Flu shot doing poor job of protecting older people

ATLANTA (AP) — It turns out this year's flu shot is doing a startlingly dismal job of protecting older people, the most vulnerable age group.

The vaccine is proving only 9 percent effective in those 65 and older against the harsh strain of the flu that is predominant this season, the Centers for Disease Control and Prevention said Thursday.

Health officials are baffled as to why this is so. But the findings help explain why so many older people have been hospitalized with the flu this year.

Despite the findings, the CDC stood by its recommendation that everyone over 6 months get flu shots, the elderly included, because some protection is better than none, and because those who are vaccinated and still get sick may suffer less severe symptoms.

"Year in and year out, the vaccine is the best protection we have," said CDC flu expert Dr. Joseph Bresee.

Overall, across the age groups studied, the vaccine's effectiveness was found to be a moderate 56 percent, which means those who got a shot have a 56 percent lower chance of winding up at the doctor with the flu. That is somewhat worse than what has been seen in other years.

For those 65 and older, the vaccine was only 27 percent effective against the three strains it is designed to protect against, the worst level in about a decade. It did a particularly poor job against the tough strain that is causing more than three-quarters of the illnesses this year.

It is well known that flu vaccine tends to protect younger people better than older ones. Elderly people have weaker immune systems that don't respond as well to flu shots, and they are more vulnerable to the illness and its complications, including pneumonia.

But health officials said they don't know why this year's vaccine did so poorly in that age group.

One theory, as yet unproven, is that older people's immune systems were accustomed to strains from the last two years and had more trouble switching gears to handle this year's different, harsh strain.

The preliminary data for senior citizens is less than definitive. It is based on fewer than 300 people scattered among five states.

But it will no doubt surprise many people that the effectiveness is that low, said Michael Osterholm, a University of Minnesota infectious-disease expert who has tried to draw attention to the need for a more effective flu vaccine.

Among infectious diseases, flu is considered one of the nation's leading killers. On average, about 24,000 Americans die each flu season, according to the CDC.

This flu season started in early December, a month earlier than usual, and peaked by the end of year. Hospitalization rates for people 65 and older have been some of the highest in a decade, at 146 per 100,000 people.

Flu viruses tend to mutate more quickly than others, so a new vaccine is formulated each year to target the strains expected to be the major threats. CDC officials have said that in formulating this year's vaccine, scientists accurately anticipated the strains that are circulating this season.

Because of the guesswork involved, scientists tend to set a lower bar for flu vaccine. While childhood vaccines against diseases like measles are expected to be 90 or 95 percent effective, a flu vaccine that's 60 to 70 percent effective in the U.S. is considered pretty good. By that standard, this year's vaccine is OK.

For senior citizens, a flu vaccine is considered pretty good if it's in the 30 to 40 percent range, said Dr. Arnold Monto, a University of Michigan flu expert.

A high-dose version of the flu shot was recently made available for those 65 and older, but the new study was too small to show whether that has made a difference.

The CDC estimates are based on about 2,700 people who got sick in December and January. The researchers traced back to see who had gotten shots and who hadn't. An earlier, smaller study put the vaccine's overall effectiveness at 62 percent, but other factors that might have influenced that figure weren't taken into account.

The CDC's Bresee said there is a danger in providing preliminary results because it may result in people doubting — or skipping — flu shots. But the figures were released to warn older people who got shots that they may still get sick and shouldn't ignore any serious flu-like symptoms, he said.

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Online:

CDC report: http://www.cdc.gov/mmwr

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Oscar Pistorius Sobs as Bail Ruling Is Expected

The fourth and likely final day of the bail hearing for Oscar Pistorius, the Olympian accused of murdering his girlfriend Feb. 14, opened with arguments from the prosecution that the runner's version of events is improbable and the defense countering that Pistorius had no intent to kill the woman.

Pistorius, who gained global acclaim for racing at the 2012 London Olympics, shot his model-girlfriend through a closed bathroom. He says he killed Reeva Steenkamp accidentally, but prosecutors allege that he took a moment to put on his prosthetic legs, indicating that he thought out and planned to kill Steenkamp when he shot her three times through the bathroom door.

Pistorius sobbed today in court. Barry Roux, his defense attorney, said the prosecution has misinterpreted the assigning of intent, meaning that the runner's intent to shoot at a supposed intruder in his home cannot be transferred to someone else who was shot -- in this case, Steenkamp.

"He did not want to kill Reeva," Roux told the court.

PHOTOS: Paralympics Champion Charged in Killing

When Magistrate Desmond Nair, who has been overhearing the bail hearing, asked Roux what the charges should be if Pistorius intended to kill an intruder, the defense attorney responded that he should be charged with culpable homicide.

Culpable homicide is defined in South Africa as "the unlawful negligent killing of a human being."

Oscar Pistorius: Detective Facing Attempted Murder Charges Watch Video

Oscar Pistorius: Investigator Faces Attempted Murder Charges Watch Video

Oscar Pistorius's Bail Hearing: Prosecutors Argue Premeditated Murder Watch Video

Roux also made light of the prosecution's argument that Pistorius is a flight risk, saying that every time the double-amputee goes through airport security, it causes a commotion. He said that Pistorius' legs need constant maintenance and he needs medical attention for his stumps.

The prosecution argued today that the onus is on Pistorius to provide his version of events, and his version is improbable.

Prosecutor Gerrie Nel also spoke of Pistorius' fame and his disability, even relating him to Wikipedia founder Julian Assange, who is now confined to Ecuador's London Embassy, where he has been granted political asylum.
"[Assange's] facial features are as well known as Mr. Pistorius' prostheses," Nel said.

Nel argued that Pistorius' prostheses do not set him apart, stating that it's no different to any other feature, and the court cannot be seen to treat people with disabilities accused of a crime, or famous people accused of crime, any differently.

Pistorius has said that in the early hours of Feb. 14 he was closing his balcony doors when he heard a noise from the bathroom. Fearing an intruder, and without his prosthetic legs on, he grabbed a gun from under his bed and fired through the closed bathroom door, he told the court.

But prosecutors say that's implausible, that the gun's holster was found under the side of the bed where Steenkamp slept, and that Pistorius would have seen she wasn't there. Prosecutors also say the angle at which the shots were fired shows Pistorius was already wearing his prosthetics when he fired.

Meanwhile, Lt. General Vinesh Moonoo was named Thursday the new chief investigator to the murder case after the surprise revelation that the former head detective and the prosecution's key witness, Hilton Botha, was charged with seven counts of attempted murder in connection to a 2011 shooting. The charges against Botha amount to an significant oversight by the state, which could sway the court's opinion.

Prosecutors maintain that Pistorius was out to kill on the night of Valentine's Day, prompting him to fire four shots into the locked bathroom door that Steenkamp was behind.

Friends of the couple say they were happy, and there is no reason why Pistorius would intentionally hurt Steenkamp.

"If Oscar was to ask her to get married, she would have said yes," friend Kevin Lerena said. "That's how happy and joyful their relationship was."

Ampie Louw, Pistorius' trainer, spoke with reporters outside the courthouse today, saying that he hopes Pistorius gets bail and can start training again, but that he won't push it.

"I'm not the legal side of it. But I'm ready," he said. "We can start training Monday if he's out."

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Genting Singapore's Q4 net profit drops 38%

SINGAPORE: Casino operator Genting Singapore's fourth quarter net profit fell 38 per cent to S$162.2 million, due mainly to one-time property write-offs.

Its adjusted earnings before interest, tax, depreciation and amortization slipped 6 per cent to S$369.3 million.

The group reported a revenue of S$792 million in the October to December period, up from S$786 million from a year ago.

Gaming revenue from Resorts World Sentosa fell 3 per cent to S$627 million.

The casino operator is fighting a slowing market and tighter local regulations.

In a filing with the Singapore Exchange, Genting Singapore warned that margins will be under pressure for the first half of this year.

But the group said the global economic outlook appears more positive this year and it remains cautiously optimistic of its performance.

- CNA/al

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Trade unions warn of bigger agitation

NEW DELHI: Major trade unions on Thursday warned the central government of bigger agitation in the country, describing the two-day national strike as "the beginning of the chapter".

"The two-day countrywide agitation has been successful but we will launch a bigger agitation and this is only a beginning of the chapter," All India Trade Union Congress (AITUC) general secretary Gurudas Dasgupta told reporters here.

"More and more factories and people joined the strike on the last day (Thursday). Those factories which were opened yesterday (Wednesday) joined the agitation today (Thursday)," he told reporters here.

He was accompanied by other leaders of several trade unions which included likes of Indian Trade Union Congress (INTUC), Hind Mazdoor Sabha (HMS), Centre of Indian Trade Unions (CITU).

Dasgupta also said that international trade unions of Greece, Cyprus, Italy, Japan and other countries expressed their solidarity with the strike.

"It is not us but the government which is responsible for the strike, which has reportedly caused a loss of Rs.26,000 crore. Had they paid heed to our demands, it would not have happened," Dasgupta said when asked about the strike's ramifications on the economy of the country.

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Adults get 11 percent of calories from fast food

ATLANTA (AP) — On an average day, U.S. adults get roughly 11 percent of their calories from fast food, a government study shows.

That's down slightly from the 13 percent reported the last time the government tried to pin down how much of the American diet is coming from fast food. Eating fast food too frequently has been seen as a driver of America's obesity problem.

For the research, about 11,000 adults were asked extensive questions about what they ate and drank over the previous 24 hours to come up with the results.

Among the findings:

— Young adults eat more fast food than their elders; 15 percent of calories for ages 20 to 39 and dropping to 6 percent for those 60 and older.

— Blacks get more of their calories from fast-food, 15 percent compared to 11 percent for whites and Hispanics.

— Young black adults got a whopping 21 percent from the likes of Wendy's, Taco Bell and KFC.

The figures are averages. Included in the calculations are some people who almost never eat fast food, as well as others who eat a lot of it.

The survey covers the years 2007 through 2010 and was released Thursday by the Centers for Disease Control and Prevention. The authors couldn't explain why the proportion of calories from fast food dropped from the 13 percent found in a survey for 2003 through 2006.

One nutrition professor cast doubts on the latest results, saying 11 percent seemed implausibly low. New York University's Marion Nestle said it wouldn't be surprising if some people under-reported their hamburgers, fries and milkshakes since eating too much fast food is increasingly seen as something of a no-no.

"If I were a fast-food company, I'd say 'See, we have nothing to do with obesity! Americans are getting 90 percent of their calories somewhere else!'" she said.

The study didn't include the total number of fast-food calories, just the percentage. Previous government research suggests that the average U.S. adult each day consumes about 270 calories of fast food — the equivalent of a small McDonald's hamburger and a few fries.

The new CDC study found that obese people get about 13 percent of daily calories from fast food, compared with less than 10 percent for skinny and normal-weight people.

There was no difference seen by household income, except for young adults. The poorest — those with an annual household income of less than $30,000 — got 17 percent of their calories from fast food, while the figure was under 14 percent for the most affluent 20- and 30-somethings with a household income of more than $50,000.

That's not surprising since there are disproportionately higher numbers of fast-food restaurants in low-income neighborhoods, Nestle said.

Fast food is accessible and "it's cheap," she said.

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Lead Pistorius Cop Facing Attempted Murder Charge

Hilton Botha, the detective at the center of the Oscar Pistorius murder case, is facing his own attempted murder charges in connection with a 2011 shooting in which he and other police officers allegedly fired a gun at passengers in a vehicle.

Botha is scheduled to appear in court in May on seven counts of attempted murder in connection to the October 2011 incident in which he and two other officers allegedly fired shots at a minibus they were attempting to stop. It's unclear whether any of the passengers were injured.

Botha has been outlining details this week at the Olympic runner's bail hearing of his investigation into the Feb. 14 shooting death of Reeva Steenkamp at Pistorius' home in Pretoria, South Africa. Botha was one of the first officers to arrive at the scene, where Steenkamp, a 29-year-old model, was found fatally shot three times.

PHOTOS: Paralympic Champion Charged in Killing

Pistorius, a double-amputee who walks on carbon fiber blades, says he killed his girlfriend accidentally.

Prosecutors say they were unaware of the charges against the detective when he took the stand this week, according to The Associated Press.

Oscar Pistorius: Investigator Faces Attempted Murder Charges Watch Video

Oscar Pistorius's Bail Hearing: Prosecutors Argue Premeditated Murder Watch Video

Oscar Pistorius Bail Hearing: New Evidence Revealed Watch Video

"The prosecutors were not aware of those charges [against Botha]," Medupe Simasiku of the National Prosecution Agency said. "We are calling up the information so we can get the details of the case. From there, we can take action and see if we remove him from the investigation or if he stays."

FULL COVERAGE: Oscar Pistorius Case

Botha muddled testimony and eventually admitted Wednesday at Pistorius' bail hearing that the suspect's account of the Valentine's Day shooting did not contradict the police's version of events.

A spokesman for the NPA admitted today that charges pending against Botha were not helpful for the credibility of the prosecution's case, but that the case would hinge on forensic evidence, not the testimony of a police officer.

Pistorius has argued in court that he was closing his balcony doors when he heard a noise from the bathroom. Fearing an intruder, and without his prosthetic legs on, he grabbed a gun from under his bed and fired through the closed bathroom door, he told the court.

But prosecutors say that's implausible, that the gun's holster was found under the side of the bed where Steenkamp slept, and that Pistorius would have seen she wasn't there. Prosecutors also say the angle at which the shots were fired shows Pistorius was already wearing his prosthetics when he fired.

Defense attorneys representing Pistorius tore into investigators Wednesday, accusing them of sloppy police work and saying the substance that police identified as testosterone, which they found in his bathroom, was an herbal supplement.

In a statement overnight, Pistorius' family said the new testimony brought "more clarity" to the hearing.

Meanwhile, Steenkamp's cousin told CNN that she wants to believe Pistorius' story.

"That is what in my heart, I hope and wish is the truth, because I would not like to think my cousin suffered," Kim Martin, Steenkamp's cousin, told CNN's Piers Morgan. "I would not like to think that she was scared."

Steenkamp's brother Adam Steenkamp said the family is trying to focus on better days.

"We're remembering the positive," he said. "We're remembering the good."

Pistorius today was dropped by two of his sponsors, Nike and Thierry Mugler.

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Bulgarian government resigns amid growing protests

SOFIA (Reuters) - Bulgaria's government resigned on Wednesday after violent nationwide protests against high power prices, joining a long list of European administrations felled by austerity during Europe's debt crisis.

Prime Minister Boiko Borisov, a former bodyguard who swept to power in 2009 on pledges to root out corruption and raise living standards in the European Union's poorest member, now faces a tough task to prop up eroding support ahead of a probable early election.

Wage and pension freezes and tax hikes have bitten deep in a country where living standards are less than half the EU average and tens of thousands of Bulgarians have rallied in protests that have turned violent, chanting "Mafia" and "Resign".

On Tuesday, 11 people were hospitalized - including one man bleeding heavily from the head - and 11 arrested after protesters threw flares at police, who fought demonstrators with shields and truncheons.

"I will not participate in a government under which police are beating people," Borisov, who began his career guarding the Black Sea state's communist dictator Todor Zhivkov, said as he announced his resignation on Wednesday.

Parliament is expected to accept the resignation later in the day.

The spark for the protests was high electricity bills, after the government raised prices by 13 percent last July. But it quickly spilled over into wider frustration with Borisov's domineering manner and unpredictable decision making.

The prime minister made sacrifices in an attempt to cling on, sacking his finance minister, cutting power prices and risking a diplomatic row with the Czech Republic by punishing foreign-owned companies, a move that conflicted with EU norms on protection of investors and due process.

Borisov's rightist GERB party is the dominant faction in parliament but will not take part in talks to form a new government, Interior Minister Tsvetan Tsvetanov said, indicating that an election planned for July will now be held early.

"He made my day," student Borislav Hadzhiev, 21, in central Sofia said, commenting on Borisov's resignation. "The truth is that we're living in an extremely poor country."

IRE

GERB's popularity has held up well and it still leads, just, in the polls, largely because budget cutbacks have been relatively mild compared with those in many other European countries. Salaries and pensions were frozen rather than cut.

But the last opinion poll, taken before protests grew last weekend already showed the opposition Socialists were nearly tied with the ruling party and analysts said the protests had boosted the Socialists' chances.

Unemployment in the country of 7.3 million is far from the highs hit in the decade after the end of communism but remains at 11.9 percent and average salaries are stuck at around 800 levs ($550) a month.

Millions have emigrated in search of a better life, leaving swathes of the country depopulated and little hope for those who remain.

The measures announced this week has also put the country on a collision course with the EU and financial investors without easing the tension at home.

Czech Prime Minister Petr Necas demanded an explanation from Bulgaria and accused it of "politicizing" the power sector by threatening to revoke the electricity distribution license of central Europe's largest listed company CEZ, 70 percent of which is owned by the Czech state.

There have also been fines for another Czech company, Energo-Pro and Austria's EVN.

The precedent is unlikely to encourage other foreign investors, who already have to navigate complicated bureaucracy and widespread corruption and organized crime if they want to take advantage of Bulgaria's 16-percent flat tax rate.

"The resignation is the only responsible move," said Kantcho Stoychev, an analyst with pollster Gallup International. "It also gives Borisov some legitimacy to stay in political life in the future, despite the violent police actions last night."

(Additional reporting by Angel Krasimirov; editing by Patrick Graham)

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China octogenarian on trial for four decade-old murder

BEIJING: A man in his eighties has gone on trial in a Chinese court for a murder he allegedly committed during the tumultuous Cultural Revolution over four decades ago, state media reported Wednesday.

A court in the eastern province of Zhejiang this week tried the man for the 1967 murder of a doctor suspected of being a spy, the state-run China News Service reported.

It said the defendant surnamed Qiu is accused of strangling his victim, surnamed Hong, with a rope before cutting off his legs and burying him.

Qiu was a member of a member of "an armed group" during the decade of upheaval known as the Cultural Revolution, the report said, adding that he was arrested last July.

The Cultural Revolution was launched in 1966 by then-leader Mao Zedong, who called on ordinary citizens to struggle against the privileged, resulting in attacks on government officials, intellectuals and other groups.

The period, which still stirs emotions in China, saw young people form "Red Guard" units which engaged in mass violence, destroyed cultural relics and sometimes obtained weapons.

China has never publicly estimated how many died during the period, which saw citizens turn on their neighbours. Half a million died in 1967 alone, according to British historian Roderick MacFarquhar.

The verdict in the trial is yet to be announced.

-AFP/fl

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Chopper scam: CBI engages two law firms in Italy

NEW DELHI: CBI has engaged two law firms in Italy for liaisoning with the authorities to get legal assistance in probing the role of Indians in connection with the alleged kickbacks in the Rs 3,600 crore VVIP helicopter deal.

Official sources said on Wednesday that Chiomenti law firm and Grippo law firm have been asked to help in coordinating with the Italian authorities for getting documents and other relevant material pertaining to the AgustaWestland deal for supplying 12 helicopters to India.

The two firms will represent India's case with the Italian government and the local courts for getting evidence regarding alleged kickbacks in the deal. Kickbacks to the tune of Rs 362 crore were allegedly paid to swing the deal in favour of AgustaWestland.

The sources said the joint team of the CBI and defence ministry in Italy was told that the probe in that country was also in its initial stage and that arrests made in that country so far were more of a preventive nature so that the evidence was not tampered with.

Italian authorities have arrested Giuseppe Orsi, the chairman of Italian Finmeccanica, and Bruno Spagnolini, chief executive officer of AgustaWestland.

The team, which comprises a legal officer from the CBI as well, is likely to soon meet the judge hearing the matter in connection with the alleged kickbacks.

The joint team comprising a CBI DIG, a law officer of the agency, a joint secretary level officer of the ministry and an official of the external affairs ministry has been camping in Milan to gather as much inputs as possible.

The two law firms have been appointed keeping in mind their work in international cases. Chiomenti law firm was established in 1948 and has 270 attorneys in six countries including in London. Grippo law firm with 360 attorneys has a presence in five countries including the UK.

The CBI's decision to send a team to Italy came after it virtually drew a blank from the defence ministry in getting some official inputs regarding alleged kickbacks.

The CBI was handed over a letter from the defence ministry seeking a probe by it in the case which has triggered a storm in the country. Attached with the letter were some Indian and Italian press clippings, which, the CBI said, could not form the basis for registering a case.

This was followed by CBI seeking help of Interpol which also expressed inability to provide any help in the absence of any regular case not having been registered by the agency, they said.

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Drug overdose deaths up for 11th consecutive year

CHICAGO (AP) — Drug overdose deaths rose for the 11th straight year, federal data show, and most of them were accidents involving addictive painkillers despite growing attention to risks from these medicines.

"The big picture is that this is a big problem that has gotten much worse quickly," said Dr. Thomas Frieden, head of the Centers for Disease Control and Prevention, which gathered and analyzed the data.

In 2010, the CDC reported, there were 38,329 drug overdose deaths nationwide. Medicines, mostly prescription drugs, were involved in nearly 60 percent of overdose deaths that year, overshadowing deaths from illicit narcotics.

The report appears in Tuesday's Journal of the American Medical Association.

It details which drugs were at play in most of the fatalities. As in previous recent years, opioid drugs — which include OxyContin and Vicodin — were the biggest problem, contributing to 3 out of 4 medication overdose deaths.

Frieden said many doctors and patients don't realize how addictive these drugs can be, and that they're too often prescribed for pain that can be managed with less risky drugs.

They're useful for cancer, "but if you've got terrible back pain or terrible migraines," using these addictive drugs can be dangerous, he said.

Medication-related deaths accounted for 22,134 of the drug overdose deaths in 2010.

Anti-anxiety drugs including Valium were among common causes of medication-related deaths, involved in almost 30 percent of them. Among the medication-related deaths, 17 percent were suicides.

The report's data came from death certificates, which aren't always clear on whether a death was a suicide or a tragic attempt at getting high. But it does seem like most serious painkiller overdoses were accidental, said Dr. Rich Zane, chair of emergency medicine at the University of Colorado School of Medicine.

The study's findings are no surprise, he added. "The results are consistent with what we experience" in ERs, he said, adding that the statistics no doubt have gotten worse since 2010.

Some experts believe these deaths will level off. "Right now, there's a general belief that because these are pharmaceutical drugs, they're safer than street drugs like heroin," said Don Des Jarlais, director of the chemical dependency institute at New York City's Beth Israel Medical Center.

"But at some point, people using these drugs are going to become more aware of the dangers," he said.

Frieden said the data show a need for more prescription drug monitoring programs at the state level, and more laws shutting down "pill mills" — doctor offices and pharmacies that over-prescribe addictive medicines.

Last month, a federal panel of drug safety specialists recommended that Vicodin and dozens of other medicines be subjected to the same restrictions as other narcotic drugs like oxycodone and morphine. Meanwhile, more and more hospitals have been establishing tougher restrictions on painkiller prescriptions and refills.

One example: The University of Colorado Hospital in Aurora is considering a rule that would ban emergency doctors from prescribing more medicine for patients who say they lost their pain meds, Zane said.

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Stobbe reported from Atlanta.

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Online:

JAMA: http://www.jama.ama-assn.org

CDC: http://www.cdc.gov

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AP Medical Writer Lindsey Tanner can be reached at http://www.twitter.com

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