CDC: Flu Outbreak Could Be Waning

The flu season appears to be waning in some parts of the country, but that doesn't mean it won't make a comeback in the next few weeks, according to the Centers for Disease Control and Prevention.

Five fewer states reported high flu activity levels in the first week of January than the 29 that reported high activity levels in the last week of December, according to the CDC's weekly flu report. This week, 24 states reported high illness levels, 16 reported moderate levels, five reported low levels and one reported minimal levels, suggesting that the flu season peaked in the last week of December.

"It may be decreasing in some areas, but that's hard to predict," CDC Director Dr. Thomas Frieden said in a Friday morning teleconference. "Trends only in the next week or two will show whether we have in fact crossed the peak."

The flu season usually peaks in February or March, not December, said Dr. Jon Abramson, who specializes in pediatric infectious diseases at Wake Forest Baptist Health in North Carolina. He said the season started early with a dominant H3N2 strain, which was last seen a decade ago, in 2002-03. That year, the flu season also ended early.

Click here to see how this flu season stacks up against other years.

Cheryl Evans/The Arizona Republic/AP Photo

Increasing Flu Cases: Best Measures to Ensure Your Family's Health Watch Video

Because of the holiday season, Frieden said the data may have been skewed.

For instance, Connecticut appeared to be having a lighter flu season than other northeastern states at the end of December, but the state said it could have been a result of college winter break. College student health centers account for a large percentage of flu reports in Connecticut, but they've been closed since the fall semester ended, said William Gerrish, a spokesman for the state's department of public health.

The flu season arrived about a month early this year in parts of the South and the East, but it may only just be starting to take hold of states in the West, Frieden said. California is still showing "minimal" flu on the CDC's map, but that doesn't mean it will stay that way.

Click here to read about how flu has little to do with cold weather.

"It's not surprising. Influenza ebbs and flows during the flu season," Frieden said. "The only thing predictable about the flu is that it is unpredictable."

Dr. William Schaffner, chair of preventive medicine at Vanderbilt University Medical Center in Nashville, Tenn., said he was expecting California's seeming good luck with the flu to be over this week.

"Flu is fickle, we say," Schaffner said. "Influenza can be spotty. It can be more severe in one community than another for reasons incompletely understood."

Early CDC estimates indicate that this year's flu vaccine is 62 percent effective, meaning people who have been vaccinated are 62 percent less likely to need to see a doctor for flu treatment, Frieden said.

Although the shot has been generally believed to be more effective for children than adults, there's not enough data this year to draw conclusions yet.

"The flu vaccine is far from perfect, but it's still by far the best tool we have to prevent flu," Frieden said, adding that most of the 130 million vaccine doses have already been administered. "We're hearing of shortages of the vaccine, so if you haven't been vaccinated and want to be, it's better late than never."

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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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Python clings to Qantas wing on two-hour flight

SYDNEY: It was not quite a "Snakes on a Plane" scenario, but passengers on a Qantas jet watched in amazement as a three-metre (nine feet) python clung to the outside of their aircraft during a flight.

The Australian carrier said the flight from the Queensland city of Cairns to Port Moresby, capital of the Pacific island nation of Papua New Guinea, took off early Thursday morning with the unintended passenger tucked into its wing.

"The snake was seen by passengers once (the plane) reached cruising altitude," a Qantas spokesman told AFP.

"It was still on the aircraft when it arrived in Port Moresby but it had died by that stage."

Once they spotted it on the wing, passengers watched as the reptile engaged in a life-and-death struggle to maintain its grip on the plane despite the winds and chilly altitude temperatures for the two-hour journey.

Passenger Robert Weber told Fairfax Media Friday that while people at the front of the plane were unaware of the python, those at the back were "all totally focused on the snake and how it might have got onto the aircraft".

Unlike the 2006 "Snakes on a Plane" movie starring Samuel L. Jackson, this reptile did not affect the flight.

"There was no panic. At no time did anyone stop to consider that there might be others on board," Weber said.

He added that the snake had been nestled neatly at first, but once the wind caught the end of its tail, it was "pulling him straight out" and from then on it became a hopeless "life-and-death struggle".

"I felt quite sad for it, really," he said.

An expert said the snake was probably a scrub python, Australia's longest snake and one common in northern Queensland.

Qantas said it had never heard of anything similar happening before, adding that there was no way the reptile could have accessed the cabin.

- AFP/ck

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BJP's Hindutva forces back in limelight

LUCKNOW: It was in late 1990, after the then chief minister Mulayam Singh Yadav ordered firing on unarmed Kar Sevaks leaving several dead and subsequently leading to Hindu outrage across the state that Kalyan Singh came up as a prominent discovery on Hindutva front. It was Bharatiya Janata Party's pan-Hindu outreach initiative which led Singh, belonging to the backward caste of Lodhs, ride the crest of Hindutva wave.

After being in and out of the party twice in the past, Kalyan already planning to make a third time entry in BJP, might put the party's shunned ideology at centre stage.

After remaining as chief minister in the BJP government twice -- 1991-1992 and 1997-1999, Kalyan left the party for the first time in December 1999 and returned again in January, 2004 before the Lok Sabha elections. He contested the 2004 Lok Sabha elections on the BJP ticket from Bulandshahar. Again before the Lok Sabha election of 2009, he left BJP and contested election from Etah Lok Sabha seat as an independent and subsequently won it.

Cut to 2012:

BJP's poor performance and Kalyan Singh' failure to present his own creation -- Jan Kranti Party, as a force to reckon with in 2012 Assembly election brought both of them closer, while Samajwadi Party-led by Mulayam's son Akhilesh Yadav won the election with majority.

Though third rejoining likely in over a decade, Kalyan's re-entry in BJP, now expected anytime, political pundits feel could be an attempt to repeat 1991 and 1998 history partially if not in totality. But, what can be for sure said is that the saffron outfit is on way to make yet another bid to revive hindutva, feel political experts.

The effort gains prominence with subsequent developments which have taken place in the state BJP in the past a few months.

The indicators:

Giving credence to the strategy is the debut made by firebrand sanyasin Uma Bharti in UP politics winning Charkhari assembly seat, rare presence of torch-bearers of hindutva Gorakhpur MP Yogi Adityanath and Pilibhit MP Varun Gandhi at party's state council meeting and unanimous election of Laxmikant Bajpayi, a known hardliner, as state BJP chief.

Former chief minister of Madhya Pradesh Uma Bharti, who is known for her firebrand image, rejoined BJP after a hiatus of a few years, has made a comeback in mainstream politics, for the first time from Uttar Pradesh's Charkhari. She won the seat in UP assembly election this year.

Besides, torch-bearers of hindutva including Pilibhit MP Varun Gandhi and Gorakhpur MP Yogi Adityanath were among a few, who have also hogged the limelight at the party's state council meeting held at erstwhile Capitol picture hall on December 2.

While the Rashtriya Swayemsewak Sangh (RSS)-backed Gorakhpur MP Yogi Adityanath is said to have made one of his first visit at the BJP's state council meeting. Yogi while talking to TOI had admitted that it was his first visit to the state BJP office. About his presence, the firebrand MP and torch-bearer of Hindutva said that even after his busy schedule in Gorakhpur, he had come to express support to newly-elected state BJP chief Laxmikant Bajpayi.

Both Yogi and Gandhi had remained out of sight for different reasons during UP Assembly elections in March 2012 clearly indicating differences among senior party leaders.

Last but not the least, the unanimous election of Laxmikant Bajpayi, known for his hardliner image, for full three-year term as state BJP chief.

With past political experiences proving that any communal simmering in the state has benefitted both 'Mullah' Mulayam's (called by Sadhvi Ritambhara after 1990 firing on kar sevaks) Samajwadi Party and Bharatiya Janata Party on politics of polarisation, around a dozen communal tensions have taken place in the state since Samajwadi Party came to power in March this year.

This has given opportunity to BJP to take on Samajwadi Party government in the state. While on the one hand, BJP leaders are now lambasting Akhilesh-led SP government for adopting Muslim appeasement policy, on the other hand they have questioned the state government's inability to contain communal tensions especially in Faizabad, Bareilly, Mathura, Ghaziabad etc.

The BJP has now decided to hold a Hahakar Rally on December 15 at Meerut on law and order issue and even presented reports of their fact-finding team on clashes in Mathura, Banda, and Sultanpur on Wednesday itself. The BJP state chief Laxmikant Bajpayi also demanded to the chief minister to set up a probe into a dozen communal clashes that have taken place in the last over five months by special investigation agency.A planned revival of Hindutva, it seems!

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Flu season strikes early and, in some places, hard

NEW YORK (AP) — From the Rocky Mountains to New England, hospitals are swamped with people with flu symptoms. Some medical centers are turning away visitors or making them wear face masks, and one Pennsylvania hospital set up a tent outside its ER to deal with the feverish patients.

Flu season in the U.S. has struck early and, in many places, hard.

While flu normally doesn't blanket the country until late January or February, it is already widespread in more than 40 states, with about 30 of them reporting some major hot spots. On Thursday, health officials blamed the flu for the deaths of 20 children so far.

Whether this will be considered a bad season by the time it has run its course in the spring remains to be seen.

"Those of us with gray hair have seen worse," said Dr. William Schaffner, a flu expert at Vanderbilt University in Nashville.

The evidence so far points to a moderate season, Schaffner and others say. It looks bad in part because last year was unusually mild and because the main strain of influenza circulating this year tends to make people sicker and really lay them low.

David Smythe of New York City saw it happen to his 50-year-old girlfriend, who has been knocked out for about two weeks. "She's been in bed. She can't even get up," he said.

Also, the flu's early arrival coincided with spikes in a variety of other viruses, including a childhood malady that mimics flu and a new norovirus that causes vomiting and diarrhea, or what is commonly known as "stomach flu." So what people are calling the flu may, in fact, be something else.

"There may be more of an overlap than we normally see," said Dr. Joseph Bresee, who tracks the flu for the Centers for Disease Control and Prevention.

Most people don't undergo lab tests to confirm flu, and the symptoms are so similar that it can be hard to distinguish flu from other viruses, or even a cold. Over the holidays, 250 people were sickened at a Mormon missionary training center in Utah, but the culprit turned out to be a norovirus, not the flu.

Flu is a major contributor, though, to what's going on.

"I'd say 75 percent," said Dr. Dan Surdam, head of the emergency department at Cheyenne Regional Medical Center, Wyoming's largest hospital. The 17-bed emergency room saw its busiest day ever last week, with 166 visitors.

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

One hospital in Allentown, Pa., set up a tent this week for a steady stream of patients with flu symptoms. But so far "what we're seeing is a typical flu season," said Terry Burger, director of infection control and prevention for the hospital, Lehigh Valley Hospital-Cedar Crest.

On Wednesday, Boston declared a public health emergency, with the city's hospitals counting about 1,500 emergency room visits since December by people with flu-like symptoms.

All the flu activity has led some to question whether this year's flu shot is working. While health officials are still analyzing the vaccine, early indications are that it's about 60 percent effective, which is in line with what's been seen in other years.

The vaccine is reformulated each year, based on experts' best guess of which strains of the virus will predominate. This year's vaccine is well-matched to what's going around. The government estimates that between a third and half of Americans have gotten the vaccine.

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

But her daughter got the vaccine. "And she got sick twice," Quinones said.

Europe is also suffering an early flu season, though a milder strain predominates there. Flu reports are up, too, in China, Japan, the West Bank, the Gaza Strip, Algeria and the Republic of Congo. Britain has seen a surge in cases of norovirus.

On average, about 24,000 Americans die each flu season, according to the CDC. That's an estimate — the agency does not keep a running tally of adult flu deaths each year, only for children. Some state health departments do keep count, and they've reported dozens of flu deaths so far.

Flu usually peaks in midwinter. Symptoms can include fever, cough, runny nose, head and body aches and fatigue. Some people also suffer vomiting and diarrhea, and some develop pneumonia or other severe complications.

Most people with flu have a mild illness and can help themselves and protect others by staying home and resting. But people with severe symptoms should see a doctor. They may be given antiviral drugs or other medications to ease symptoms.

Flu vaccinations are recommended for everyone 6 months or older. Of the 20 children killed by the flu this season, only two were fully vaccinated.

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

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Online:

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

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Judge: Holmes Can Face Trial for Aurora Shooting

Jan 10, 2013 8:45pm

(Arapahoe County Sheriff/AP Photo)

In a ruling that comes as little surprise, the judge overseeing the Aurora, Colo., theater massacre has ordered that there is enough evidence against James Holmes to proceed to a trial.

In an order posted late Thursday, Judge William Sylvester 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 for 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.

PHOTOS: Colorado ‘Dark Knight Rises’ Theater Shooting

Holmes is charged with 166 counts, including murder, attempted murder and other charges related to the July 20 shooting that left 12 people dead and 58 wounded by gunfire. An additional 12 people suffered non-gunshot injuries.

One of the next legal steps is an arraignment, at which Holmes will enter a plea. The arraignment was originally expected to take place Friday morning.

Judge Sylvester indicated through a court spokesman that he would allow television and still cameras into the courtroom, providing the outside world the first images of Holmes since a July 23 hearing. Plans for cameras in court, however, were put on hold Thursday afternoon.

“The defense has notified the district attorney that it is not prepared to proceed to arraignment in this case by Friday,” wrote public defenders Daniel King, Tamara Brady and Kristen Nelson Thursday afternoon in a document objecting to cameras in court.

A hearing in the case will still take place Friday morning. In his order, Judge Sylvester said it should technically be considered an arraignment, but noted the defense has requested a continuance.  Legal experts expect the judge will grant the continuance, delaying the arraignment and keeping cameras out of court for now.

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.

SHOWS: World News

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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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NEL service delayed due to power fault

SINGAPORE: Train services in both directions on the North East Line (NEL) are delayed due to a power fault.

Train operator SBS Transit alerted commuters at 10:18am on Twitter of a delay of 15 minutes.

It said free bus rides are available at designated bus stops.

SBS Transit first alerted commuters via SMS at about 10am, saying there had been a delay of 15 minutes due to a power fault.

It said at about 10:30am that shuttle services were activated at designated bus stops to provide free bus rides.

- CNA/ck

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TOI Social Impact Awards: Wheeling healthcare to remote corners

Mental health and trauma — two of India's top killers — have seldom received the attention they deserve from the government. But the awards jury turned the spotlight squarely on these problems. This year, it awarded organizations that provide emergency care or work for the welfare of persons with mental disabilities.

In the corporate category, Ziqitza Health Care, which operates over 860 ambulances in Rajasthan, Punjab, Bihar , Kerala and Mumbai, and says it has transported more than 1.8 million people, has won the award.

Ziqitza was set up to help establish an ambulance service that's accessible and affordable to all sections of society in medical emergencies, irrespective of the affected person's capacity to pay for it. It conceived a cross-subsidy , fee-based service using differential pricing where wealthier customers would pay the full rate for the ambulance service while the poor get hefty discounts and free service.

In the government category, the jury unanimously approved the National Trust for the Welfare of Persons with Autism Cerebral Palsy Mental Retardation and Multiple Disabilities. The organization provides health insurance for people with intellectual and developmental disabilities . Under the ministry of social justice & empowerment, this centre was started in 2007 when no health insurance products were available for people with intellectual and developmental disabilities.

The scheme does not discriminate on severity of any pre-insurance condition and is for all ages. It provides for a bouquet of services, including therapy, surgery and even alternative medicine up to Rs 1 lakh per annum at a nominal premium of Rs 250 per annum for those earning just Rs 15,000 per month and a premium of Rs 500 per annum for those earning more. Over 800 NGOs across India are involved in rolling out the scheme.

In the NGO category, the Karuna Trust that provides free primary healthcare in remote, tribal and insurgency-prone regions in partnership with the government left behind all other claimants. The trust was started by Dr H Sudarshan in BR Hills, Karnataka for the integrated development of tribal people. Karuna Trust has worked to "reach the unreached" and provide free primary healthcare for the past 26 years.

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Retooling Pap test to spot more kinds of cancer

WASHINGTON (AP) — For years, doctors have lamented that there's no Pap test for deadly ovarian cancer. Wednesday, scientists reported encouraging signs that one day, there might be.

Researchers are trying to retool the Pap, a test for cervical cancer that millions of women get, so that it could spot early signs of other gynecologic cancers, too.

How? It turns out that cells can flake off of tumors in the ovaries or the lining of the uterus, and float down to rest in the cervix, where Pap tests are performed. These cells are too rare to recognize under the microscope. But researchers from Johns Hopkins University used some sophisticated DNA testing on the Pap samples to uncover the evidence — gene mutations that show cancer is present.

In a pilot study, they analyzed Pap smears from 46 women who already were diagnosed with either ovarian or endometrial cancer. The new technique found all the endometrial cancers and 41 percent of the ovarian tumors, the team reported Wednesday in the journal Science Translational Medicine.

This is very early-stage research, and women shouldn't expect any change in their routine Paps. It will take years of additional testing to prove if the so-called PapGene technique really could work as a screening tool, used to spot cancer in women who thought they were healthy.

"Now the hard work begins," said Hopkins oncologist Dr. Luis Diaz, whose team is collecting hundreds of additional Pap samples for more study and is exploring ways to enhance the detection of ovarian cancer.

But if it ultimately pans out, "the neat part about this is, the patient won't feel anything different," and the Pap wouldn't be performed differently, Diaz added. The extra work would come in a lab.

The gene-based technique marks a new approach toward cancer screening, and specialists are watching closely.

"This is very encouraging, and it shows great potential," said American Cancer Society genetics expert Michael Melner.

"We are a long way from being able to see any impact on our patients," cautioned Dr. Shannon Westin of the University of Texas MD Anderson Cancer Center. She reviewed the research in an accompanying editorial, and said the ovarian cancer detection would need improvement if the test is to work.

But she noted that ovarian cancer has poor survival rates because it's rarely caught early. "If this screening test could identify ovarian cancer at an early stage, there would be a profound impact on patient outcomes and mortality," Westin said.

More than 22,000 U.S. women are diagnosed with ovarian cancer each year, and more than 15,000 die. Symptoms such as pain and bloating seldom are obvious until the cancer is more advanced, and numerous attempts at screening tests have failed.

Endometrial cancer affects about 47,000 women a year, and kills about 8,000. There is no screening test for it either, but most women are diagnosed early because of postmenopausal bleeding.

The Hopkins research piggybacks on one of the most successful cancer screening tools, the Pap, and a newer technology used along with it. With a standard Pap, a little brush scrapes off cells from the cervix, which are stored in a vial to examine for signs of cervical cancer. Today, many women's Paps undergo an additional DNA-based test to see if they harbor the HPV virus, which can spur cervical cancer.

So the Hopkins team, funded largely by cancer advocacy groups, decided to look for DNA evidence of other gynecologic tumors. It developed a method to rapidly screen the Pap samples for those mutations using standard genetics equipment that Diaz said wouldn't add much to the cost of a Pap-plus-HPV test. He said the technique could detect both early-stage and more advanced tumors. Importantly, tests of Paps from 14 healthy women turned up no false alarms.

The endometrial cancers may have been easier to find because cells from those tumors don't have as far to travel as ovarian cancer cells, Diaz said. Researchers will study whether inserting the Pap brush deeper, testing during different times of the menstrual cycle, or other factors might improve detection of ovarian cancer.

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