Study questions kidney cancer treatment in elderly

In a stunning example of when treatment might be worse than the disease, a large review of Medicare records finds that older people with small kidney tumors were much less likely to die over the next five years if doctors monitored them instead of operating right away.

Even though nearly all of these tumors turned out to be cancer, they rarely proved fatal. And surgery roughly doubled patients' risk of developing heart problems or dying of other causes, doctors found.

After five years, 24 percent of those who had surgery had died, compared to only 13 percent of those who chose monitoring. Just 3 percent of people in each group died of kidney cancer.

The study only involved people 66 and older, but half of all kidney cancers occur in this age group. Younger people with longer life expectancies should still be offered surgery, doctors stressed.

The study also was observational — not an experiment where some people were given surgery and others were monitored, so it cannot prove which approach is best. Yet it offers a real-world look at how more than 7,000 Medicare patients with kidney tumors fared. Surgery is the standard treatment now.

"I think it should change care" and that older patients should be told "that they don't necessarily need to have the kidney tumor removed," said Dr. William Huang of New York University Langone Medical Center. "If the treatment doesn't improve cancer outcomes, then we should consider leaving them alone."

He led the study and will give results at a medical meeting in Orlando, Fla., later this week. The research was discussed Tuesday in a telephone news conference sponsored by the American Society of Clinical Oncology and two other cancer groups.

In the United States, about 65,000 new cases of kidney cancer and 13,700 deaths from the disease are expected this year. Two-thirds of cases are diagnosed at the local stage, when five-year survival is more than 90 percent.

However, most kidney tumors these days are found not because they cause symptoms, but are spotted by accident when people are having an X-ray or other imaging test for something else, like back trouble or chest pain.

Cancer experts increasingly question the need to treat certain slow-growing cancers that are not causing symptoms — prostate cancer in particular. Researchers wanted to know how life-threatening small kidney tumors were, especially in older people most likely to suffer complications from surgery.

They used federal cancer registries and Medicare records from 2000 to 2007 to find 8,317 people 66 and older with kidney tumors less than 1.5 inches wide.

Cancer was confirmed in 7,148 of them. About three-quarters of them had surgery and the rest chose to be monitored with periodic imaging tests.

After five years, 1,536 had died, including 191 of kidney cancer. For every 100 patients who chose monitoring, 11 more were alive at the five-year mark compared to the surgery group. Only 6 percent of those who chose monitoring eventually had surgery.

Furthermore, 27 percent of the surgery group but only 13 percent of the monitoring group developed a cardiovascular problem such as a heart attack, heart disease or stroke. These problems were more likely if doctors removed the entire kidney instead of just a part of it.

The results may help doctors persuade more patients to give monitoring a chance, said a cancer specialist with no role in the research, Dr. Bruce Roth of Washington University in St. Louis.

Some patients with any abnormality "can't sleep at night until something's done about it," he said. Doctors need to say, "We're not sticking our head in the sand, we're going to follow this" and can operate if it gets worse.

One of Huang's patients — 81-year-old Rhona Landorf, who lives in New York City — needed little persuasion.

"I was very happy not to have to be operated on," she said. "He said it's very slow growing and that having an operation would be worse for me than the cancer."

Landorf said her father had been a doctor, and she trusts her doctors' advice. Does she think about her tumor? "Not at all," she said.

___

Online:

Kidney cancer info: http://www.cancer.net/cancer-types/kidney-cancer

and http://www.cancer.gov/cancertopics/types/kidney

Study: http://gucasym.org

___

Marilynn Marchione can be followed at http://twitter.com/MMarchioneAP

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Microsoft says Xbox 360 sales have surpassed 76 million units, Kinect sales top 24 million

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Comcast to buy rest of NBC stake for $16.7 billion

(Reuters) - Comcast Corp on Tuesday said it would buy General Electric's remaining 49 percent equity stake in their NBCUniversal joint venture for about $16.7 billion, speeding up a deal that had not been expected until at least late 2014.

Analysts said Comcast was getting a good deal at that price, while Comcast's chief executive said the company moved because it was eager to take control of the business sooner than planned.

Comcast shares rose 7.5 percent in afterhours trading.

Comcast bought 51 percent of NBC Universal in 2011 after winning antitrust approval from the Justice Department. The transaction created a $30 billion business that includes broadcast, cable networks, movie studios and theme parks.

"Pretty much in our opinion given that media stocks have gone up quite a bit, it's a very attractive price, a fair price because we had a formula buyout," Comcast Chairman and Chief Executive Brian Roberts said in an interview with Reuters. "We feel many good things coming today and in the future and we wanted to get 100 percent of that for our shareholders."

In addition to the main deal, NBCUniversal will also buy from GE Capital the properties it uses at 30 Rockefeller Plaza in New York City and CNBC's headquarters in Englewood Cliffs, New Jersey, for about $1.4 billion.

Comcast said it would fund the deal with $11.4 billion of cash on hand, $4 billion in senior unsecured notes to be issued to GE, $2 billion in credit facility borrowings and the issuance of $725 million in subsidiary preferred stock to GE.

Separately, Comcast said it would increase its dividend by 20 percent and that it would buy back $2 billion in stock this year. GE also said it would accelerate its own share buy-back program to $10 billion this year.

"It's an attractive price - Comcast is getting a good deal," Wunderlich Securities analyst Matthew Harrigan said.

LONG-HELD AMBITIONS

Comcast turned its attention to NBC after a failed $54 billion hostile takeover attempt of Disney in 2004 that ultimately led to the resignation of that company's CEO, Michael Eisner, after more than 20 years on the job.

The hostile offer exposed Comcast's desire to merge content with distribution at a time when most of its industry peers, such as Viacom-CBS and AOL-Time Warner, were doing the opposite.

While Comcast held the title of the nation's leading cable operator by a wide margin, its status as a content player was always second tier, with middling networks like E!, G4 and Golf forming the basis of its channel portfolio.

The NBC deal gave the Philadelphia-based cable operator the cable industry's top-rated entertainment network, USA, its leading business network CNBC, upstart news network MSNBC and Bravo, among others.

For GE, the sale culminates a long-planned exit from the entertainment business.

Since reaching the deal to sell its majority stake in NBC Universal, GE officials have made clear that they eventually planned to exit the entertainment business entirely.

The initial sale contract gave GE the option to sell back as much as all its remaining stake in NBC Universal by mid-2014.

The company's accelerated share buyback could be an answer to shareholders, who have wondered what GE would do with a cash windfall that could total tens of billions of dollars over several years, as the company sold its remaining NBC stake and recouped more profits earned by GE Capital.

COMCAST EARNINGS

In addition to the GE deal, Comcast reported fourth-quarter earnings on Tuesday.

It posted $15.94 billion in revenue, up 6 percent from a year ago. It posted net income of $1.8 billion, or 56 cents per share, up from $1.56 billion, or 47 cents a year ago.

In its cable business, it lost a net 7,000 video customers, which is better than the 17,000 subscribers lost a year ago.

Wall Street analysts were expecting Comcast to lose 5,000 customers, according to StreetAccount. It added 341,000 Internet customers in the quarter, which beat the 329,000 new customers analysts were expecting.

Comcast shares rose to $41.89 after the market close from $38.97 in regular trading. GE shares rose 3 percent to $23.37 from a $22.58 close.

(Reporting by Liana B. Baker, Jennifer Saba and Peter Lauria in New York, Diane Bartz in Washington, Scott Malone in Boston and A. Ananthalakshmi in Bangalore; Writing by Ben Berkowitz; Editing by Dan Grebler)

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North Korea Is Suspected of Conducting 3rd Nuclear Test

Lee Jin-Man/Associated Press

A South Korean watched news reporting about a possible nuclear test conducted by North Korea on a TV screen in Seoul on Tuesday.

WASHINGTON — American and South Korean officials reported seismic activity in North Korea on Tuesday that appeared to be evidence of the country’s third, and long-threatened nuclear test and a new challenge for the Obama administration in its effort to keep the country from becoming a full-fledged nuclear power.

“We believe that North Korea has conducted a nuclear test,” said Kim Min-seok, spokesman of the South Korean Defense Ministry.

The shock appeared to be centered in the same location where the North conducted tests in 2006 and 2009, and the United States Geological Survey said it was only a kilometer underground, all indications consistent with a nuclear blast.

If confirmed, the test would be the first under the country’s new leader, Kim Jong-un, and an open act of defiance to the Chinese, who urged the young leader not to risk open confrontation by setting off the weapon. Just in the past few days a Chinese newspaper that is often reflective of the government’s thinking said the North must “pay a heavy price” if it proceeded with the test.

But past United Nations Security Council sanctions have not deterred the country from accelerating its missile and nuclear programs. And recent actions, including a successful missile test nearly two months ago that reached as far as the Philippines and sent a washing-machine sized satellite into space have dashed hopes that the country’s Swiss-educated new leader might be willing to focus on economic reform rather than pursuing the path taken by his father and grandfather: open defiance of the country’s adversaries.

The Obama administration has already threatened to take additional action to penalize the North if it conducts a test, through the United Nations. But the fact is that there are few sanctions left to apply against the most unpredictable country in Asia. The only penalty that would truly hurt the North would be a cutoff of oil and other aid from China. And until now, despite issuing warnings, the Chinese have feared instability and chaos in the North more than its growing nuclear and missile capability, and the Chinese leadership has refused to participate in sanctions.

Mr. Kim, believed to be about 29, appears betting that even a third test would not change the Chinese calculus.

It may take days or weeks to determine if the test, if that is what it proves to be, was successful. But American officials will also be looking for signs of whether the North, for the first time, conducted a test of a uranium weapon, based on a uranium enrichment capability it has been pursuing for a decade. The past two tests used plutonium, reprocessed from one of the country’s now-defunct nuclear reactors. While the country only has enough plutonium for a half-dozen or so bombs, it can produce enriched uranium well into the future.

No country is more interested in the results of the North’s nuclear program, or the Western reaction, than Iran, which is pursuing its own uranium enrichment program. The two countries have long cooperated on missile technology, and many intelligence officials believe they share nuclear knowledge as well, though so far there is no hard evidence. The Iranians are also pursuing uranium enrichment, and one senior American official said two weeks ago that “it’s very possible that the North Koreans are testing for two countries.” Some believe that the country may have been planning two simultaneous tests, but it could take time to sort out the data.

The timing of the test, if that is what it was, is critical. It comes just as a transition of power is about to take place in South Korea, and the North detested the South’s hard-line outgoing president, Lee Myung-bak. By conducting a test just before he leaves office, the North could be both sending a message and giving his successor, Park Guen-Hye, the chance to restore relations after the breach a test will undoubtedly cause.

Western officials considered the country’s first nuclear test, in 2006, a fizzle, but the next one in 2009 was judged more successful. It may take outside experts days or weeks to determine if the latest blast moved the program to a “higher level,” as Pyongyang recently promised, allowing it to improve, or even expand, an arsenal that intelligence experts say includes enough plutonium for roughly 6 to 10 nuclear bombs.

David E. Sanger reported from Washington, and Choe Sang-hun reported from Seoul, South Korea.

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It's a Girl for John Cho

Mom & Babies
Celebrity Baby Blog

02/11/2013 at 06:30 PM ET

Paul Drinkwater/NBC

Surprise: Actor John Cho is a dad again!

The Go On star and his wife welcomed a daughter recently, Cho’s rep confirms to PEOPLE exclusively.

Baby girl is the second child for the couple, who are also parents to a son. No further details are available.

Cho currently stars alongside Jason Bateman in Identity Thief and will reprise his role as Hikaru Sulu in Star Trek Into Darkness in May.

He is also well known for his roles in American Pie and the Harold and Kumar films.

– Anya Leon with reporting by Julie Jordan

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Pope shows lifetime jobs aren't always for life

The world seems surprised that an 85-year-old globe-trotting pope who just started tweeting wants to resign, but should it be? Maybe what should be surprising is that more leaders his age do not, considering the toll aging takes on bodies and minds amid a culture of constant communication and change.

There may be more behind the story of why Pope Benedict XVI decided to leave a job normally held for life. But the pontiff made it about age. He said the job called for "both strength of mind and body" and said his was deteriorating. He spoke of "today's world, subject to so many rapid changes," implying a difficulty keeping up despite his recent debut on Twitter.

"This seemed to me a very brave, courageous decision," especially because older people often don't recognize their own decline, said Dr. Seth Landefeld, an expert on aging and chairman of medicine at the University of Alabama at Birmingham.

Age has driven many leaders from jobs that used to be for life — Supreme Court justices, monarchs and other heads of state. As lifetimes expand, the woes of old age are catching up with more in seats of power. Some are choosing to step down rather than suffer long declines and disabilities as the pope's last predecessor did.

Since 1955, only one U.S. Supreme Court justice — Chief Justice William Rehnquist — has died in office. Twenty-one others chose to retire, the most recent being John Paul Stevens, who stepped down in 2010 at age 90.

When Thurgood Marshall stepped down in 1991 at the age of 82, citing health reasons, the Supreme Court justice's answer was blunt: "What's wrong with me? I'm old. I'm getting old and falling apart."

One in 5 U.S. senators is 70 or older, and some have retired rather than seek new terms, such as Hawaii's Daniel Akaka, who left office in January at age 88.

The Netherlands' Queen Beatrix, who just turned 75, recently said she will pass the crown to a son and put the country "in the hands of a new generation."

In Germany, where the pope was born, Chancellor Angela Merkel, who is 58, said the pope's decision that he was no longer fit for the job "earns my very highest respect."

"In our time of ever-lengthening life, many people will be able to understand how the pope as well has to deal with the burdens of aging," she told reporters in Berlin.

Experts on aging agreed.

"People's mental capacities in their 80s and 90s aren't what they were in their 40s and 50s. Their short-term memory is often not as good, their ability to think quickly on their feet, to execute decisions is often not as good," Landefeld said. Change is tougher to handle with age, and leaders like popes and presidents face "extraordinary demands that would tax anybody's physical and mental stamina."

Dr. Barbara Messinger-Rapport, geriatrics chief at the Cleveland Clinic, noted that half of people 85 and older in developed countries have some dementia, usually Alzheimer's. Even without such a disease, "it takes longer to make decisions, it takes longer to learn new things," she said.

But that's far from universal, said Dr. Thomas Perls, an expert on aging at Boston University and director of the New England Centenarians Study.

"Usually a man who is entirely healthy in his early 80s has demonstrated his survival prowess" and can live much longer, he said. People of privilege have better odds because they have access to good food and health care, and tend to lead clean lives.

"Even in the 1500s and 1600s there were popes in their 80s. It's remarkable. That would be today's centenarians," Perls said.

Arizona Sen. John McCain turned 71 while running for president in 2007. Had he won, he would have been the oldest person elected to a first term as president. Ronald Reagan was days away from turning 70 when he started his first term as president in 1981; he won re-election in 1984. Vice President Joe Biden just turned 70.

In the U.S. Senate, where seniority is rewarded and revered, South Carolina's Strom Thurmond didn't retire until age 100 in 2002. Sen. Robert Byrd of West Virginia was the longest-serving senator when he died in office at 92 in 2010.

Now the oldest U.S. senator is 89-year-old Frank Lautenberg of New Jersey. The oldest congressman is Ralph Hall of Texas who turns 90 in May.

The legendary Alan Greenspan was about to turn 80 when he retired as chairman of the Federal Reserve in 2006; he still works as a consultant.

Elsewhere around the world, Cuba's Fidel Castro — one of the world's longest serving heads of state — stepped down in 2006 at age 79 due to an intestinal illness that nearly killed him, handing power to his younger brother Raul. But the island is an example of aged leaders pushing on well into their dotage. Raul Castro now is 81 and his two top lieutenants are also octogenarians. Later this month, he is expected to be named to a new, five-year term as president.

Other leaders who are still working:

—England's Queen Elizabeth, 86.

—Abdullah bin Abd al-Aziz al-Saud, king of Saudi Arabia, 88.

—Sabah al-Ahmad al-Jaber al-Sabah, emir of Kuwait, 83.

—Ruth Bader Ginsburg, U.S. Supreme Court associate justice, 79.

__

Associated Press writers Paul Haven in Havana, Cuba; David Rising in Berlin; Seth Borenstein, Mark Sherman and Matt Yancey in Washington, and researcher Judy Ausuebel in New York contributed to this report.

___

Marilynn Marchione can be followed at http://twitter.com/MMarchioneAP

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Yen near fresh lows versus dollar, Asian shares steady

TOKYO (Reuters) - The yen hovered near fresh lows against the dollar and Tokyo stocks jumped back near a 33-month high on Tuesday after markets took comments from a U.S. official as giving Japan the green light to pursue policies that weaken the yen as long as they help beat deflation.

Asian shares were steady, with many regional bourses shut for holidays. Encouraging trade data from China late last week was lending support but non-Japan markets lacked momentum as investors awaited key events such as the U.S. president's State of the Union address for trading cues.

While Japan has faced some criticism from German and other European officials that it is intentionally trying to weaken the yen with monetary easing, rhetoric about a so-called currency war was dialled back ahead of a Group of 20 meeting in Moscow on Friday and Saturday.

U.S. Treasury Undersecretary Lael Brainard said on Monday the United States supports Japanese efforts to end deflation. But she also mentioned that the G7 has long committed to exchange rates determined by market forces, "except in rare circumstances where excess volatility or disorderly movements might warrant cooperation.

European Central Bank council member Jens Weidmann also said the euro was not overvalued at current levels.

The dollar was trading at 94.22 yen after marking on Monday its highest level since May 2010 of 94.465. The euro was trading at 126.28 yen after the yen fell 2 percent against the euro on Monday, pushing it back towards 127.71 yen hit last week, its highest level since April 2010.

"I think the yen's weakening is a function of (playing)catch-up," and not Japan resorting to deliberate devaluation of its currency, said Andrew Wilkinson, chief economic strategist at Miller Tabak & Co. in New York.

"It's the market's way of saying: we're convinced there is a movement afoot to reinflate Japan."

The weaker yen in turn helped bolster sentiment for Japanese stocks, sending the Nikkei average <.n225> 2.6 percent higher. <.t/>

"While currency moves have been sensitive to officials' comments in general, people thought any comment from the G20 would trigger yen buying," said Hiroichi Nishi, an assistant general manager at SMBC Nikko Securities.

"But such worries are receding as she (Brainard) said she supports Japan's efforts to end deflation."

The yen is expected to stay under pressure on expectations that Prime Minister Shinzo Abe will endorse a far more dovish Bank of Japan regime when the current leadership's term ends next month. The BOJ is expected to refrain from taking fresh easing steps when it meets this week.

The MSCI's broadest index of Asia-Pacific shares outside Japan <.miapj0000pus> was little changed. Australian shares inched up 0.1 percent led by financials, as investors waited for corporate earnings results.

Trading resumed in Japan and South Korea but markets remained closed in Singapore, Hong Kong, mainland China, Malaysia and Taiwan.

G20 officials said on Monday the Group of Seven nations are considering a statement this week reaffirming their commitment to "market-determined" exchange rates.

Currency and equities markets were also looking ahead to President Barack Obama's State of the Union address later on Tuesday, for any signs of a deal to avert automatic spending cuts due to take effect on March 1.

"We believe that the G20's take on currency wars, Mr. Obama's upcoming state of the union address, and data on the current condition of the US economy should help markets assess where the global recovery stands and where we are heading," Barclays Capital said in a research report.

Wall Street and world equity markets were little changed in light volume on Monday as a lack of major economic news gave investors little incentive to push prices higher after a robust performance last week.

U.S. and Chinese data last week lifted the tech-focused Nasdaq Composite Index <.ixic> to a 12-year closing high and the Standard & Poor's 500 Index <.spx> to a five-year peak on Friday.

U.S. crude futures edged down 0.2 percent to $96.88 a barrel while Brent steadied around $118.12.

Spot gold stayed near a one-month low.

(Additional reporting by Ayai Tomisawa and Lisa Twaronite in Tokyo; Editing by Edwina Gibbs)

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Rome Journal: Itavia Flight 870 Ruling Adds Support to a Theory

Emiliano Grillotti/Associated Press

A police officer near Rome guarded the reconstructed wreckage of Itavia Flight 870, in 2003.

ROME — Itavia Flight 870 was entering the final leg of a routine domestic trip from Bologna, Italy, to Palermo, Sicily, one clear summer evening when it suddenly plunged into the Tyrrhenian Sea near the small island of Ustica, killing all 81 people aboard.

Mechanical failure was ruled out early on, and almost 33 years later, the causes that led to the crash on June 27, 1980, are still a topic of passionate debate in Italy, fueled by three decades of inquiry boards, parliamentary commissions, countless expert reports and one of the longest judicial inquiries in recent Italian history. But despite all that, no formal charges have ever been filed in connection with the crash.

The crash, known as the Ustica affair, has produced legions of conspiracy theories here, the way the Kennedy assassination — or, on a lesser scale, the crash of TWA Flight 800 off Long Island in 1996 — have in the United States. But in the Ustica affair, the case for a cover-up is far stronger.

Last week, when Italy’s highest court ruled that the country’s Defense and Transportation Ministries had to compensate the families of some of the victims, the court implicitly acknowledged the most widely accepted theory behind the crash: that a missile fired by a warplane had hit the twin-engine McDonnell Douglas DC-9 on Itavia, a now-defunct domestic Italian airline. But the court did not say where that missile came from.

To conspiracy buffs, it was vindication — to a point.

“It’s like the O. J. Simpson affair, where he got off in criminal court but was found guilty in a civil procedure and had to pay damages,” said Andrea Purgatori, an investigative reporter whose exhaustive book on the disaster and the presumed cover-up was made into a 1992 film.

Over the years, several Air Force officials have been investigated for withholding evidence — wiping clean flight tracks and radar scans — and four generals were tried on charges of treason and obstructing investigations. But no one has been convicted.

In this hothouse atmosphere, it is not surprising that conspiracy theories have proliferated over the years. The crash has been blamed on U.F.O.’s (several Web sites subscribe to this reconstruction) or domestic terrorism (the Bologna train station was bombed not five weeks later, killing 85 and wounding dozens more). In this scenario, the plane went down after a bomb exploded onboard, most likely in the toilet.

The missile theory gained a new impetus in 2008 when Francesco Cossiga, the prime minister at the time of the Ustica affair, said in an interview that the flight had been shot down by French military planes. Mr. Cossiga did not provide further details, nor can he. He died in 2010, at age 82.

Cover-up theories have been fueled through the years by what news reports have described as a “suspiciously high mortality” among military personnel and others connected to the case. (Mr. Cossiga is not included among them.)

Through traffic accidents, shooting deaths and suicides by hanging, there were 36 untimely deaths by 2011, according to a television report about Ustica. The program also cited a number of “bizarre accidents” that befell Ustica witnesses, like being run over by a tricycle and slipping on a banana peel in a Rome subway station.

“What terrifying truth warranted a cover-up at the cost of the lives of all these people?” asked the show’s host, Adam Kadmon, who plays a mysterious masked vigilante who investigates topics like Ustica, underskin microchip implants and, more recently, Michael Jackson’s prophecy about Sept. 11, and favors the French missile theory.

At the time, proponents say, Italy was covertly allowing Libyan aircraft to fly through its airspace undisturbed. They did so by gliding in the slipstream of Italian domestic aircraft, where they could not be detected by radar. On the night of June 27, 1980, there were unsubstantiated reports that Col. Muammar el-Qaddafi was on one of those planes, the theory goes, and French forces tried to shoot it down to kill the Libyan leader, but hit the DC-9 by mistake. Don’t ask why. It has to do with rebels in North Africa and jockeying for oil concessions between Italy and France.

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Relive All the Grammy One-Liners & Tweets

01/04/2011 at 10:00 AM EST

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After early start, worst of flu season may be over

NEW YORK (AP) — The worst of the flu season appears to be over.

The number of states reporting intense or widespread illnesses dropped again last week, and in a few states there was very little flu going around, U.S. health officials said Friday.

The season started earlier than normal, first in the Southeast and then spreading. But now, by some measures, flu activity has been ebbing for at least four weeks in much of the country. Flu and pneumonia deaths also dropped the last two weeks, the Centers for Disease Control and Prevention reported.

"It's likely that the worst of the current flu season is over," CDC spokesman Tom Skinner said.

But flu is hard to predict, he and others stressed, and there have been spikes late in the season in the past.

For now, states like Georgia and New York — where doctor's offices were jammed a few weeks ago — are reporting low flu activity. The hot spots are now the West Coast and the Southwest.

Among the places that have seen a drop: Lehigh Valley Hospital-Cedar Crest in Allentown, Pa., which put up a tent outside its emergency room last month to help deal with the steady stream of patients. There were about 100 patients each day back then. Now it's down to 25 and the hospital may pack up its tent next week, said Terry Burger, director of infection control and prevention for the hospital.

"There's no question that we're seeing a decline," she said.

In early December, CDC officials announced flu season had arrived, a month earlier than usual. They were worried, saying it had been nine years since a winter flu season started like this one. That was 2003-04 — one of the deadliest seasons in the past 35 years, with more than 48,000 deaths.

Like this year, the major flu strain was one that tends to make people sicker, especially the elderly, who are most vulnerable to flu and its complications

But back then, that year's flu vaccine wasn't made to protect against that bug, and fewer people got flu shots. The vaccine is reformulated almost every year, and the CDC has said this year's vaccine is a good match to the types that are circulating. A preliminary CDC study showed it is about 60 percent effective, which is close to the average.

So far, the season has been labeled moderately severe.

Like others, Lehigh Valley's Burger was cautious about making predictions. "I'm not certain we're completely out of the woods," with more wintry weather ahead and people likely to be packed indoors where flu can spread around, she said.

The government does not keep a running tally of flu-related deaths in adults, but has received reports of 59 deaths in children. The most — nine — were in Texas, where flu activity was still high last week. Roughly 100 children die in an average flu season, the CDC says

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

According to the CDC report, the number of states with intense activity is down to 19, from 24 the previous week, and flu is widespread in 38 states, down from 42.

Flu is now minimal in Florida, Kentucky, Maine, Montana, New Hampshire and South Carolina.

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Online:

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

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