James Holmes Told to 'Rot in Hell' By Victim's Dad

The father of a young woman allegedly slain by James Holmes in the Aurora movie theater massacre yelled "Rot in hell, Holmes" during a court hearing today.

The outburst by Steve Hernandez prompted judge William Sylvester to have an off-the-record conference with prosecutors and defense attorneys. Sylvester then reconvened court to address the issue while armed court deputies watched over Hernandez at the front of the gallery.

Hernandez's daughter, Rebecca Wingo, was one of Holmes' 12 murder victims when he opened fire in the crowded movie theater July 20 during the midnight showing of "Dark Knight Rises." Wingo, 32, was the mother of two young girls.

"I am terribly sorry for your loss," Sylvester told Hernandez. "I can only begin to imagine the emotions that this is raising."

He then lectured Hernandez about the decorum order in place to prevent outbursts in the courtroom.

"I meant no disrespect," Hernandez apologized, promising there would be no further trouble and he was let go.

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The judge decided on Thursday night that there is enough evidence against Holmes to proceed to trial and scheduled Holmes' arraignment for March 12. Holmes will enter a plea at the arraignment.

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

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

Holmes is charged with 166 counts, including murder, attempted murder and other charges. His shooting rampage left 12 people dead and 58 wounded by gunfire. An additional 12 people suffered non-gunshot injuries.

Sylvester also ordered that Holmes be held without bail.

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

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Obama, Karzai agree to speed up Afghan military transition

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 this year, underscoring Obama's determination to move decisively to wind down the long, unpopular war.

Signaling a narrowing of differences, Karzai appeared to give ground in White House talks on U.S. demands for immunity from prosecution for any U.S. 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. They each voiced support for the establishment of a Taliban political office in the Gulf state of Qatar in hopes of bringing insurgents to inter-Afghan talks.

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.

The Obama administration has been considering a residual force of between 3,000 and 9,000 troops in Afghanistan to conduct counterterrorism operations while providing training and assistance for Afghan forces.

But 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 still-fragile Afghan government and its fledgling security apparatus.

Saying that Afghan forces were being trained and 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 was originally planned.

"Starting this spring, our troops will have a different mission: training, advising, assisting Afghan forces," Obama said. "It will be a historic moment and another step toward full Afghan sovereignty."

There are some 66,000 U.S. troops currently in Afghanistan. NATO allies have also been steadily reducing their troop numbers there with the aim of ending the foreign combat role in 2014, despite doubts about the ability of Afghan forces to shoulder full responsibility for security.

Obama said final decisions on this year's troop reductions and the post-2014 U.S. military role were still months away, but his comments raised the prospects of an accelerated withdrawal timetable as the security transition proceeds.

Precisely how much of an acceleration was unclear.

For his part, Karzai voiced satisfaction over Obama's agreement to turn over control of detention centers to Afghan authorities, a source of dispute between their countries.

The two leaders, who have had a tense relationship in the past, stood side by side in the White House East Room, nodding occasionally as the other spoke.

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 by al Qaeda on the United States.

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

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China landslide kills 43, three missing

BEIJING: Three people remain missing after a landslide which killed 43, including seven from a single family, struck a remote village in southwestern China, state media said Saturday.

Another two victims were sent to hospital after being rescued from the debris from the landslip on Friday which engulfed 16 homes in the village of Gaopo, the official news agency Xinhua said.

It reported that 19 children were among those caught in the disaster.

Rescuers continued their search for the three missing people in the early hours of Saturday morning, with the help of lamps and life detectors in freezing conditions, Xinhua said.

It added that the landslide had been triggered by prolonged rain and snow, according to initial geologists' reports.

Photos posted on Yunnan Web, run by the Yunnan provincial government, showed rescuers in orange uniforms digging into wide swathes of mud against a backdrop of snow-covered, terraced hills.

A video posted on a Chinese social networking site appeared to show a group of villagers digging through thick mud and debris to uncover a body, which was carried away on a stretcher.

"The landslide, which brought about several hundred thousand cubic metres of watery mud to the village, buried all of the houses there," Xinhua quoted a local rescue team leader, Sun Anfa, as saying.

The conditions "created great difficulties for rescue efforts amid low temperatures", he added.

More than 1,000 rescuers were sent to the disaster site, which was estimated to be 300 metres (1,000 feet) long, 80 metres wide and 30 metres deep, according to authorities.

Snow was visible in images of the rescue, in an area that has experienced unusually low temperatures in recent weeks during what authorities have called China's coldest winter in 28 years.

The Communist Party's top leaders Xi Jinping and Li Keqiang, along with Premier Wen Jiabao, ordered "all-out efforts to rescue victims", Xinhua said

It reported that villagers had rushed to the scene with shovels and hoes to dig through the mud.

"We pulled out several people, one of whom was breathing weakly, but after a while he died," resident Li Yongju told Xinhua.

Another resident, Zhou Benju, said she had lost several relatives in the disaster, according to the agency.

"Several relatives of my parents, my grandma, brother, uncle and my aunt's family members died," she said.

Yunnan province, which borders Myanmar, Thailand, Laos and Vietnam, is a relatively poor part of China where rural houses are often cheaply constructed.

Gaopo is in Zhenxiong county, in the northeast of Yunnan, a temperate province known for its tobacco industry and for being the home of Pu'er tea.

But its mountainous areas are prone to landslides and earthquakes. Two in September -- one of magnitude 5.7 -- left 81 people dead and hundreds injured.

Wen made an overnight trip to the quake zone at the time to comfort survivors, many of whom had taken refuge in tents erected on a public square.

A county neighbouring Zhenxiong was hit by a landslide in October that killed 18 children, after one which killed 216 people in 1991, according to the United States Geological Survey.

An earthquake in neighbouring Sichuan province in 2008 claimed around 70,000 lives -- the worst natural disaster to hit China in three decades, with shoddy buildings blamed for the high toll.

-AFP/ac

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India Inc calls Narendra Modi leader with vision

GANDHINAGAR: There were no lofty investment promises but captains of the industry and a battery of foreign diplomats queued up to hail Gujarat's economic progress on Friday when the sixth edition of the two-day Vibrant Gujarat business summit started at Mahatma Mandir here on Friday.

Apart from tycoons, several foreign dignitaries, including Japanese ambassador to India Takashi Yagi, Canadian high commissioner Stuart Beck and UK high commissioner James Bevan were present. As were heads of US India Business Council, UK India Business Council and Japan External Trade Organisation.

While most industry captains praised Modi, the most lavish praise came from ADAG chairman Anil Ambani, who placed Modi on the same pedestal as Mahatma Gandhi, Sardar Patel and Dhirubhai Ambani, as a visionary. He called Modi "king of kings"; at last year's Vibrant Gujarat, Anil Ambani had controversially said Modi should become a national leader.

Ratan Tata, the star attraction of the 2009 Vibrant Gujarat summit for bringing Nano factory to Gujarat from West Bengal, said Gujarat stands out, the credit for which goes to Narendra Modi. He has set "high standards" for investment, said Tata.

Adi Godrej, who came as Confederation of Indian Industries (CII) representative, spoke of Modi's "futuristic approach" in making Gujarat "one of the best investment destinations".

Shashi Ruia of Essar, whose company was forced to pay thousands of crores as sales tax dues to Gujarat government, also referred to "Modi's vision and unparalleled leadership" — which was in complete contrast to his reference to being treated as "ghar ki murgi" (taken for granted) at a previous summit.

Most tycoons confined their focus on what they called "the entrepreneurial spirit of Gujarat". In fact, speaking of the great strides made by Gujarat in the past, General Motors' Lowell C Paddock recalled how Halol, where the GM plant came up decades ago, was connected with a "high-speed highway" with Vadodara. "Earlier, it took four hours to reach Vadodara but after the highway it takes just half-an-hour," he said.

Modi, who concluded the inaugural ceremony, said this summit was about "finding solutions" to the impact of global slowdown. "Despite the slowdown, Gujarat did reasonably well," he claimed, adding, "We did well with 10% rate of growth in service, industry and agricultural sectors." Modi further claimed Gujarat accounts for 72% of nation's employment generation, and the growth rate of small and medium industries was 85% in a year.

UK treads cautiously

British high commissioner James Bevan, who met Narendra Modi in October after the British felt the need to "engage Modi", was cautious at the inaugural session of the Vibrant Gujarat meet. Bevan avoided any direct or indirect reference to Modi, even while speaking about "natural" and "traditional" partnership between Gujarat and Britain over several centuries. Recalling the huge Gujarati population at Leicester, he hoped for a "thriving and stronger relationship" with Gujarat.

Money flows

Mukesh Ambani of the Reliance Industries said his company will invest Rs 100,000 crore over the next five years and focus on expansion in Jamnagar, Hazira and Dahej, apart from setting up a higher education hub. Essar chairman Shashi Ruia said his company was proposing to invest Rs 14,000 crore — Rs 10,000 crore in ports sector at Hazira and Salaya, and Rs 4,000 crore in bulk water supply.

Modi for PM

Contrary to earlier summits when at least two leading industrialists said Modi was fit for prime minister's post, this time around only Gautam Adani wished that Modi, armed with his "able leadership", should go "up north". Interestingly, the only other person who expressed a similar wish was Konstantin Makarelov, vice-governor of the tiny Astrakhan province of the Russian Federation, saying — amidst a huge applause from Modi supporters — that he hoped Modi will win the "next general elections".

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Flu more widespread in US; eases off in some areas

NEW YORK (AP) — Flu is more widespread across the nation, but the number of hard-hit states has declined, health officials said Friday.

Flu season started early this winter, and includes a strain that tends to make people sicker. Health officials have forecast a potentially bad flu season, following last year's unusually mild one. The latest numbers, however, hint that the flu season may already have peaked in some spots.

Flu was widespread in 47 states last week, up from 41 the week before, the Centers for Disease Control and Prevention said on Friday. Many cases may be mild. The only states without widespread flu are California, Mississippi and Hawaii.

The hardest hit states fell to 24 from 29, with large numbers of people getting treated for flu-like illness. Dropped off that list were Florida, Arkansas and South Carolina in the South, the first region hit this flu season.

Recent flu reports have included the holidays when some doctor's offices were closed, so it will probably take a couple more weeks to know if the flu has peaked in some places or grown stronger in others, CDC officials said Friday.

"Only time will tell how moderate or severe this flu season will be," CDC Director Dr. Thomas Frieden said in a teleconference with reporters.

Nationally, 20 children have died from the flu. There is no running tally of adult deaths, but the CDC estimates that the flu kills about 24,000 people in an average year.

Flu vaccinations are recommended for everyone 6 months or older, and health officials say it is not too late to get vaccinated. flu reports.

Nearly 130 million doses of flu vaccine were distributed this year, and at least 112 million have been used. Vaccine is still available, but supplies may have run low in some locations, health officials say.

Hyrmete Sciuto, of Edgewater, N.J., got a flu shot Friday at a New York City drugstore. She hadn't got one in years, but news reports on the flu this week made her concerned.

As a commuter by ferry and bus, "I have people coughing in my face," she said. "I didn't want to risk it this year."

The flu vaccine isn't foolproof; people who get vaccinated can still get sick.

On Friday, CDC officials said a recent study of more than 1,100 people has concluded the current flu vaccine is 62 percent effective. That means the average vaccinated person is 62 percent less likely to get a case of flu that's bad enough to require a trip to the doctor, compared to people who don't get the vaccine.

That's in line with how effective the vaccine has been in other years.

The flu vaccine is reformulated annually, and officials say this year's version is a good match to the viruses going around.

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. But people with severe symptoms should see a doctor. They may be given antiviral drugs or other medications to ease symptoms.

Some shortages have been reported for children's liquid Tamiflu, a prescription medicine used to treat flu. But health officials say adult Tamiflu pills are available, and pharmacists can convert those to doses for children.

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AP Science Writer Malcolm Ritter in New York contributed to this report.

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Online:

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

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Biden Hints at Executive Order on Gun Control

Vice President Biden, meeting today with outside groups on gun safety, told reporters he has already started putting together a list of recommendations that he plans to issue next Tuesday.

He has suggested the administration would be ready to take executive action on the issue, which would not require votes from Congress. That prospect has raised alarm bells for gun rights advocates.

Biden told reporters Thursday, during a meeting a with sportsmen, women and wildlife groups, that he would deliver the list of recommendations to the president on Jan. 15, and that an improved system for background checks has emerged as a a priority for the stakeholders he's met so far. Guns have been at the top of the White House agenda since the December shootings at Sandy Hook Elementary School in Newtown, Conn.

"I am putting together a series of recommendations for the president that will, that he will take a look at. There's a real, very tight window to do this," Biden said at the top of his meeting with advocates for sportsmen, sportswomen and wildlife interest groups. "I committed to him I'd have these recommendations to him by Tuesday. And it doesn't mean it's the end of the discussion, but the public wants us to act."

Biden said he has not reached any conclusions just yet but recounted the recommendations that have been made to him from the various stakeholders he's met with over the past month. The vice president emphasized the consensus emerging from the meetings on the need to strengthen the background check system.

"So far, a surprising recurrence of suggestions that we have universal background checks, not just close the gun show loophole, but total, universal background checks, even including private sales," Biden said.

Other suggestions offered at the meetings have centered on gun safety and the responsibility that goes along with gun ownership, dealing with high capacity magazines, and the ability of federal agencies to do research on gun violence.

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Biden sat down with representatives of the NRA and other supporters of gun rights on the second day of this week's meetings on gun violence.

He said at one meeting that he has "never quite heard so much talk about high-capacity magazines" as he has since the shootings in Newtown.

Biden met with gun-violence victims' groups and proponents of gun control on Wednesday. Thursday was his opportunity to get a different side of the story. Biden met with the National Rifle Association and Attorney General Eric Holder met with representatives from Wal-Mart, one of the largest sellers of firearms in the country.

"There are executive orders, executive action that can be taken. We haven't decided what that is yet, but we're compiling it all with the help the attorney general and all the rest of the cabinet members, as well as legislative action, we believe, is required," Biden said.

Spokesmen for the NRA and Wal-Mart confirmed representatives from their organizations would be included in the meetings Thursday. The NRA said it would be represented by James J. Baker, its top lobbyist. Advocates for sportsmen, women's groups, wildlife groups and gun owners were also invited. The vice president is slated to meet with members of the entertainment industry in the evening.

In December, the NRA called for armed officers to be placed in every school after the massacre at Sandy Hook Elementary.

Wal-Mart initially turned down an invitation to participate in the talks but reversed its decision after it "underestimated the expectation to attend the meeting on Thursday in person," a spokesman said.

"We take this issue very seriously and are committed staying engaged in this discussion as the administration and Congress work toward a consensus on the right path forward," David Tovar, vice president of corporate communications for Wal-Mart, said.

The latest meetings come one day after Biden held a first round of talks this week with gun safety advocacy groups and victims of gun violence. Speaking to reporters before the meeting, the vice president expressed the administration's commitment to develop effective gun policy by considering all ideas.

Colin Goddard, a survivor of the shooting at Virginia Tech University in 2007, participated in the meeting at the White House Wednesday and said the talks gave the groups "encouragement from the highest office in the country."

"I was really encouraged by seeing how focused and determined the administration is in seeing comprehensive changes to the gun violence in America," Goddard, who is now the assistant director for federal legislation at the Brady Campaign to Prevent Gun Violence, told ABC News. "It was really great to see even the Vice President of the United States of America supporting us. He wants to see this done to the end and bringing us all to the table to share our personal stories, share our ideas about what our proposals could be."

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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 will stand by Afghanistan, Panetta tells Karzai

WASHINGTON: The United States sought to assure Afghan President Hamid Karzai on Thursday that it would remain committed to his country even as US officials weigh a major withdrawal of American forces.

After an elaborate military ceremony for Karzai outside the Pentagon, US Defense Secretary Leon Panetta told his "distinguished visitor" that more than 10 years of war had paved the way for Afghanistan to stand on its own.

"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 said.

"We've come a long way towards a shared goal of establishing a nation that you and we can be proud of, one that never again becomes a safe haven for terrorism."

He also offered Karzai assurances that the future of the two countries was now entwined.

"We have sacrificed together -- that has created a bond that will not be broken in the future," Panetta said.

Since US-led troops toppled the Taliban in 2001 after the September 11 attacks, the Afghan president has had a stormy relationship with his US allies, and officials here want to demonstrate Washington's full-fledged support.

The talks come as President Barack Obama, newly elected to a second term, charts a plan to pull most of the 66,000 US troops out of Afghanistan -- well down from a high of about 100,000.

The United States and its NATO allies have already agreed to withdraw combat troops by the end of 2014, but questions remain on a US training and security role after that.

Throughout his visit, Karzai is expected to push for a substantial US military presence in Afghanistan after 2014.

But some White House officials favour only a light footprint of several thousand troops, and Ben Rhodes, a deputy national security adviser, even suggested Tuesday the United States might pull out all of its troops.

US military officers privately acknowledged those comments about a total withdrawal were primarily designed as a tactic in negotiations with Kabul.

Karzai was also due to meet later Thursday with US Secretary of State Hillary Clinton, for talks and an official dinner at the State Department, before a White House summit on Friday with Obama.

Among the issues topping the agenda at the State Department are progress on reconciliation talks with the Taliban, as well as the distribution of US aid to Afghanistan.

"We have had some modest steps forward in recent months, including a commitment by Pakistan to support Afghan reconciliation," State Department spokeswoman Victoria Nuland said.

Karzai has also pressed for more US assistance to go directly into Afghan coffers, instead of being distributed via non-governmental and aid organizations.

"We've made a pledge that about 50 per cent ought to go through the Afghan government," Nuland said earlier this week. But she stressed that this was "tied to our expectation that the Afghan government will in turn meet the commitments... with regard to continuing to make progress on corruption, on transparency, on accountability."

For his part, Karzai thanked Panetta for the US military's contributions and for the red-carpet ceremony, saying he was hopeful Washington and Kabul would work out an agreement allowing a future US military role beyond 2014.

"Afghanistan will, with the help that you provide, be able to provide security to its people and to protect its borders; so Afghanistan would not ever again be threatened by terrorists from across our borders," he said.

Karzai also voiced confidence the two countries can "work out a modality for a bilateral security agreement that will ensure the interests of Afghanistan and also the interests of the United States."

- AFP/jc

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Prayers for Akbaruddin Owaisi in temple

HYDERABAD: About 50 Hindus living in the Old City performed a 'havan' at a temple for the release of Majlis-e-Ittehadul Muslimeen (MIM) leader Akbaruddin Owaisi, who was arrested on Sunday over a hate speech.

The 41-year-old Majlis leader was remanded to 14-day judicial custody this week with multiple cases being filed against him. Legal experts say chances of his immediate release are remote.

But while the speech incurred the wrath of people across the country, a section of residents living in and around Jagjivanram Nagar, mostly Hindus, are fond of Akbaruddin for the development work he had carried out in the past as a legislator.

The Chandrayangutta MLA has found supporters among some Hindus of the Old City with 'puja' organiser Kanduri Anita saying that many people from the neighbourhood had gathered for the 'havan' and 'aarti' in the evening, which took a few by surprise.

"Akbaruddin Owaisi got small sheds constructed for this Maisamma temple and Boolakshmi temple, both of which are in Jagjivanram Nagar. He also got borewell pumps repaired. All of us have prayed for his release," said Anita.

Further, scores of MIM leader's supporters gathered at Dargah Yousufain in Nampally to express solidarity with the arrested legislator and offered prayers for his release.

While shops in the Old City were open and the RTC resumed services after its fleet stayed off the roads on Wednesday, people in street corners were seen discussing the issue with many enquiring when their leader will be released.

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Flu season hits 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 have limited visitors, and one Pennsylvania hospital set up a tent outside its ER to handle the feverish patients.

Flu season in the U.S. has hit early and, in some places, hard. But 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 is pointing to a moderate season, Schaffner and others believe. It just looks bad compared with last year — an unusually mild one.

Flu usually doesn't blanket the country until late January or February, but it is already widespread in more than 40 states.

What's probably complicating the situation: The main influenza virus this year tends to make people sicker. And there are other bugs out there causing flu-like illnesses. 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.

The flu's early arrival in the U.S. coincided with spikes in a variety of other viruses, including a childhood malady that mimics flu and a new norovirus that causes what some people call "stomach flu."

Most people don't undergo lab tests to confirm flu, and the symptoms are so similar that it's sometimes 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 ER saw its busiest day ever last week, with 166 visitors.

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

One hospital in Allentown, Pa., this week set up a tent 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, and all the flu activity has caused some to question whether this year's flu shot is working.

There's a new flu vaccine each year, based on the best guess of what flu viruses will be strongest that year. This year's vaccine is well-matched to what's going around. The government estimates that between a third and a half of Americans have gotten the vaccine.

But the vaccine isn't foolproof, and even those who were vaccinated can still get sick. At best, the vaccine may be only 75 percent effective in younger people and even less so in the elderly and people with weak immune systems.

Health officials are analyzing the vaccine's effectiveness, but early indications are that about 60 percent of all vaccinated people have been protected from the flu. That's in line with how effective flu vaccines have been in other years.

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

She decided to skip getting a flu shot last fall. But her daughter got the shot. "And she got sick twice," Quinones said.

On average, about 24,000 Americans die each flu season, according to the CDC.

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.

The last bad flu season involved a swine flu that hit in two waves in the spring and fall of 2009. But that was considered a unique strain, different from the regular winter flu.

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Online:

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

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