our part to seek meaningful solutions” but offered no specifics.

Biden, hinting at other possible recommendations to the president, said he is interested in technology that would keep a gun from being fired by anyone other than the person who bought it. He said such technology may have curtailed what happened last month in Connecticut, where the shooter used guns purchased by his mother.

The vice president has also discussed making gun trafficking a felony, a step Obama can take through executive action. And he is expected to make recommendations for improving mental health care and school safety.

“We know this is a complex problem,” Biden said. “We know there’s no single answer.”

The president plans to push for the new measures in his State of the Union address, scheduled for Feb. 12.

___

Associated Press writers Lauran Neergaard and Darlene Superville contributed to this report.

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Britney & Jason's Love Story in 6 Sweet Shots

From a snuggle in the surf to a surprise engagement, see the former couple's most romantic moments

Credit: Kevin Mazur/Wireimage

Updated: Friday Jan 11, 2013 | 07:00 AM EST
By: Cara Lynn Shultz

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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.

___

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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Kurdish Killings in Paris, and Motive Is a Mystery

Thomas Samson/Agence France-Presse — Getty Images

Members of the Kurdish community watched as the body of one of the three Kurdish women shot dead at the Kurdish Institute was carried away on Thursday in Paris.

PARIS — The three Kurdish women were murdered, two with bullets to the head, the third with a shot to the stomach. It was a carefully planned killing in a nondescript building in central Paris.

When the bodies were found early Thursday, the office was locked from the outside. Three bullet casings were found on the floor. Blood was splattered on the door.

One of the dead women was a founder of the Kurdistan Workers Party — or P.K.K. — a Kurdish separatist group that has waged a guerrilla war against Turkey since 1984. The other two were Kurdish activists who may well have died because they were simply in the wrong place at the wrong time.

There were competing theories over who was responsible, and outraged Kurds poured into the street in Paris, blaming Turkey. Officials there said the killings were probably a dispute among Kurds, perhaps intended to derail new peace talks between the government and the P.K.K.’s jailed leader, or to settle a score.

But these were theories. The evidence spoke only to a well-planned job.

“No hypothesis can be excluded at this stage” about the motive, said Agnès Thibault-Lecuivre, a spokeswoman for the Paris prosecutor’s office. Visiting the crime scene on Thursday, Interior Minister Manuel Valls called the killings “intolerable” and said they were “without doubt an execution.”

The shootings took place in the gritty 10th District of the city, near the Gare du Nord railroad station, in a working-class immigrant neighborhood of Turkish kebab shops and African hair salons. The killings prompted outrage, raised fears of violent revenge violence and opened a new chapter in the often murky annals of Kurdish exile life.

The bodies were found around 2 a.m. inside the Kurdish Information Center, which is used to promote Kurds’ political and cultural agendas. Someone would have to have known the office was there; there was no plaque outside. And the front door could only be opened with a digital code or if the occupants buzzed someone in, the manager of the center, Leon Edart, told reporters.

That possibility led to many questions. Did the women know their killer? Did the killer slip into the center behind a welcomed guest? An organization called the Federation of Kurdish Associations in France, representing many of the estimated 150,000 Kurdish exiles in the country, added to the intrigue, saying in a statement that the victims might have been killed with weapons equipped with silencers.

“Why anyone would want to do this is unclear,” said Rusen Werdi, a Kurdish lawyer who knew two of the women. “It was an ambush.”

The bodies, she said, were discovered after friends became concerned about the women because cellphone calls had gone unanswered and none of them had returned home.

Ms. Thibault-Lecuivre said the antiterrorism department of the prosecutor’s office would oversee the investigation.

The authorities confirmed the identities of two of the victims: Leyla Soylemeza, a young Kurdish activist, and Fidan Dogan, the head of the Kurdish Information Center and a representative of the Kurdistan National Congress. News media reports said the third woman was Sakine Cansiz, a founder of the Kurdistan Workers Party.

But for all the intrigue, Ms. Werdi said, it appeared that the target was Ms. Cansiz and that the other two victims might well have been killed because they were with her.

Ms. Werdi said that at least one of the women had been under surveillance by the French police because of her activism. She said that Ms. Cansiz had been keeping a low profile in recent months, and that it was rare for her to be at the information center.

The P.K.K.  is no stranger to infighting and internal strife. Hurriyet, a Turkish daily newspaper, said Ms. Cansiz was “known for her opposition to the alleged head of the P.K.K.’s armed wing, Syrian citizen Ferman Hussein.”

Ms. Cansiz had been in Paris since 2007 after the authorities in Germany arrested and briefly held her before turning down a Turkish request for her extradition. Kurdish activists said she was very close to Abdullah Ocalan, the head of the P.K.K., who has been in prison since 1999. Ms. Cansiz was imprisoned in Turkey in 1979 and freed in 1991, after which they said she became active in the organization. She played a leading role garnering financial and political support for the Kurdish cause in Europe.

Scott Sayare contributed reporting from Paris, and Sebnem Arsu from Istanbul.

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Academy Launches Oscar App on Android, Amazon

LOS ANGELES (TheWrap.com) – The Academy launched its official Oscars app on Android and Amazon on Thursday, expanding its initiative to direct fans’ attention from the television to the second screen.

The app, already available on the iPad and iPhone, was made available for free on the Google Play store and the Amazon app store, the Academy said. According to iTunes, the iPad app was updated earlier on Wednesday.

Developed by the Academy and Disney/ABC Television Group’s digital media arm, the app allows users to see behind-the-scenes videos and stories with host Seth MacFarlane and search information about the nominees. It also features a “My Picks” ballot on which users can organize their dream-team of winners.

On Oscar night on February 24, the app will feature “Backstage Pass,” a live telecast from more than a dozen cameras placed on the Red Carpet and throughout the Dolby Theatre – in the press room, the control room, backstage and elsewhere.

And a ticker on the app will notify when a users’ favorite actor and actress arrives on stage.

“We’re always looking for ways to bring fans closer to the show and this app provides a unique and fun way to do that,” Josh Spector, the managing director of digital media and marketing for the Academy, said in a statement. “More fans than ever will be able to enjoy the full Oscar experience now that our app is available to Droid users.”

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Audrey Hepburn: Remembering the Private Legend

By Elizabeth McNeil

01/10/2013 at 07:35 PM EST

Audrey Hepburn with her son, Luca Dotti, in 1985

Audrey Hepburn Childrens Fund

She captivated the world with her doe-eyed beauty, but behind the Givenchy glamour, there was an Audrey Hepburn few people knew.

She thought her nose too big, her feet too large and her neck too long. She loved to shop for groceries (but not clothes), didn't wear makeup at home, never went to the gym and enjoyed two fingers of Scotch every night. 

"She was not this ethereal creature," says Robert Wolders, 76, the Dutch actor who was her companion for the last 13 years of her life. "She was an earthy woman with a ribald sense of humor."

What Hepburn had, adds Wolders, "was more than beauty. It was this extraordinary mystique."

Hepburn left Hollywood at age 34 at the height of her fame, moving into a 1732 farmhouse in Tolochenaz, a small Swiss village, where she found happiness raising two sons and purpose in her charity work for UNICEF. 

Two decades after her death from abdominal cancer at 63 on Jan. 20, 1993, her children and her last love remember the Audrey they adored. 

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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.

___

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

___

Online:

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

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