Poisoned Lottery Winner's Kin Were Suspicious

Urooj Khan had just brought home his $425,000 lottery check when he unexpectedly died the following day. Now, certain members of Khan's family are speaking publicly about the mystery -- and his nephew told ABC News they knew something was not right.

"He was a healthy guy, you know?" said the nephew, Minhaj Khan. "He worked so hard. He was always going about his business and, the thing is: After he won the lottery and the next day later he passes away -- it's awkward. It raises some eyebrows."

The medical examiner initially ruled Urooj Khan, 46, an immigrant from India who owned dry-cleaning businesses in Chicago, died July 20, 2012, of natural causes. But after a family member demanded more tests, authorities in November found a lethal amount of cyanide in his blood, turning the case into a homicide investigation.

"When we found out there was cyanide in his blood after the extensive toxicology reports, we had to believe that ... somebody had to kill him," Minhaj Khan said. "It had to happen, because where can you get cyanide?"

In Photos: Biggest Lotto Jackpot Winners

Authorities could be one step closer to learning what happened to Urooj Khan. A judge Friday approved an order to exhume his body at Rosehill Cemetery in Chicago as early as Thursday to perform further tests.

Lottery Winner Murdered: Widow Questioned By Police Watch Video

Moments after the court hearing, Urooj Khan's sister, Meraj Khan, remembered her brother as the kind of person who would've shared his jackpot with anyone. Speaking at the Cook County Courthouse, she hoped the exhumation would help the investigation.

"It's very hard because I wanted my brother to rest in peace, but then we have to have justice served," she said, according to ABC News station WLS in Chicago. "So if that's what it takes for him to bring justice and peace, then that's what needs to be done."

Khan reportedly did not have a will. With the investigation moving forward, his family is waging a legal fight against his widow, Shabana Ansari, 32, over more than $1 million, including Urooj Khan's lottery winnings, as well as his business and real estate holdings.

Khan's brother filed a petition Wednesday to a judge asking Citibank to release information about Khan's assets to "ultimately ensure" that [Khan's] minor daughter from a prior marriage "receives her proper share."

Ansari may have tried to cash the jackpot check after Khan's death, according to court documents, which also showed Urooj Khan's family is questioning if the couple was ever even legally married.

Ansari, Urooj Khan's second wife, who still works at the couple's dry cleaning business, has insisted they were married legally.

She has told reporters the night before her husband died, she cooked a traditional Indian meal for him and their family, including Khan's daughter and Ansari's father. Not feeling well, Khan retired early, Ansari told the Chicago Sun-Times, falling asleep in a chair, waking up in agony, then collapsing in the middle of the night. She said she called 911.

"It has been an incredibly hard time," she told ABC News earlier this week. "We went from being the happiest the day we got the check. It was the best sleep I've had. And then the next day, everything was gone.

"I am cooperating with the investigation," Ansari told ABC News. "I want the truth to come out."

Ansari has not been named a suspect, but her attorney, Steven Kozicki, said investigators did question her for more than four hours.

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Russia rejects Assad exit as precondition for Syria deal

MOSCOW/BEIRUT (Reuters) - Russia voiced support on Saturday for international peace envoy Lakhdar Brahimi but insisted Syrian President Bashar al-Assad's exit cannot be a precondition for a deal to end the country's conflict.

Some 60,000 Syrians have been killed during the 21-month-old revolt and world powers are divided over how to stop the escalating bloodshed. Government aircraft bombed outer districts of Damascus on Saturday after being grounded for a week by stormy weather, opposition activists in the capital said.

A Russian Foreign Ministry statement following talks on Friday in Geneva with the United States and Brahimi reiterated calls for an end to violence in Syria, but there was no sign of a breakthrough.

Brahimi said the issue of Assad, who the United States, European powers and Gulf-led Arab states insist must step down to end the civil war, appeared to be a sticking point.

Russia's Foreign Ministry said: "As before, we firmly uphold the thesis that questions about Syria's future must be decided by the Syrians themselves, without interference from outside or the imposition of prepared recipes for development."

Russia has been Assad's most powerful international backer, joining with China to block three Western- and Arab-backed U.N. Security Council resolutions aimed to pressure him or push him from power. Assad can also rely on regional powerhouse Iran.

Russia called for "a political transition process" based on an agreement by foreign powers last June.

Brahimi, who is trying to build on that agreement, has met three times with senior Russian and U.S. diplomats since early December and met Assad in Damascus.

Russia and the United States disagreed over what the June agreement meant for Assad, with Washington saying it sent a clear signal he must go and Russia contending it did not.

Qatar on Saturday made a fresh call for an Arab force to end bloodshed in Syria if Brahimi's efforts fail, according to the Doha-based al Jazeera television.

"It is not a question of intervention in Syria in favor of one party against the other, but rather a force to preserve security," Qatar's Prime Minister and Foreign Minister, Sheikh Hamad bin Jassim al-Thani, said in an al Jazeera broadcast.

CONFLICT INTENSIFIES

Moscow has been reluctant to endorse the "Arab Spring" popular revolts of the last two years, saying they have increased instability in the Middle East and created a risk of radical Islamists seizing power.

Although Russia sells arms to Syria and rents one of its naval bases, the economic benefit of its support for Assad is minimal. Analysts say President Vladimir Putin wants to prevent the United States from using military force or support from the U.N. Security Council to bring down governments it opposes.

However, as rebels gain ground in the war, Russia has given indications it is preparing for Assad's possible exit, while continuing to insist he must not be forced out by foreign powers.

Opposition activists say a military escalation and the hardship of winter have accelerated the death toll.

Rebel forces have acquired more powerful anti-tank and anti-aircraft weapons during attacks on Assad's military bases.

Assad's forces have employed increasing amounts of military hardware including Scud-type ballistic missiles in the past two months. New York-based Human Rights Watch said they had also used incendiary cluster bombs that are banned by most nations.

STALEMATE IN CITIES

The weeklong respite from aerial strikes has been marred by snow and thunderstorms that affected millions displaced by the conflict, which has now reached every region of Syria.

On Saturday, the skies were clear and jets and helicopters fired missiles and dropped bombs on a line of towns to the east of Damascus, where rebels have pushed out Assad's ground forces, the Syrian Observatory for Human Rights said.

The British-based group, which is linked to the opposition, said it had no immediate information on casualties from the strikes on districts including Maleiha and farmland areas.

Rebels control large swathes of rural land around Syria but are stuck in a stalemate with Assad's forces in cities, where the army has reinforced positions.

State TV said government forces had repelled an attack by terrorists - a term it uses for the armed opposition - on Aleppo's international airport, now used as a helicopter base.

Reuters cannot independently confirm reports due to severe reporting restrictions imposed by the Syrian authorities and security constraints.

On Friday, rebels seized control of one of Syria's largest helicopter bases, Taftanaz in Idlib province, their first capture of a military airfield.

Eight-six people were killed on Friday, including 30 civilians, the Syrian Observatory said.

(Writing by Oliver Holmes; Editing by Tom Pfeiffer and Doina Chiacu)

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Oil prices slip on profit taking

NEW YORK: World oil prices fell Friday as investors booked profits from the previous day's rally amid sluggish global economic growth.

New York's main West Texas Intermediate (WTI) contract, light sweet crude for February, settled 26 cents lower at $93.56 a barrel.

In London, Brent North Sea crude for delivery in February closed at $110.64 a barrel, down $1.25 from Thursday's close.

"Today we simply could be seeing profit taking as the oil markets have rallied over the last three weeks," Andy Lipow of Lipow Oil Associates.

Traders were facing an overbought market with no significant news to take prices higher, Robert Yawger of Mizuho Securities said.

He noted that WTI had hit the highest level in several months on Thursday, at $94.70 a barrel. The surge was largely driven by upbeat trade data from China, the world's second-biggest oil consumer.

Tim Evans of Citi Futures said rising US petroleum product inventories were to blame for Friday's price weakness.

"The rally of the past few weeks largely ignored the rising stocks," he said.

-AFP/ac

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Police get Owaisi's custody

NIRMAL: : Nirmal munsif magistrate K Ajesh Kumar on Friday granted the local police five days custody of MIM MLA Akbaruddin Owaisi. Arrested for delivering hate speeches on January 8, Akbaruddin has been lodged in the Adilabad district jail and is on judicial remand till January 22.

The Nirmal police had sought 7-day custody of the MLA but the magistrate granted them 5- day custody beginning Saturday. The cops can question Akbaruddin from 10 am to 5 pm every day till January 17 when he should be produced before the court.

According to sources, the cops want to record Akbaruddin's voice and match it with the videos in which the MLA is seen delivering the speech at a public meeting in Nirmal on December 22, 2012. A police team led by Nirmal rural circle inspector A Raju will question Akbaruddin in the Armed Reserve police headquarters in Adilabad town.

Meanwhile, a team of doctors from Rajiv Gandhi Institute of Medical Sciences (RIMS) led by its superintendent Suresh Chandra conducted a health check-up on Akbaruddin after he complained of a pain in the stomach on Friday. After the check-up, the doctors said the pain in the stomach could be due to the food served in the jail and added that the MLA's condition was stable.

Earlier in the day, All India Human Rights Association state wing secretary Bahuddin Akbatull Hussain met Akabaruddin in the jail. However, the jail authorities refused 'mulaqat' permission to MIM MLA Mumtaz Khan, who wanted to meet Akbar. In other developments, Akbar's plea for special category prisoner status was listed for hearing on January 16.

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Flu season puts businesses and employees in a bind

WASHINGTON (AP) — Nearly half the 70 employees at a Ford dealership in Clarksville, Ind., have been out sick at some point in the past month. It didn't have to be that way, the boss says.

"If people had stayed home in the first place, a lot of times that spread wouldn't have happened," says Marty Book, a vice president at Carriage Ford. "But people really want to get out and do their jobs, and sometimes that's a detriment."

The flu season that has struck early and hard across the U.S. is putting businesses and employees alike in a bind. In this shaky economy, many Americans are reluctant to call in sick, something that can backfire for their employers.

Flu was widespread in 47 states last week, up from 41 the week before, the Centers for Disease Control and Prevention said Friday. The only states without widespread flu were California, Mississippi and Hawaii. And the main strain of the virus circulating tends to make people sicker than usual.

Blake Fleetwood, president of Cook Travel in New York, says his agency is operating with less than 40 percent of its full-time staff because of the flu and other ailments.

"The people here are working longer hours and it puts a lot of strain on everyone," Fleetwood says. "You don't know whether to ask people with the flu to come in or not." He says the flu is also taking its toll on business as customers cancel their travel plans: "People are getting the flu and they're reduced to a shriveling little mess and don't feel like going anywhere."

Many workers go to the office even when they're sick because they are worried about losing their jobs, says John Challenger, CEO of Challenger, Gray & Christmas, an employer consulting firm. Other employees report for work out of financial necessity, since roughly 40 percent of U.S. workers don't get paid if they are out sick. Some simply have a strong work ethic and feel obligated to show up.

Flu season typically costs employers $10.4 billion for hospitalization and doctor's office visits, according to the CDC. That does not include the costs of lost productivity from absences.

At Carriage Ford, Book says the company plans to make flu shots mandatory for all employees.

Linda Doyle, CEO of the Northcrest Community retirement home in Ames, Iowa, says the company took that step this year for its 120 employees, providing the shots at no cost. It is also supplying face masks for all staff.

And no one is expected to come into work if sick, she says.

So far, the company hasn't seen an outbreak of flu cases.

"You keep your fingers crossed and hope it continues this way," Doyle says. "You see the news and it's frightening. We just want to make sure that we're doing everything possible to keep everyone healthy. Cleanliness is really the key to it. Washing your hands. Wash, wash, wash."

Among other steps employers can take to reduce the spread of the flu on the job: holding meetings via conference calls, staggering shifts so that fewer people are on the job at the same time, and avoiding handshaking.

Newspaper editor Rob Blackwell says he had taken only two sick days in the last two years before coming down with the flu and then pneumonia in the past two weeks. He missed several days the first week of January and has been working from home the past week.

"I kept trying to push myself to get back to work because, generally speaking, when I'm sick I just push through it," says Blackwell, the Washington bureau chief for the daily trade paper American Banker.

Connecticut is the only state that requires some businesses to pay employees when they are out sick. Cities such as San Francisco and Washington have similar laws.

Challenger and others say attitudes are changing, and many companies are rethinking their sick policies to avoid officewide outbreaks of the flu and other infectious diseases.

"I think companies are waking up to the fact right now that you might get a little bit of gain from a person coming into work sick, but especially when you have an epidemic, if 10 or 20 people then get sick, in fact you've lost productivity," Challenger says.

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Associated Press writers Mike Stobbe in Atlanta, Eileen A.J. Connelly in New York, Paul Wiseman in Washington, Barbara Rodriguez in Des Moines, Iowa, and Jim Salter in St. Louis contributed to this report.

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Poisoned Lottery Winner's Exhumation Approved

A judge has approved the exhumation of the Chicago lottery winner who died of cyanide poisoning.

Judge Susan Coleman of the Probate Division of the Cook County Circuit Court in Illinois today approved the county medical examiner's request to exhume the body of Urooj Khan at Rosehill Cemetery in Chicago.

Khan, 46, died July 20, 2012, from what was initially believed to be natural causes. But a family member whose identity has yet to be revealed asked the medical examiner's office to re-examine the cause of death, which was subsequently determined to be cyanide poisoning.

The office did so by retesting fluid samples that had been taken from Khan's body, including tests for cyanide and strychnine.

In explaining the request for exhumation, Chief Medical Examiner Stephen Cina has said, "If or when this goes to court, it would be nice to have all the data possible."

The Chicago businessman had won a $1 million lottery jackpot -- before taxes -- the month before he died.

In Photos: Biggest Lotto Winners

In the latest legal twist, Khan's brother filed a petition Wednesday to a judge asking Citibank to release information about Khan's assets to "ultimately ensure" that [Khan's] minor daughter "receives her proper share." Khan reportedly did not have a will.

He left behind a widow, Shabana Ansari, 32, and a teenage daughter from his first marriage. Ansari and Khan reportedly married 12 years ago in India.

Andrew A. Nelles/Chicago Sun-Times via AP Photo

Authorities questioned Ansari in November and searched the home she shared with Khan. She and her attorney, Al Haroon Husain, say she had nothing to do with his death.

"It's sad that I lost my husband," she told ABC News. "I love him and I miss him. That's all I can say."

The siblings of the poisoned lottery winner have pursued legal action to protect their niece's share of her late father's estate. They also questioned whether he and Ansari were legally married, but Ansari's attorney said she has a marriage certificate from India that is valid in the United States.

ImTiaz Khan, 56, Khan's brother, and Meraj Khan, 37, their sister, had won a court order to freeze the lottery winnings after Ansari cashed the check.

Husain said Ansari cashed the lottery check after it was mailed to the home, which she did not request.

The lottery check, about $425,000 in cash, was issued July 19 by the Illinois Comptroller's Office, then mailed, according to Brad Hahn, spokesman for the Comptroller's Office. Hahn said it was cashed Aug. 15, nearly a month after Khan's death, but he did not know who cashed it.

The judge later approved Ansari's competing claim as an administrator of the estate.

"I don't care what they talk [sic]," Ansari told ABC News of what her in-laws are saying.

Ansari said she was married to Khan but declined to comment to ABC News about cashing the check after his death, although The Associated Press has reported that she denied removing any of the assets.

Meraj Khan filed in September to become the legal guardian of her niece. After the judge asked the 17-year old daughter with whom she wished to live, she chose her aunt and has been there since November, Husain said.

Neither sibling has petitioned to obtain a share of the dead man's estate, which is estimated to be $1.2 million in lottery winnings, real estate, Khan's laundry business and automobiles.

Neither the attorney for ImTiaz Khan nor the two siblings has responded to requests for comment.

A status hearing on the future of the estate is scheduled for Jan. 24, according to the AP.

ABC News' Alex Perez and Matthew Jaffe contributed to this report.

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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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Bombs kill 92 in Pakistan's Quetta: police

QUETTA: Bomb attacks killed 92 people in Pakistan's city of Quetta on Thursday, as twin suicide bombers targeted a snooker hall frequented by Shiites in the deadliest single attack in the country for nearly two years.

At least 81 people were killed and 121 wounded when two suicide bombers blew themselves up at the crowded club in an area of the southwestern city dominated by members of the Shiite Muslim community, a senior police officer said.

It was one of the worst single attacks ever on the minority community, which account for around 20 per cent of Pakistan's 180-million strong population.

It was the deadliest attack in Pakistan since twin suicide bombers killed 98 people outside a police training centre in the northwestern town of Shabqadar on May 13, 2011 -- shortly after US troops killed Osama bin Laden.

The double suicide blasts came hours after a bomb ripped through a security forces' vehicle in a crowded part of the city, killing 11 people and wounding dozens more.

At the snooker club the first suicide bomber struck inside the building, then 10 minutes later an attacker in a car outside blew himself up as police, media workers and rescue teams rushed to the site, said officer Mir Zubair Mehmood.

"The death toll has risen to 81 so far," senior police official Mir Zubair Mehmood told a news conference, putting the number of wounded at 121.

"Both (attacks) were (carried out by) suicide bombers and the death toll could rise further," he added.

Mehmood said the dead also included nine police personnel and a local television camera man. Several rescue workers were also killed in the attacks, he said.

The snooker club is frequented mostly by Shiites, police said.

According to the US-based Human Rights Watch, 2012 was the deadliest year on record for Shiites in Pakistan.

The organisation late Thursday called the government's failure to protect the community, which accounts for around 20 per cent of the population, "reprehensible and amounts to complicity in the barbaric slaughter of Pakistani citizens".

People were seen wailing and crying beside the bodies lying on the ground, an AFP photographer said.

The bombings damaged several shops and nearby buildings. At least four vehicles of local ambulance service were destroyed. The blast site was also littered with the belongings of the victims.

There was no immediate claim of responsibility.

Quetta has been a flashpoint for attacks against Shiites, in particular those from the ethnic Hazara minority, as well as suffering from attacks linked to a separatist insurgency and Islamist militancy.

Police said the attacks disrupted power supplies and plunged the area into darkness that hampered rescue work.

Quetta is the capital of the province of Baluchistan, one of the most deprived parts of Pakistan but rich in natural gas and mineral deposits on the Afghan and Iranian borders.

In the earlier attack bombers had targeted Frontier Corps personnel, planting their device underneath an FC vehicle, a senior police investigator said.

"At least one FC personnel was killed and 10 others wounded, two of them seriously," FC spokesman Murtaza Baig told AFP.

Bomb disposal official Abdul Razzaq said the bomb, packed with 20 to 25 kilograms of explosives, was detonated by remote control.

"I went out of my shop and saw a thick cloud of dust. I was very scared and saw people screaming in panic. There were dead bodies and injured people shouting for help," said Allah Dad, a local shopkeeper.

In the northwestern Swat valley on Thursday a gas cylinder blast at a religious gathering killed 22 people and wounded more than 80, officials said, prompting a probe into possible sabotage.

The explosion took place at a weekly meeting of the local Tableeghi Jamaat (preachers' party) at its centre on the outskirts of Mingora, the main town in the district, regional police chief Akhtar Hayat said.

It was the deadliest blast in Swat since the Pakistan army declared it back under government control in July 2009 following a two-year Taliban-led insurgency in the valley.

- AFP/jc

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India rejects Pak's call for UN probe into border row

NEW DELHI: India on Thursday rebuffed Pakistan's proposal for a UN probe into the border flare-up as a sly attempt to internationalize the issue.

After the meeting of the Cabinet Committee on Security, finance minister P Chidambaram said, "We are certainly not going to agree to internationalize the issue or allow the United Nations to hold an inquiry. That demand is obviously rejected out of hand."

The terse comment came in reaction to Pakistan's offer that the UN could be asked to probe the charge that its troops killed Indian soldiers and mutilated their bodies.

Pakistan rejected the accusations from India as "propaganda", saying its troops were not involved in the attack.

However, India has chosen to keep up the heat on the ceasefire violation and inhuman treatment of its dead soldiers while being cautious of the neighbour's design.

Chidambaram's reaction came after defence minister AK Antony briefed the CCS on the Poonch flare-up. "We take a serious view of what happened ... whatever has to be done will be done," the finance minister said, adding there was no violation of ceasefire agreement from the Indian side.

Information and broadcasting minister Manish Tewari said the action of Pakistani troops was inhuman and the government had taken the matter seriously. "It was inhuman. We have condemned it," he said.

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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 hotspots. 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 suffered her worst case of flu-like illness in years and was 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.

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.

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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