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.

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

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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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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 study warns of extreme heat, more severe storms

WASHINGTON: A government report warned on Friday that the United States could face more frequent severe weather including heat waves and storms for decades to come as temperatures rise far beyond levels being planned for.

The draft Third National Climate Assessment, a scientific study legally mandated to advise US policymakers, made few bones that carbon emissions have been causing climate change -- a source of controversy among some lawmakers.

"Evidence for climate change abounds, from the top of the atmosphere to the depths of the oceans," the study said. "The sum total of this evidence tells an unambiguous story: The planet is warming."

The study, which was submitted for public and expert review and could be revised, said there was "strong evidence" that human activity had already roughly doubled the probability of extreme heat of the kind seen in Texas and Oklahoma in the summer of 2011.

The assessment expected temperatures to keep rising and offered different scenarios for the future -- including temperatures rising between 2.8 and 5.6 degrees Celsius (5 and 10 degrees Fahrenheit) after 2050 if emissions climb further.

Such a rise would be far beyond the level anticipated by world leaders in UN-backed climate change negotiations, which have committed to holding warming to no more than two degrees Celsius above pre-industrial levels.

The report warned that climate change "threatens human health and well-being in many ways," including through more frequent storms, wildfires, diseases and worse air quality.

Rising sea levels have already damaged infrastructure and climate change could increasingly reduce the reliability of water supplies, particularly in the southern half of the United States and Great Plains, the report said.

While US agriculture will likely remain resilient in the next 25 years, yields of major crops could start declining by mid-century and warming oceans could threaten fish, the study said.

The draft assessment said that some additional climate change was "now unavoidable" but said that the United States still could decide how much to allow.

The draft assessment was released three days after the National Oceanic and Atmospheric Administration said that 2012 was easily the warmest year on record in the continental United States and ranked second for extreme weather.

Environmental advocates hoped that the release of the draft report would bring fresh momentum to efforts to tackle climate change.

"Climate change is taking its toll on people and their economies, and will only become more intense without a strong and rapid response here in the United States and around the globe," Andrew Steer, president of the World Resources Institute, said in a statement.

President Barack Obama has hinted he will make a new effort on climate change in the wake of his November 6 re-election and massive storm Sandy, which killed at least 120 people in the US Northeast.

Efforts by Obama's Democratic Party to mandate cuts in carbon emissions failed in 2010 in the Senate. Lawmakers of the rival Republican Party said that legislation would be too costly and voiced doubt over climate science.

Since then, the Obama administration has ordered higher standards for power plants. US emissions dropped in 2011, largely due to increased use of natural gas instead of coal.

World Bank president Jim Yong Kim, who released a report in November that warned of potentially catastrophic 4.0 degree Celsius warming if no action is taken, said that evidence is "overwhelming" on climate change.

Speaking on Friday at a luncheon honouring Korean Americans, Kim voiced fear that his three-year-old son would live "a world that looks completely different from the world we have today" when he nears his father's age in 2060.

"If you have a three-year-old child, or if you have a three-year-old grandchild, what you've got to understand is, if we don't act aggressively on climate change, the world they live in will be daily fights over access to water, daily fights over access to food," he said.

- AFP/al

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Carnatic music: Classic collaborations work

CHENNAI: Shannon Donald, who lives in Mumbai, doesn't mind going for a Carnatic concert these days. And that's not because she grew up listening to south Indian classical music. "I love the singing style now," says the singer, who was amazed to see musician Bombay Jayashri being a picture of composure at MTV's Coke Studio a year ago.

"I was a backing vocalist on the episode in which she sang with Bollywood singer Richa Sharma. Though we had a long day, when it came to shooting her parts, she nailed every note effortlessly," says Donald about Jayashri, who was nominated on January 10 for the 2013 Oscars for writing a Tamil song, 'Pi's Lullaby', for Ang Lee's fantasy epic, 'Life of Pi'.

For many like Jayashri, collaborating with artists from other fields is not just about covering more creative ground. Notching up unlikely fans for classical music is one of the benefits that Jayashri and other Carnatic artists treasure while jamming with world musicians.

"After the Coke Studio episode, more people know me and come for my concerts. It's a win-win situation," says Jayashri, who has worked with Egyptian singer Hisham Abbas, done jugalbandis with Hindustani musicians Ronu Majumdar and sung for Bharatanatyam dancer Leela Samson's performances.

"I do collaborations because I like doing new things," says Jayashri. According to fellow artists like flautist S Shashank, it could have been Jayashri's love for experimentation that helped 'Life of Pi' director Ang Lee zero in on her for the Oscar-nominated project.

"I got to work on guitarist John McLaughlin's album 'Floating Point' because I work with world musicians. The album was nominated for a Grammy award in 2009," says the flautist, who will release an album, 'Here and Now', with Danish guitar maestro John Sund.

What draws western musicians is the ability of Indian musicians to improvise, says Shashank who has worked with legendary Spanish guitarist Paco de Lucia and with jazz musicians. Shashank loves the freedom to explore the flute outside the traditional concert format of Carnatic, which is a text-laden system and favours the vocalist. "It is a great learning experience. Also, as India is flooded with film music this is the only way classical musicians, especially instrumentalists, can carve a niche for themselves and establish commercially."

These artists still face the criticism that they are diluting pure music. "When, the late Pandit Ravi Shankar did jugalbandis, he was accused of doing the same. Now, jugalbandis have become the norm," says Jayashri.

To mandolin player U Shrinivas, collaborations mean more recognition for classical music. "My audience is bigger. My students come from all over the world to learn to Carnatic music," he says. And to Shrinivas, who is happy and proud of Jayashri's Oscar nomination, this could well be the best time for Indian classical music.

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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 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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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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US flu outbreak claims at least 18 lives

WASHINGTON: The United States was in the grip Thursday of a deadly influenza outbreak that has hit harder and earlier than in previous years, and has claimed the lives of at least 18 children.

"It looks like the worst year we had since 2003-2004," said Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases.

Fauci said this year's influenza strain, which has sickened thousands across the country, is particularly severe.

"The type of flu is one that generally is more serious. It's the H3N2 variety, which is historically more serious than we see with other types of virus," he said.

The epidemic, which broke out at the beginning of December, has caused some 2,200 hospitalizations across the United States, federal health officials said.

Particularly hard hit has been the northeastern city of Boston, where officials have declared a public health emergency.

City officials there said there so far have been about 700 confirmed cases of flu, almost 10 times the number from this time last year.

"This is the worst flu season we've seen since 2009, and people should take the threat of flu seriously," Boston Mayor Thomas Menino said in a statement.

"I'm urging residents to get vaccinated if they haven't already. It's the best thing you can do to protect yourself and your family. If you're sick, please stay home from work or school," he said.

Joe Bresee, chief of the Epidemiology and Prevention Branch of the Centers for Disease Control and Prevention's Influenza division, said officials don't yet know how much worse this year's outbreak will get.

"While we can't say for certain how severe this season will be, we can say that a lot of people are getting sick with influenza and we are getting reports of severe illness and hospitalizations," he said.

US states, particularly in the northeast of the country, have seen a sharp spike in emergency room visits from patients reporting flu-like symptoms, according to the federal CDC in Atlanta.

In Allentown, Pennsylvania, one hospital had to erect a large outdoor tent to admit and treat the large number of flu sufferers.

Health officials said that the flu vaccine is a good match for the strain of influenza circulating around the nation, and confers about 60 per cent to 65 per cent protection against the illness.

"You might get the flu but it will likely be less severe if you are vaccinated," Fauci said.

- AFP/ck

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Motor vehicle trader dies on H1N1 in Amritsar

TARN TARAN: A motor vehicle trader of Booh Hawelian village in Tarn Taran district died of swine flu in Amritsar on Thursday. Joga Singh, 26, was admitted in Guru Nanak Dev Hospital in the wee hours of Thursday and shifted to isolation ward after he tested H1N1 positive. District epidemiologist, civil hospital, Tarn Taran,. Swaranjit Singh Dhawan said the deceased had undertaken a business trip of Moga and other places about 10 days back and had not been feeling well after that. Initially, he had taken treatment at a private hospital in Amritsar.

Undertrial escapes from court complex: An undertrial lodged in Gurdaspur jail escaped after dodging the policemen accompanying him at district court complex on Thursday. According to reports, Avtar Singh was brought to the complex under police security for a court appearance. Police have registered a case and begun investigations.

Father, son arrested with opium, poppy husk: Jalandhar (rural) police have arrested a father-son duo with opium, poppy husk and a revolver from Shahkot area. SSP Yurinder Singh Hayer said police had intercepted a jeep stolen from Chandigarh on a tip off and arrested Pooran Singh and his son Jodh Singh of Bhoepur village of Shahkot subdivision. SP(D) Rajinder Singh said Pooran was convicted in an NDPS case and sentenced to 10 years imprisonment but was out on bail after spending four and half years in jail.

2 youth caught with 1kg gold: Shambu police arrested two Mathura-based residents and seized 1kg gold from their possession when they failed to show any documents. A team led by SHO Manjit Singh had laid a naka on the Punjab and Haryana border and were checking a PRTC bus around 4.30pm, when two young men became nervous when asked about their destination. A search revealed seizure of gold worth Rs 40 lakhs from their possession. The accused have been identified as Sandip Kumar and Ghanaiya Sharma. They were taking the gold from Mathura to Patiala.

Meet discusses steps to check wastage: At a conference organized by at the National Institute of Food Technology Entrepreneur and Management in Sonipat on Thursday, experts blamed lack of skilled manpower and shortage of infrastructure for wastage of up to 40% of food produced in India every year. They stressed on the need for skilled manpower of around 35 lakh people in the next seven years for food processing industry, besides creating cold storage chains across the country to cut down the wastage. Minister of state for agriculture and food processing industries Tariq Anwar said that FDI in retail sector had been allowed with the conditions to invest 50% of the total money on creating infrastructure like cold storages and processing units.

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