Q&A: Scramble for vaccine as flu season heats up


WASHINGTON (AP) — Missed flu-shot day at the office last fall? And all those "get vaccinated" ads? A scramble for shots is under way as late-comers seek protection from a miserable flu strain already spreading through much of the country.


Federal health officials said Friday that there is still some flu vaccine available and it's not too late to benefit from it. But people may have to call around to find a clinic with shots still on the shelf, or wait a few days for a new shipment.


"We're hearing of spot shortages," said Dr. Thomas Frieden, director of the Centers for Disease Control and Prevention.


Colorado offers an example. Kaiser Permanente, which has 535,000 members in the state, stopped giving flu shots this week. But it expected to resume vaccinations when new shipments arrive, expected this weekend.


Some questions and answers about flu vaccines:


Q: Are we running out of vaccine?


A: It's January — we shouldn't have a lot left. The traditional time to get vaccinated is in the fall, so that people are protected before influenza starts spreading.


Indeed, manufacturers already have shipped nearly 130 million doses to doctors' offices, drugstores and wholesalers, out of the 135 million doses they had planned to make for this year's flu season. At least 112 million have been used so far.


The nation's largest manufacturer, Sanofi Pasteur, said Friday that it still has supplies of two specialty vaccines, a high-dose shot for seniors, and an under-the-skin shot for certain adults, available for immediate shipment. But it also is working to eke out a limited supply of its traditional shots — some doses that it initially hadn't packaged into syringes, said spokesman Michael Szumera. They should be available late this month.


And MedImmune, the maker of the nasal spray vaccine FluMist, said it has 620,000 extra doses available.


Q: Can't they just make more?


A: No. Flu vaccine is complicated to brew, with supplies for each winter made months in advance and at the numbers expected to sell. Although health officials recommend a yearly flu vaccination for nearly everybody, last year 52 percent of children and just 39 percent of adults were immunized. Most years, leftover doses have to be thrown out.


Q: Should I still hunt for a vaccine?


A: It does take two weeks for full protection to kick in. Still, health officials say it's a good idea to be vaccinated even this late, especially for older people, young children and anyone with medical conditions such as heart or lung diseases that put them at high risk of dangerous flu complications. Flu season does tend to be worst in January and February, but it can run through March.


Q: I heard that a new flu strain is spreading. Does the vaccine really work?


A: Flu strains constantly evolve, the reason that people need an updated vaccine every year. But the CDC says this year's is a good match to the types that are circulating, including a new kind of the tough H3N2 strain. That family tends to be harsher than other flu types — and health officials warned last fall that it was coming, and meant this winter would likely be tougher than last year's flu season, the mildest on record.


Q: But don't some people get vaccinated and still get sick?


A: Flu vaccine never is 100 percent effective, and unfortunately it tends to protect younger people better than older ones. But the CDC released a study Friday showing that so far this year, the vaccine appears 62 percent effective, meaning it's working about as well as it has in past flu seasons.


While that may strike some people as low, Frieden said it's the best protection available. "It's a glass 62 percent full," he said. "It's well worth the effort."


Q: What else can I do?


A: Wash your hands often, and avoid touching your eyes, nose and mouth. Viruses can spread by hand, not just through the air. Also, cough in your elbow, not your hand. When you're sick, protect others by staying home.


And people who are in those high-risk groups should call a doctor if they develop symptoms, added CDC spokesman Tom Skinner. They might be prescribed antiviral medication, which works best if given within the first 48 hours of symptoms.


___


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


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Wall Street Week Ahead: Attention turns to financial earnings

NEW YORK (Reuters) - After over a month of watching Capitol Hill and Pennsylvania Avenue, Wall Street can get back to what it knows best: Wall Street.


The first full week of earnings season is dominated by the financial sector - big investment banks and commercial banks - just as retail investors, free from the "fiscal cliff" worries, have started to get back into the markets.


Equities have risen in the new year, rallying after the initial resolution of the fiscal cliff in Washington on January 2. The S&P 500 on Friday closed its second straight week of gains, leaving it just fractionally off a five-year closing high hit on Thursday.


An array of financial companies - including Goldman Sachs and JPMorgan Chase - will report on Wednesday. Bank of America and Citigroup will join on Thursday.


"The banks have a read on the economy, on the health of consumers, on the health of demand," said Quincy Krosby, market strategist at Prudential Financial in Newark, New Jersey.


"What we're looking for is demand. Demand from small business owners, from consumers."


EARNINGS AND ECONOMIC EXPECTATIONS


Investors were greeted with a slightly better-than-anticipated first week of earnings, but expectations were low and just a few companies reported results.


Fourth quarter earnings and revenues for S&P 500 companies are both expected to have grown by 1.9 percent in the past quarter, according to Thomson Reuters I/B/E/S.


Few large corporations have reported, with Wells Fargo the first bank out of the gate on Friday, posting a record profit. The bank, however, made fewer mortgage loans than in the third quarter and its shares were down 0.8 percent for the day.


The KBW bank index <.bkx>, a gauge of U.S. bank stocks, is up about 30 percent from a low hit in June, rising in six of the last eight months, including January.


Investors will continue to watch earnings on Friday, as General Electric will round out the week after Intel's report on Thursday.


HOUSING, INDUSTRIAL DATA ON TAP


Next week will also feature the release of a wide range of economic data.


Tuesday will see the release of retail sales numbers and the Empire State manufacturing index, followed by CPI data on Wednesday.


Investors and analysts will also focus on the housing starts numbers and the Philadelphia Federal Reserve factory activity index on Thursday. The Thomson Reuters/University of Michigan consumer sentiment numbers are due on Friday.


Jim Paulsen, chief investment officer at Wells Capital Management in Minneapolis, said he expected to see housing numbers continue to climb.


"They won't be that surprising if they're good, they'll be rather eye-catching if they're not good," he said. "The underlying drive of the markets, I think, is economic data. That's been the catalyst."


POLITICAL ANXIETY


Worries about the protracted fiscal cliff negotiations drove the markets in the weeks before the ultimate January 2 resolution, but fear of the debt ceiling fight has yet to command investors' attention to the same extent.


The agreement was likely part of the reason for a rebound in flows to stocks. U.S.-based stock mutual funds gained $7.53 billion after the cliff resolution in the week ending January 9, the most in a week since May 2001, according to Thomson Reuters' Lipper.


Markets are unlikely to move on debt ceiling news unless prominent lawmakers signal that they are taking a surprising position in the debate.


The deal in Washington to avert the cliff set up another debt battle, which will play out in coming months alongside spending debates. But this alarm has been sounded before.


"The market will turn the corner on it when the debate heats up," Prudential Financial's Krosby said.


The CBOE Volatility index <.vix> a gauge of traders' anxiety, is off more than 25 percent so far this month and it recently hit its lowest since June 2007, before the recession began.


"The market doesn't react to the same news twice. It will have to be more brutal than the fiscal cliff," Krosby said. "The market has been conditioned that, at the end, they come up with an agreement."


(Reporting by Gabriel Debenedetti; editing by Rodrigo Campos)



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Immigration Arrests Lead to Online Outcry, and Release





PHOENIX — Immigration agents arrested the mother and brother of a prominent activist during a raid at her home here late Thursday, unleashing a vigorous response on social media and focusing new attention on one of the most controversial aspects of the Obama administration’s policies on deportation.




The agents knocked on Erika Andiola’s door shortly after 9 p.m., asking for her mother, Maria Arreola.


Ms. Arreola had been stopped by the police in nearby Mesa last year and detained for driving without a license. Her fingerprints were sent to federal immigration officials as part of a controversial program called Secure Communities, which the Obama administration has been trying to expand nationwide.


That routine check revealed that Ms. Arreola had been returned to Mexico in 1998 after she was caught trying to illegally cross the border into Arizona with Erika and two of her siblings in tow. As a result, she was placed on a priority list for deportation.


After being seized on Thursday, she could have been sent back to Mexico in a matter of hours, but Obama administration officials moved quickly to undo the arrests. Officials had been pressured by the robust response from advocates — through phone calls, e-mails and online petitions, but primarily on Twitter, where they mobilized support for Ms. Andiola, a well-known advocate for young illegal immigrants, under the hashtag #WeAreAndiola.


The reaction offered the Obama administration a taste of what it might expect when it gets into the thick of the debate over an immigration overhaul, which Congress is expected to tackle this year. President Obama has already been under harsh criticism for the number of illegal immigrants deported since he took office — roughly 400,000 each year, a record unmatched since the 1950s.


Ms. Andiola, 25, posted a tearful video on YouTube shortly after her mother and brother were handcuffed and driven away. “I need everybody to stop pretending that nothing is wrong,” she said in the video, “stop pretending that we’re all just living normal lives, because we’re not. This could happen to any of us anytime.”


She is the co-founder of the Arizona Dream Act Coalition, one of the groups pushing for a reprieve for immigrants brought illegally to the United States as children, as she was. She has been arrested while camped in front of Senator John McCain’s office here, protested outside the United States Capitol, and appeared on the cover of Time magazine in June under the headline, “We are Americans — just not legally.”


In November, Ms. Andiola got a work permit under a program begun by the Obama administration last year that gives certain young illegal immigrants temporary reprieve from deportation. She graduated from Arizona State University in 2009.


On Friday afternoon, her mother returned home from a detention center in Florence, 70 miles southeast of Phoenix and usually the last stop for certain illegal immigrants before they are deported. Her brother, Heriberto Andiola Arreola, 36, who had been kept in Phoenix, was let go earlier, at 6 a.m.


Their swift releases underline the power of the youth-immigrant movement and their social media activism, which was critical in spreading Ms. Andiola’s story overnight.


In a statement, Barbara Gonzalez, a spokeswoman for Immigration and Customs Enforcement, said a preliminary review of the case revealed that it contains some of the elements outlined in the agency’s “prosecutorial discretion policy” and would “merit an exercise of discretion.” Advocates have long argued that the policy has done little to keep families from being broken apart by deportations.


Ms. Andiola said in an interview that she told her mother to go to her room before opening the door Thursday night; she suspected the men standing outside worked for immigration. By the time the men came in, her brother, who was outside talking to a neighbor, was already in handcuffs, she said.


“Where’s Maria?” the men asked her, she recalled.


Ms. Arreola walked out of the room and, in Spanish, the men asked her to accompany them outside, where they placed her under arrest.


Though she and her son are free, their future is uncertain, as they could be arrested again while their cases are under review or deported should the eventual ruling go against them, said Marielena HincapiƩ, executive director of the National Immigration Law Center, one of the groups helping the family.


Stories like this, Ms. HincapiĆ© went on, “happen every day, in every state,” outside of the media spotlight. What made it different this time is that Ms. Andiola had connections and wasted no time mobilizing them. There are others, she said, whom “you never hear about.”


Julia Preston contributed reporting from New York.



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A sense of dread shrouds Nintendo’s Wii U






The latest Wii U sales numbers are out from Japan, the United States and the United Kingdom — and unease is deepening. In Japan, Famitsu Magazine reported Wii U weekly sales slipping to 70,000 units from 76,000 units during the important period ending in January 6. This is the week many Japanese teenagers spend their New Year’s money and sales of consoles tend to bounce. During the week, the portable 3DS sold 305,000 units, up sharply from the already impressive 266,000 units in the previous week. The seven-year-old Sony (SNE) PlayStation 3 managed to increase its sales to 64,000 units from 54,000 units. The equally ancient PSP climbed to 53,000 from 34,000. Even the star-crossed PS Vita managed to vault to 31,000 from 18,000.


[More from BGR: LG reportedly halts Nexus 4 production to make way for new Nexus device]






As Wii U sales are mired close to PlayStation 3 levels in Japan, it is getting hammered by the aging Microsoft (MSFT) Xbox 360 in America. NPD just reported that Xbox 360 moved 1.4 million units in December while Wii U limped through the holiday season with 460,000 units. This is below the 600,000 unit level that the earlier Wii console managed years ago against a much younger console competition in 2006. Back then, Wii launched head-to-head with Sony’s PlayStation 3 in the US market, and the Xbox 360 had been launched just one year earlier.


[More from BGR: BlackBerry Z10 shown off in leaked marketing materials]


In 2012, Wii U debuted against two rival home consoles that were more than half a decade old. The results are not pretty. Meanwhile in the U.K., the Wii U shifted 40,000 units during its launch weekend, but none of the titles cracked the top 10 of the GfK game software chart.


It is clear that the lack of compelling software is hurting Wii U right now. Nintendo (NTDOY) wanted to push it out well before the buzz around the next generations of Sony and Microsoft consoles started building. The problem with the rush is that Wii U is now facing several fallow months before big titles arrive. The January-April sales period could be spectacularly ugly and may cause real damage to Nintendo’s home console reputation if it leads to U.S. sales dipping below 300,000 a month and Japanese sales dipping below 30,000 a month. The danger here is that if consumers start suspecting that the Wii U is a lame duck, they may choose to wait for one of the big rival vendors to roll out some spectacular hardware next winter.


All in all, it’s hard to avoid the notion that the console gaming universe is shrinking. In the U.S., game software sales contracted by a disastrous 26% in December. PS Vita is in dire straits and may leave Nintendo’s 3DS as the only viable portable console in 2014. Wii U is wobbling badly, possibly leading to a 2014 scenario when only Sony and Microsoft are left standing in the home console battle. U.S. consumers are still wild about huge, violent console epics like Call of Duty, Assassin’s Creed and Halo. Those are titles that define PlayStation and Xbox. The casual gaming that defines Wii U is under siege by the smartphone/tablet gaming frenzy that shows no sign of abating.


This article was originally published on BGR.com


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Britney & Jason's Love Story in 6 Sweet Shots





From a snuggle in the surf to a surprise engagement, see the former couple's most romantic moments








Credit: Kevin Mazur/Wireimage



Updated: Friday Jan 11, 2013 | 07:00 AM EST
By: Cara Lynn Shultz




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Wall Street Week Ahead: Attention turns to financial earnings

NEW YORK (Reuters) - After over a month of watching Capitol Hill and Pennsylvania Avenue, Wall Street can get back to what it knows best: Wall Street.


The first full week of earnings season is dominated by the financial sector - big investment banks and commercial banks - just as retail investors, free from the "fiscal cliff" worries, have started to get back into the markets.


Equities have risen in the new year, rallying after the initial resolution of the fiscal cliff in Washington on January 2. The S&P 500 on Friday closed its second straight week of gains, leaving it just fractionally off a five-year closing high hit on Thursday.


An array of financial companies - including Goldman Sachs and JPMorgan Chase - will report on Wednesday. Bank of America and Citigroup will join on Thursday.


"The banks have a read on the economy, on the health of consumers, on the health of demand," said Quincy Krosby, market strategist at Prudential Financial in Newark, New Jersey.


"What we're looking for is demand. Demand from small business owners, from consumers."


EARNINGS AND ECONOMIC EXPECTATIONS


Investors were greeted with a slightly better-than-anticipated first week of earnings, but expectations were low and just a few companies reported results.


Fourth quarter earnings and revenues for S&P 500 companies are both expected to have grown by 1.9 percent in the past quarter, according to Thomson Reuters I/B/E/S.


Few large corporations have reported, with Wells Fargo the first bank out of the gate on Friday, posting a record profit. The bank, however, made fewer mortgage loans than in the third quarter and its shares were down 0.8 percent for the day.


The KBW bank index <.bkx>, a gauge of U.S. bank stocks, is up about 30 percent from a low hit in June, rising in six of the last eight months, including January.


Investors will continue to watch earnings on Friday, as General Electric will round out the week after Intel's report on Thursday.


HOUSING, INDUSTRIAL DATA ON TAP


Next week will also feature the release of a wide range of economic data.


Tuesday will see the release of retail sales numbers and the Empire State manufacturing index, followed by CPI data on Wednesday.


Investors and analysts will also focus on the housing starts numbers and the Philadelphia Federal Reserve factory activity index on Thursday. The Thomson Reuters/University of Michigan consumer sentiment numbers are due on Friday.


Jim Paulsen, chief investment officer at Wells Capital Management in Minneapolis, said he expected to see housing numbers continue to climb.


"They won't be that surprising if they're good, they'll be rather eye-catching if they're not good," he said. "The underlying drive of the markets, I think, is economic data. That's been the catalyst."


POLITICAL ANXIETY


Worries about the protracted fiscal cliff negotiations drove the markets in the weeks before the ultimate January 2 resolution, but fear of the debt ceiling fight has yet to command investors' attention to the same extent.


The agreement was likely part of the reason for a rebound in flows to stocks. U.S.-based stock mutual funds gained $7.53 billion after the cliff resolution in the week ending January 9, the most in a week since May 2001, according to Thomson Reuters' Lipper.


Markets are unlikely to move on debt ceiling news unless prominent lawmakers signal that they are taking a surprising position in the debate.


The deal in Washington to avert the cliff set up another debt battle, which will play out in coming months alongside spending debates. But this alarm has been sounded before.


"The market will turn the corner on it when the debate heats up," Prudential Financial's Krosby said.


The CBOE Volatility index <.vix> a gauge of traders' anxiety, is off more than 25 percent so far this month and it recently hit its lowest since June 2007, before the recession began.


"The market doesn't react to the same news twice. It will have to be more brutal than the fiscal cliff," Krosby said. "The market has been conditioned that, at the end, they come up with an agreement."


(Reporting by Gabriel Debenedetti; editing by Rodrigo Campos)



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Japan Approves $116 Billion in Emergency Economic Stimulus


TOKYO — The Japanese government approved emergency stimulus spending of more than $100 billion on Friday, part of an aggressive push by Prime Minister Shinzo Abe to kick-start growth in Japan’s long-moribund economy.


Mr. Abe also reiterated pressure on Japan’s central bank to make a firmer commitment to stopping deflation by pumping more money into the economy — a measure the prime minister says is crucial to getting businesses to invest and consumers to spend.


“We will put an end to this shrinking, and aim to build a stronger economy where earnings and incomes can grow,” Mr. Abe told a televised news conference. “For that, the government must first take the initiative to create demand, and boost the entire economy.”


Under the plan, the Japanese government will spend about 10.3 trillion yen (about $116 billion) on public works and disaster mitigation projects, subsidies for companies that invest in new technology and financial aid to small businesses.


The government will seek to raise real economic growth by 2 percentage points and add 600,000 jobs to the economy, Mr. Abe said. The measures announced Friday amount to one of the largest spending plans in Japan’s history, he stressed.


By simply talking about stimulus measures, Mr. Abe, who took office late last month, has already driven down the value of the yen, much to the relief of Japanese exporters whose competitiveness benefits from a weaker currency.


But the government’s promises to spend its way out of economic stagnation also raise concerns over Japan’s public debt, which has already mushroomed to twice the size of its economy and is the largest in the industrialized world.


At the root of Japan’s debt woes was a similar attempt in the 1990s by Mr. Abe’s own Liberal Democratic Party to stimulate economic growth through government spending on extensive public works projects across the country.


Mr. Abe said, however, that the spending this time around would be better focused to bring about growth through investment in innovation. He said the government would also invest in measures that would help mitigate the fall in Japan’s population, by encouraging families to have more children.


“To grow in a sustainable way, we must help create a virtuous cycle where companies actively borrow and invest, and in so doing raise employment and incomes,” Mr. Abe said.


“For that, it is extremely important that we adopt a growth strategy that gives everyone solid hope that the future of the Japanese economy lies in growth.”


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Baby Bones Found Scattered in Ancient Italian Village






SEATTLE — The death of an infant may not have been an occasion for mourning in ancient Italy, according to archaeologists who have found baby bones scattered on the floor of a workshop dating to the seventh century B.C.


The grisly finds consist of bone fragments uncovered over years of excavation at Poggio Civitate, a settlement about 15 miles (25 kilometers) from the city of Siena in what is now Tuscany. The settlement dates back to at least the late eighth century B.C. Archaeologists excavating the site have found evidence of a lavish residential structure as well as an open-air pavilion that stretches an amazing 170 feet (52 meters) long. Residents used this pavilion was as a workshop, manufacturing goods such as terracotta roof tiles.






In 1983, scientists uncovered a cache of bones on the workshop floor, consisting mostly of pig, goat and sheep remains. But among the bony debris was a more sobering find: two arm bones from an infant (or infants) who died right around birth.


In 2009, another baby bone surfaced at the workshop, this one a portion of the pelvis of a newborn. [See Images of the Infant Bones]


The bones “were either simply left on the floor of the workshop or ended up in an area with a concentration of discarded, butchered animals,” said Anthony Tuck, an archaeologist at the University of Massachusetts, Amherst, who presented an analysis of the bones Friday (Jan. 4) at the annual meeting of the Archaeological Institute of America.


Abandoned bones


The discovery of the discarded infant bones in an area used for work could suggest that the people who labored in the workshop had little social status, Tuck said. They may have been slaves or servants whose lost infants would garner little sympathy from the community at large.


However, a third find complicates the picture. In 1971, archaeologists found an arm bone from another newborn or near-term fetus pushed up against the wall of the lavish residence along with other bones and debris. It seems as if someone swept the debris up against the wall, not differentiating between baby bones and garbage, Tuck said. [8 Grisly Archaeological Discoveries]


There’s no way to know whose infant came to rest up against the wall of a wealthy person’s home, said Tuck, who plans to submit the findings to the journal Etruscan Studies. Perhaps the infant belonged to a desperate servant, or perhaps to a member of the family. If so, it may be that even high-status families didn’t consider babies worth mourning when they died in infancy.


The possibility can sound horrifying to modern ears, Tuck said.


“This kind of new data makes people a bit uncomfortable,” he told LiveScience. “People have a tendency to romanticize the past, especially in a place like Tuscany. When we have direct evidence for this kind of behavior, it can be a little tricky to present.”


Death in infancy


Nevertheless, Tuck said, there is reason to think that people have not always given infants the same community status as adults or older children. However, baby bones tend not to preserve well, which makes it difficult to know how ancient Italians in Tuscany treated their deceased infants.


Very few signs of infant burial appear in central Italian cemeteries from this time period, though, Tuck said. The handful of coffins containing baby bones that have been found are loaded with ornaments and jewelry, suggesting that only families of great wealth could have given a lost baby an adult-style funeral.


Even in modern times, societies have sometimes seen babies as belonging to a different category than adults, Tuck said. In areas of extreme poverty and stress that have high infant mortality, the death of a newborn may not trigger many outward displays of mourning, he said.


And many cultures have naming traditions that only recognize the baby’s identity significantly after birth. For example, in traditional Jewish culture, a baby boy’s name isn’t revealed outside the family until the bris, or the ritual of circumcision eight days after birth. According to superstition, naming the baby before then would attract the attention of the Angel of Death.


The Maasai people of Africa give their newborns temporary names until a ceremony as late as age 3, in which the child receives a new name and has his or her head shaved to symbolize a fresh start in life.


On the other hand, not all ancient cultures differentiate between the burials of babies and adults. Stone Age infant graves found in Austria in 2006 date back to 27,000 years ago and contain the same beads and pigments as adult gravesites.


The people who lived in Poggio Civitate more than 2,000 years ago have left little evidence of how they viewed infants, but Tuck and his colleagues expect more finds to emerge as the researchers continue to dig in the Tuscany hills. More evidence that high- and low-class babies were buried differently would suggest that the civilization had a rigid hierarchy, they said.


Images of more than 25,000 objects recovered from the site can be found at Open Context, an open-source research database developed by the Alexandra Archive Institute.


Follow Stephanie Pappas on Twitter @sipappas or LiveScience @livescience. We’re also on Facebook & Google+.


Copyright 2013 LiveScience, a TechMediaNetwork company. All rights reserved. This material may not be published, broadcast, rewritten or redistributed.
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Audrey Hepburn: Remembering the Private Legend















01/10/2013 at 07:35 PM EST







Audrey Hepburn with her son, Luca Dotti, in 1985


Audrey Hepburn Childrens Fund


She captivated the world with her doe-eyed beauty, but behind the Givenchy glamour, there was an Audrey Hepburn few people knew.

She thought her nose too big, her feet too large and her neck too long. She loved to shop for groceries (but not clothes), didn't wear makeup at home, never went to the gym and enjoyed two fingers of Scotch every night. 

"She was not this ethereal creature," says Robert Wolders, 76, the Dutch actor who was her companion for the last 13 years of her life. "She was an earthy woman with a ribald sense of humor."

What Hepburn had, adds Wolders, "was more than beauty. It was this extraordinary mystique."

Hepburn left Hollywood at age 34 at the height of her fame, moving into a 1732 farmhouse in Tolochenaz, a small Swiss village, where she found happiness raising two sons and purpose in her charity work for UNICEF. 

Two decades after her death from abdominal cancer at 63 on Jan. 20, 1993, her children and her last love remember the Audrey they adored. 

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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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