Flu shot did poor job against worst bug in seniors

ATLANTA (AP) — For those 65 and older, this season's flu shot is only 9 percent effective against the most common and dangerous flu bug, according to a startling new government report.

Flu vaccine tends to protect younger people better than older ones and never works as well as other kinds of vaccines. But experts say the preliminary results for seniors are disappointing and highlight the need for a better vaccine.

For all age groups, the vaccine's effectiveness is moderate at 56 percent, which is nearly as well as other flu seasons, the Centers for Disease Control and Prevention said Thursday.

For those 65 and older, it is 27 percent effective against the three strains in the vaccine, the lowest in about a decade but not far below from what's expected. But the vaccine did a particularly poor job of protecting older people against the harshest flu strain, which is causing most of the illnesses this year. CDC officials say it's not clear why.

Vaccinations are now recommended for anyone over 6 months, and health officials stress that some vaccine protection is better than none at all. While it's likely that older people who were vaccinated are still getting sick, many of them may be getting less severe symptoms.

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

To be sure, the preliminary data for seniors is less than definitive. It is based on fewer than 300 people scattered among five states.

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

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

This flu season started in early December, a month earlier than usual, and peaked by the end of year. Older people are most vulnerable to flu and its complications, and the nation has seen some of the highest hospitalization rates for people 65 and older in a decade.

Flu viruses tend to mutate more quickly than others, and it's not unusual for multiple strains to be spreading at the same time. A new vaccine is formulated each year targeting the three strains expected to be the major threats. But that involves guesswork.

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

By that standard, this year's vaccine is OK. The 56 percent effectiveness figure means people have a 56 percent lower chance of winding up at the doctor for treatment of flu symptoms.

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

Older people have weaker immune systems that don't respond as well to flu shots. That's why a high-dose version was recently made available for those 65 and older. The new study was too small to show whether that made a difference this year.

The CDC estimates are based on about 2,700 people who got sick in December and January. The researchers traced back to see who had gotten flu shots and who hadn't. An earlier study put the vaccine's overall effectiveness slightly higher, at 62 percent.

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

The new data highlights an evolution in how experts are evaluating flu vaccine effectiveness. For years, it was believed that if the viruses in the vaccine matched the ones spreading around the country, then the vaccine would be effective. This year's shot was a good match to the bugs going around this winter, including the harsher H3N2 that tends to make people sicker.

But the season proved to be a moderately severe one, with many illnesses occurring in people who'd been vaccinated.

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Online:

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

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Doctor sexually assaulted unconscious patients, police say

An Orange County anesthesiologist convicted of sexually assaulting three unconscious female patients  has been sentenced to six months in jail and five years probation, despite the objections of prosecutors who wanted state prison time.

Yashwant Balgiri Giri, 60, pleaded guilty to a court offer to multiple felony counts related to the sexual battery of patients, including a 16-year-old, according to a statement from the Orange County district attorney's office.

Giri will have to register as a lifetime sex offender and will have his medical license revoked, in addition to the jail time and probation.

Prosecutors sought a state prison sentence, citing a violation of his "position of power and trust" with the women at a particularly vulnerable time.

Giri, who lives in Cypress, was working at Placentia-Linda Hospital at the time of the crimes, prosecutors said. He previously worked at several hospitals in Anaheim and Lakewood.

Through a spokeswoman, Placentia-Linda Hospital declined to comment.

Prosecutors said that in February 2009,  while a 16-year-old was unconscious from medication, Giri assaulted the girl when a scrub nurse preparing surgery tools had her back turned. The nurse witnessed the assault, prosecutors said, and reported it immediately to a hospital official.

Prosecutors allege that the hospital did not report the incident to police at the time.

In March 2011, prosecutors said, a hospital employee witnessed Giri fondling the breasts of a 36-year-old woman while she was under anesthesia for an outpatient surgery procedure.

An employee allegedly witnessed the incident  Prosecutors said the fondling continued for an extended period of time, as his actions were concealed from the surgeon and nurse.

The alleged assault was reported to a hospital official and then to Placentia police, prosecutors said.

Soon after an investigation began, Giri resigned from his duties at the hospital.

After he was arrested in May 2011, a third alleged victim stepped forward, saying she had been assaulted by Giri.

In April 2010, prosecutors said, Giri assaulted a 27-year-old woman while she was being put under anesthesia but before she was unconscious. Prosecutors said he touched the woman under the pretense of performing an examination, although it had no legitimate medical purpose.

During a sentencing hearing, a statement from the then-36-year-old woman, who was fondled, was read by prosecutors.

"His actions make me question every single doctor, nurse, medical decision and procedure I encounter within my everyday life," she said. "I not only fear for myself, I fear for my child, my friends, my family. This is a burden caused by the perverted actions of this predator."

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-- Rick Rojas

Photo: Yashwant Balgiri Giri. Credit: Orange County district attorney's office.

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Former Lebanon Minister and Syrian Co-Defendant Could Face Death Penalty

BEIRUT, Lebanon — A Lebanese military court judge on Wednesday charged a former government information minister and his suspected Syrian accomplice of a conspiracy to kill Lebanese political and religious leaders and foment sectarian strife, recommending the death penalty for both.

The announcement about the defendants, Michel Samaha, the former minister, and Mr. Mamlouk, a Syrian security official, came amid increased sectarian tensions in Lebanon that are directly tied to the nearly two-year-old conflict in neighboring Syria, which occupied Lebanon for nearly three decades until 2005 and still deeply polarizes Lebanese politics.

Lebanese officials have said explosives were found in a car belonging to Mr. Samaha, who was arrested on Aug. 9. Mr. Mamlouk was accused of plotting with Mr. Samaha to transport the explosives into the country. An arrest warrant for Mr. Mamlouk was issued this month. His whereabouts is unclear.

It also was unclear how long a trial would last or whether the judge’s recommendations of punishment would be followed if the pair were found guilty. But the Lebanese government’s handling of the politically sensitive case carries its own risks of aggravating sectarian tensions in this country.

On Tuesday, a group claiming to represent a faction of Syrian rebels threatened to lob mortar shells into Lebanon to attack Hezbollah, the Shiite militia that is also Lebanon’s most powerful political party, in retaliation for what rebels say is a Hezbollah military campaign against rebels in Syria. The statement warned Lebanese citizens, especially in the Shiite, pro-Hezbollah border town of Hermel, to stay away from Hezbollah positions that it said were shelling the rebels across the border.

A cross-border skirmish between Hezbollah and Syrian rebels could be a dangerous escalation in Lebanon, which has struggled to stay out of the conflict in Syria.

Representatives of the main group of rebel fighters, the Free Syrian Army, issued conflicting statements, with one saying the threat was a provocation fabricated by Hezbollah, and another confirming it and giving Hezbollah 48 hours to end its attacks or face retaliation.

Hezbollah is closely allied to the Syrian government, while its Sunni rivals in Lebanon largely support the majority Sunni rebels. Rebels say Hezbollah has stepped up its military activity inside Syria, taking over numerous villages near the border. Hezbollah says its fighters have been active only in Syrian villages where Lebanese citizens live and are defending themselves.

With the Syrian conflict threatening to destabilize the region, Russia’s foreign minister said on Wednesday that his country would work with the Arab League to bring about direct talks between Syria’s government and the armed opposition in a bid to end the deadly civil war.

Speaking after a meeting with Arab League officials in Moscow, the minister, Sergey V. Lavrov, told reporters there were “signs of tendencies for dialogue from both the side of the government and the opposition,” Agence France-Presse reported.

Russia has long called for a political solution, but Mr. Lavrov’s statement seemed to indicate a new level of engagement in pushing for talks. Syria’s foreign minister, Walid al-Moallam, is scheduled to visit Moscow on Monday for talks, and the president of Syria’s main opposition coalition, Moaz al-Khatib, is expected to visit Moscow in March, Mr. Lavrov said.

Yet it is unclear whether Mr. Moallem and Mr. Khatib have the full backing of their own sides for talks. Mr. Khatib’s group, the National Coalition of Syrian Revolution and Opposition Forces, insists that it will speak only with members of Mr. Assad’s government without “blood on their hands.” Lakhdar Brahimi, the special Syria peace envoy representing the United Nations and the Arab League, has appeared to support Mr. Khatib’s position, calling on the government to send an “acceptable delegation.”

But on Wednesday, Mr. Lavrov said that the two sides should not impose preconditions or “say that I am going to talk to this person but not that one.” He was speaking after a meeting of the Russia-Arab Forum from which the representatives of the rebels’ main Arab backers, Saudi Arabia and Qatar, were absent.

In Syria on Wednesday, rebel shells appeared to reach new areas in Damascus, activists and witnesses reported. Goran Tomasevic, a photographer for The Associated Press who has recently produced images of fighting in the Damascus suburbs as one of the few foreign journalists with rebel fighters there, described a deadly stalemate between two well-coordinated fighting forces that he said was reminiscent of wars that gutted cities like Sarajevo and Stalingrad.

“Rebel fighters in Damascus are disciplined, skilled and brave,” he wrote in an account published on Wednesday. “In a month on the front-line, I saw them defend a swath of suburbs in the Syrian capital, mount complex mass attacks, manage logistics, treat their wounded.”

But, he added, “as constant, punishingly accurate, mortar, tank and sniper fire attested,” government soldiers, often fighting at close range, “are also well drilled, courageous — and much better armed.”

Both state media and opposition activists reported on Wednesday that mortar rounds had hit the Tishreen sports stadium in the downtown neighborhood of Baramkeh. The state news agency, SANA, said the explosion killed an athlete from the Homs-based Al Wathba soccer team as he was practicing.

Government forces hit a rebel command center in a suburb east of the capital on Wednesday, injuring a founder of the Liwaa al-Islam brigade, Sheik Zahran Alloush, the brigade said in a statement.

It said the attack “won’t stop or weaken the will of the battalion” and asked for “God’s help to reach the criminals for retribution.”

Hania Mourtada and Hwaida Saad contributed reporting.

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Sean Lowe: Tierra Made Me Feel Like 'Such a Fool'

TV Watch

The Bachelor

02/20/2013 at 12:15 PM EST

Sean Lowe and Tierra on The Bachelor

No regrets? Not so fast.

In his PEOPLE.com blog, The Bachelor's Sean Lowe has written about how he never saw Tierra LiCausi behaving badly – despite what the other women told him about the controversial contestant, who is now engaged.

But after watching, Sean realized the women were right.

"Man, I was such a fool," Sean, told host Chris Harrison on Sean Tells All special Tuesday night. "I really do feel like I was duped."

In fact, Sean, 28, who had an immediate connection with Tierra, says he never should have met her that first night.

"Tierra never should have come on this show. She's not suited for this show," he said. "She doesn't know how to handle herself in this environment. She's a woman who ... simply can't get along with her peers."

Not only did Tierra waste his time, Sean says, he witnessed her "getting into arguments and fights with the sweetest, best people in the house."

But no one may be more upset about Tierra than the women who was sent home instead of Tierra, Jackie Parr, on a two-on-one date in Montana.

I wouldn't have kept [Tierra]," Sean said on Tuesday's special. "I wish I would have kept Jackie on the two-on-one."

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Drug overdose deaths up for 11th consecutive year

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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Stobbe reported from Atlanta.

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Online:

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

CDC: http://www.cdc.gov

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

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Tourist's body found stuffed in hotel water tank; guest horrified

There were few details Wednesday on how the body of a missing Canadian tourist ended up at the bottom of a water tank on the roof of a downtown hotel.

For days, residents of the Cecil Hotel thought something was amiss. At least one said there was flooding in one of the fourth-floor rooms, while others complained about weak water pressure.
One of those complaints led a hotel maintenance worker to check Tuesday on one of the large metal water cisterns on the roof, where he discovered the body of an unidentified woman in her 20s at the bottom of the tank.

Authorities said late Tuesday the body was that of Elisa Lam, 21, a Vancouver, Canada, woman last seen at the hotel Jan. 31.

"We're not ruling out foul play," said LAPD Sgt. Rudy Lopez, noting that the location of the remains "makes it suspicious."

Los Angeles police investigators searched the roof of the Cecil with the aid of dogs when Lam was reported missing about three weeks ago. Lopez said he didn't know if the tanks were examined.

"We did a very thorough search of the hotel," he said. "But we didn't search every room; we could only do that if we had probable cause" that a crime had been committed.

Once a destination for the rich and famous in the 1930s and '40s, the Cecil has gradually deteriorated, mirroring the decay of downtown Los Angeles, particularly in the skid row area. With rock-bottom rents and flexible stays, the historic 1927 building attracted those who were a step away from homelessness.

The Cecil also became a magnet for criminal activity. Most notably it was the occasional home to infamous serial killers Jack Unterweger and Richard "Night Stalker" Ramirez. Even after a multimillion-dollar makeover in 2008, police said they frequently respond to the Cecil for calls relating to domestic abuse and narcotics.

In 2010, the hotel was the scene of a bizarre incident in which a Los Angeles city firefighter who had been honored as paramedic of the year said he was stabbed while responding to a distress call. But police found inconsistencies in the story and no assailant was ever located.

On Tuesday, the Cecil grappled with a deeper mystery.
According to detectives with the LAPD's Robbery-Homicide Division, Lam came to Los Angeles from Vancouver on Jan. 26. While they did not discuss her exact movements or whether she visited anyone here, they believe her ultimate destination was Santa Cruz. Lam's reasons for visiting California were unclear, detectives said.

She was last seen Jan. 31 inside the elevator of the hotel. In surveillance footage, Lam is seen pushing buttons for multiple floors and at one point stepping out of the elevator, waving her arms.
A cause of death is still to be determined by county coroner’s officials, Lopez said.

A locked door that only employees have access to and a fire escape are the only ways to get to the roof. The door is equipped with an alarm system that notifies  hotel personnel if someone is up there, Lopez said.

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India Ink: Image of the Day: Feb. 19

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Serve Up Dinner Straight from the South Beach Wine & Food Festival

02/19/2013 at 12:05 PM EST

Carrot Lemon Thyme Sorbet and Executive Chef Hector Morales's Gazpacho

Come Thursday, there will be plenty of familiar faces heating up Miami Beach. And we mean in the kitchen.

As celeb chefs such as Bobby Flay, Paula Deen and Rachael Ray flock to the South Beach Wine & Food Festival presented by FOOD & WINE, you, too, can get a taste of the festivities, which run through the weekend. And you don't even have to leave your kitchen – just follow these recipes.

Carrot Lemon Thyme Sorbet

From Restaurant: Impossible chef Robert Irvine, who will be serving up his sorbet at the Whole Foods Market Grand Tasting Village

• 1 tbsp. lemon zest
• 1 cup carrot juice
• 1 cup water
• ¾ cup granulated sugar
• 1 tsp. thyme (minced)
• 1 cup fresh lemon juice
• ¾ cup sparkling water
Over medium high heat, bring water, juice, lemon zest, mint and sugar to a boil. Once boiling, reduce heat to medium, and simmer for additional 10 minutes. Then remove from heat and pour through chamois; let cool. Next, in a bowl, add prepared syrup and sparkling water. Finish in an ice cream machine.

Executive Chef Hector Morales's Gazpacho

Grab a cup from Badia Spices

• 4 large beefsteak tomatoes
• 1 pint orange juice
• 1 pint tomato juice
• 3 red peppers (cleaned, seeded and chopped)
• 1 green pepper (cleaned, seeded and chopped)
• 1 large cucumber (peeled and seeded, cut in cubes)
• 1 medium onion (peeled and diced)
• 2 cloves garlic (roasted and chopped; rub with olive oil before roasting)
• 2 pieces of celery (chopped)
• 2 tsp. sea salt (recipe recommends Badia's)
• ¾ cup extra-virgin olive oil (recipe recommends Badia's)
• ¼ cup apple cider vinegar
• cayenne pepper to taste
Rub tomatoes with extra-virgin olive oil, and sprinkle with sea salt. Roast in a 400ºF oven until skin starts to come off. Let cool and peel the skins; chop the tomatoes.

Mix all ingredients together in a blender and purée until smooth.

Chef Curtis Stone's Cocktail

Chef Curtis Stone's Cocktail

The Aussie chef will host Moët Hennessy's The Q After Dark at the fest

• 2 oz. vodka (recipe recommends Belvedere)
• ¾ oz. fresh lemon juice
• ¾ oz. simple syrup
Shake and strain over cubed ice into a rocks glass. Garnish with a wedge of lemon.

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UK patient dies from SARS-like coronavirus

LONDON (AP) — A patient being treated for a mysterious SARS-like virus has died, a British hospital said Tuesday.

Queen Elizabeth Hospital in Birmingham, central England, said the coronavirus victim was also being treated for "a long-term, complex unrelated health problem" and already had a compromised immune system.

A total of 12 people worldwide have been diagnosed with the disease, six of whom have died.

The virus was first identified last year in the Middle East. Most of those infected had traveled to Qatar, Saudi Arabia, Jordan or Pakistan, but the person who just died is believed to have caught it from a relative in Britain, where there have been four confirmed cases.

The new coronavirus is part of a family of viruses that cause ailments including the common cold and SARS. In 2003, a global outbreak of SARS killed about 800 people worldwide.

Health experts still aren't sure exactly how humans are being infected. The new coronavirus is most closely related to a bat virus and scientists are considering whether bats or other animals like goats or camels are a possible source of infection.

Britain's Health Protection Agency has said while it appears the virus can spread from person to person, "the risk of infection in contacts in most circumstances is still considered to be low."

Officials at the World Health Organization said the new virus has probably already spread between humans in some instances. In Saudi Arabia last year, four members of the same family fell ill and two died. And in a cluster of about a dozen people in Jordan, the virus may have spread at a hospital's intensive care unit.

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Four dead in O.C.: No motive yet in slaying, deadly carjackings

Orange County sheriff's officials said they don't know what prompted a series of shootings across multiple cities early Tuesday morning that left at least four people dead and others wounded.

Authorities believe the violence began in Ladera Ranch, south of Mission Viejo.

The first call came at 4:45 a.m. reporting a shooting on Red Leaf Lane, where deputies discovered a woman shot dead at the scene.

The suspect, described as a man in his 20s, fled the area in an SUV.

MAP: Orange County shootings

Sheriff's Department spokesman Jim Amormino said “multiple incidents” then occurred in Tustin and another at the Santa Ana border before the suspect apparently shot and killed himself in Orange.

“There’s a lot to sort out,” he said.

Tustin Police Lt. Paul Garaven said the suspect attempted to carjack multiple vehicles in Tustin, with  each shooting occurring a few minutes apart.

Police received a report about 5:30 a.m. of a carjacking near Red Hill Avenue and Nisson Road near the 5 Freeway in Tustin, Garaven said.

The carjacking suspect opened fire and wounded a bystander, he said.

Soon after that, another carjacking was reported near the 55 Freeway, Garaven said. The victim of that carjacking was killed, Garaven said. A body lay covered by a yellow tarp on Village Way near the McFadden Avenue freeway entrance.

Another shooting was reported on Edinger Avenue near the Micro Center in Tustin, Garaven said. Officers confirmed that another carjacking had taken place, he said.

One person was killed and another was taken to a hospital. Officers spotted the suspect in a stolen vehicle, followed him into the city of Orange and initiated a traffic stop near the intersection of East Katella Avenue and North Wanda Road, Garaven said.

The suspect then shot and killed himself, Garaven said. Garaven said there is “no threat to the community” because the suspect is deceased.

Bill Myers, who works at Allied Refrigeration at Edinger Avenue in Tustin, said he passed numerous police vehicles on his way to work early Tuesday.

The Micro Center, across the street from Allied Refrigeration, was roped off, and police were at the scene, Myers said.

Myers arrived at work at about 6:20 a.m. and said there was "a bunch of activity going on. It was pretty crazy."  

kate.mather@latimes.com

hailey.branson@latimes.com

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