Pa. VA hospital knew of bacteria problem before death

(CBS News) There's been an outbreak other than the flu at the VA Hospital in Pittsburgh. It raises the question: What do patients have the right to know?

The bacterium that causes the respiratory illness known as Legionnaires' disease was found in the hospital's water system. The hospital and government officials knew about the outbreak but not the patients who were admitted there.

In November, 87-year-old William Nicklas, a Navy veteran, felt nauseated from medication. He went to the Pittsburgh VA hospital. His sons, Bob and Dave Nicklas, weren't particularly concerned.

"He had full trust in the VA," Dave said. "He was loyal to the military, loyal to the treatment he would receive there.It should be the best care in the world."

But in the hospital, he picked up an infection.

"The doctors wanted to meet with us Wednesday night. The family got together, and that's when she told us it was the Legionella bacteria that was the infection," Bob said.

William fought for his life for three days. The day after Thanks giving he was dead. His family thought they would be bringing him home.

What the family didn't know when William checked in was that the Pittsburgh VA had been battling an outbreak of Legionnaires' disease. There were at least four infections before William, and the outbreak had been reported in the hospital's water nearly a year before his death.

The manufacturer of the hospital's Legionella prevention equipment, Liquitech, claims that in December 2011 the Pittsburgh VA told them it had a Legionella problem. In emails, Liquitech wrote the had been made aware of the bacteria and an investigation showed the hospital systems were not being properly maintained.

"If they knew that there was an outbreak at that hospital then you've got two other, you know, world renowned hospitals located directly across the street from the Veterans Hospital," Dave said. "They could have easily transferred those patients so they weren't exposed."

The hospital did report the problem to the county health department and the federal Centers for Disease Control, but it wasn't until two weeks after William was admitted that it went public. It acknowledged that patients had contracted Legionnaire's disease in the hospital. Two weeks later, the hospital announced 24 more were treated there, but the hospital said the origin of 16 of those infections was unknown.

"The facility has worked... to formulate a plan to suppress the Legionella. Testing results indicate remediation... has been successful," Pittsburgh VA said in a statement, declining an interview.

A federal investigation has begun into whether the hospital was prudent in protecting its patients. The hospital said it is under no legal requirement to report Legionnaires' disease cases or outbreaks to the public or its patients. The Nicklas family plans to sue.

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Obama Promises Faster Transition in Afghanistan

President Obama and Afghan President Hamid Karzai said today that most U.S. combat operations in Afghanistan would end this spring, signaling a quickening troop drawdown that will bring the decade-long war to a close at the end of 2014.

"Our troops will continue to fight alongside Afghans when needed, but let me say it as plainly as I can: Starting this spring, our troops will have a different mission -- training, advising, assisting Afghan forces," Obama announced at an East Room news conference in Washington.

"It will be a historic moment and another step toward full Afghan sovereignty, something I know that President Karzai cares deeply about, as do the Afghan people," he said.

Administration officials said Afghan forces were "exceeding initial expectations" in their capabilities. Afghan security forces are expected to lead 90 percent of security operations across the country in February.

"By the end of next year -- 2014 -- the transition will be complete," Obama said. "Afghans will have full responsibility for their security, and this war will come to a responsible end."

The rosy assessments belied the serious political, economic and security challenges that remain.

Left unanswered by Obama and Karzai: How many U.S. troops might stay after 2014; what their mission would be and whether they could be effective; and whether the forces would have immunity from prosecution in Afghan courts.

Charles Dharapak/AP Photo

President Hamid Karzai Addresses Afghan Sovereignty at White House Watch Video

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Afghanistan Troop Surge Ends at Tumultuous Point Watch Video

Obama said he was still reviewing recommendations from the Pentagon and will make an announcement in the coming weeks after penning an anticipated bilateral security agreement with Afghanistan. Karzai said the exact number would be up to the United States to decide.

Both leaders confirmed in a statement that the United States "does not seek permanent bases in Afghanistan."

They also agreed today to turn over battlefield combatants held by the U.S. military in Afghanistan to Afghan government control, which has been long-sought by Karzai.

Roughly 66,000 U.S. troops are serving in Afghanistan. The military has proposed keeping several thousand troops in the country after 2014 as advisers, trainers and logistical support for Afghan forces; the White House has said it remains open to pulling out all troops entirely.

Obama's visit with Karzai was the first face-to-face encounter since the November election and since last year's dramatic increase in so-called green-on-blue attacks, when U.S. and NATO soldiers have been killed by the Afghans they are training or working alongside.

There were 45 insider attacks in 2012 that resulted in 62 deaths among coalition forces, including 35 Americans. There has been one attack already in the first 11 days of 2013.

The White House summit included a private Oval Office meeting between Obama, Karzai and Vice President Joe Biden. The trio also attended a private lunch in the Old Family Dining Room.

Karzai Thursday attended meetings with Defense Secretary Leon Panetta and top military brass at the Pentagon, where he was afforded all the pomp and circumstance accorded a head of state: a 21-gun salute, and marching bands and honor guards from the Army, Navy, Air Force, Marines and Coast Guard.

Karzai's relationship with the United States has at times been a rocky one as he has sometimes made critical statements about the allied troop presence in his country. U.S. officials believe he has made those comments out of political expediency to improve his standing with Afghans and show his independence.

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Muscle mimic pulls electricity from wet surface

Electricity has been squeezed from a damp surface for the first time, thanks to a polymer film that curls up and moves – a bit like an artificial muscle – when exposed to moisture. The film could be used to run small, wearable devices on nothing but sweat, or in remote locations where conventional electricity sources aren't available.

When a dry polymer absorbs water, its molecular structure changes. This can, in principle, be converted into larger-scale movement, and in turn electricity. But previous attempts at creating a material powered by a moisture gradient – the difference in chemical potential energy between a wet region and a dry region - failed to produce a useful level of force.

These unsuccessful tries used a polymer called polypyrrole. Now Robert Langer and colleagues at the Massachusetts Institute of Technology have turned to the material again, embedding chains of it within another material, polyol-borate. This more complex arrangement mimics structures found in muscles as well as in plant tissues that bend in response to changes in humidity.

Flipping film

The result looks like an ordinary piece of thin black plastic, but when placed on a wet surface, something extraordinary happens. As the material absorbs water, its end curls away from the surface and the film becomes unstable, so it flips over. The ends have now dried out, so they are ready to absorb more water, and the whole process repeats itself. This continuous flipping motion lets the film travel across a suitably moist surface unaided.

Langer found that a 0.03-millimetre-thick strip, weighing roughly 25 milligrams, could curl up and lift a load 380 times its mass to a height of 2 millimetres. It was also able to move sideways when carrying a load about 10 times its mass.

To extract energy from this effect, Langer's team added a layer of piezoelectric material – one which produces electricity when squeezed. When this enhanced film, weighing about 100 milligrams, flipped over, it generated an output of 5.6 nanowatts – enough to power a microchip in sleep mode.

Electricity from sweat

Though the output is small, it is proof that electricity can be extracted from a water gradient. "To the extent of our knowledge, we are the first to utilise a water gradient, without a pressure gradient, to generate electricity," says Langer.

Large-scale energy harvesting is unlikely as the size of the device needed would be impractical, but it could be used to power small devices such as environmental monitoring systems in remote locations. "It will be interesting for applications where the amount of energy needed may be low but where access to energy may be difficult," says Peter Fratzl at the Max-Planck Institute of Colloids and Interfaces in Potsdam, Germany, who was not involved in the work.

Another application, Langer suggests, would be to place the film inside the clothing of joggers or athletes. The evaporation of sweat could generate enough electricity to power sensors monitoring blood pressure and heart rate.

Journal reference: Science, DOI 10.1126/science.1230262

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Captain blames faulty brakes, motor for NY ferry accident

NEW YORK: The captain of a packed ferry that crashed into a New York City pier injuring 74 people blamed malfunctioning brakes and a faulty motor for the accident, US investigators said Thursday.

"As the boat was coming in, the captain found that the reverse thrust was not operating as anticipated," said Robert Sumwalt of the National Transportation Safety Board, which is investigating the accident.

The captain said there was also a problem with the motor on the vessel, telling investigators that at some point "both diesel engines shut off," while he steered it toward the pier, Sumwalt told reporters.

There were 326 passengers and five crew on board the ferry at the time of Wednesday's mishap.

The accident took place during the morning rush hour at Pier 11 in lower Manhattan's East River, not far from Wall Street. The ferry was arriving from New Jersey.

Sumwalt said the captain, who is 36 years old, has 12 years of experience as a ferryboat captain and tested negative for alchohol use, as did the entire crew. Results of drug testing have yet to be completed, he said.

Some witnesses reported that the ferry, the Seastreak Wall Street, was going too quickly as it approached the pier.

Weather conditions were good at the time of the accident, with hardly any wind and good visibility.

Dozens of ferries bring thousands of commuters from New Jersey or Brooklyn to Manhattan every day, but accidents are rare.

The most serious mishap, in October 2003, killed 11 people and injured 70 others when a Staten Island ferry slammed into a pier at full speed.

- AFP/ck

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Beheading exposes exploitation

(File photo) Sri Lankan women protest outside the Saudi Arabia embassy in Colombo on November 9, 2010.

STORY HIGHLIGHTS

• Saudi authorities beheaded Rizana Nafeek, a Sri Lankan woman


• She was convicted of killing a baby of the family employing her as a housemaid


• This was despite Nafeek's claims that the baby died in a choking accident


• Becker says her fate "should spotlight the precarious existence of domestic workers"

Jo Becker is the Children's Rights Advocacy Director for Human Rights Watch and author of 'Campaigning for Justice: Human Rights Advocacy in Practice.' Follow Jo Becker on Twitter.

(CNN) -- Rizana Nafeek was a child herself -- 17 years old according to her birth certificate -- when a four-month-old baby died in her care in Saudi Arabia. She had migrated from Sri Lanka only weeks earlier to be a domestic worker for a Saudi family.

Although Rizana said the baby died in a choking accident, Saudi courts convicted her of murder and sentenced her to death. On Wednesday, the Saudi government carried out the sentence in a gruesome fashion, by beheading Rizana.

Jo Becker

Read more: Outrage over beheading of Sri Lankan woman by Saudi Arabia

Rizana's case was rife with problems from the beginning. A recruitment agency in Sri Lanka knew she was legally too young to migrate, but she had falsified papers to say she was 23. After the baby died, Rizana gave a confession that she said was made under duress -- she later retracted it. She had no lawyer to defend her until after she was sentenced to death and no competent interpreter during her trial. Her sentence violated international law, which prohibits the death penalty for crimes committed before age 18.

Rizana's fate should arouse international outrage. But it should also spotlight the precarious existence of other domestic workers. At least 1.5 million work in Saudi Arabia alone and more than 50 million -- mainly women and girls -- are employed worldwide according to the International Labour Organization (ILO).

Read more: Indonesian maid escapes execution in Saudi Arabia

Again according to the ILO, the number of domestic workers worldwide has grown by more than 50% since the mid-1990s. Many, like Rizana, seek employment in foreign countries where they may be unfamiliar with the language and legal system, and have few rights.

When Rizana traveled to Saudi Arabia, for example, she may not have known that many Saudi employers confiscate domestic workers' passports and confine them inside their home, cutting them off from the outside world and sources of help.

It is unlikely that anyone ever told her about Saudi Arabia's flawed criminal justice system, or that while many domestic workers find kind employers who treat them well, others are forced to work for months or even years without pay, and subjected to physical or sexual abuse.

Passport photo of Rizana Nafeek

Read more: Saudi woman beheaded for 'witchcraft and sorcery'

Conditions for migrant domestic workers in Saudi Arabia are among some of the worst, but domestic workers in other countries rarely enjoy the same rights as other workers. In a new report this week, the International Labour Organization says that nearly 30% of the world's domestic workers are completely excluded from national labor laws. They typically earn only 40% of the average wage of other workers. Forty-five percent aren't even entitled by law to a weekly day off.

Last year, I interviewed young girls in Morocco who worked 12 hours a day, 7 days a week for a fraction of the minimum wage. One girl began working at age 12 and told me: "I don't mind working, but to be beaten and not to have enough food, this is the hardest part."

Many governments have finally begun to recognize the risks and exploitation domestic workers face. During 2012, dozens of countries took action to strengthen protections for domestic workers. Thailand, and Singapore approved measures to give domestic workers a weekly day off, while Venezuela and the Philippines adopted broad laws for domestic workers ensuring a minimum wage, paid holidays, and limits to their working hours. Brazil is amending its constitution to state that domestic workers have all the same rights as other workers. Bahrain codified access to mediation of labor disputes.

Read more: Convicted killer beheaded, put on display in Saudi Arabia

Perhaps most significantly, eight countries acted in 2012 to ratify -- and therefore be legally bound by -- the Domestic Workers Convention, with more poised to follow suit this year. The convention is a groundbreaking treaty adopted in 2011 to guarantee domestic workers the same protections available to other workers, including weekly days off, effective complaints procedures and protection from violence.

The Convention also has specific protections for domestic workers under the age of 18 and provisions for regulating and monitoring recruitment agencies. All governments should ratify the convention.

Many reforms are needed to prevent another tragic case like that of Rizana Nafeek. The obvious one is for Saudi Arabia to stop its use of the death penalty and end its outlier status as one of only three countries worldwide to execute people for crimes committed while a child.

Labor reforms are also critically important. They may have prevented the recruitment of a 17 year old for migration abroad in the first place. And they can protect millions of other domestic workers who labor with precariously few guarantees for their safety and rights.

Read more: Malala, others on front lines in fight for women

The opinions expressed in this commentary are solely those of Jo Becker.

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Student shot at Calif. high school by classmate

Updated at 5:48 p.m. ET

TAFT, Calif. A 16-year-old student armed with a shotgun walked into class in a rural California high school on Thursday and shot one student, fired at another but missed, and then was talked into surrendering by a teacher and another staff member, officials said.

The teen victim was in critical but stable condition, Kern County Sheriff Donny Youngblood told a press conference. The sheriff said the teacher suffered a minor pellet wound to the head but declined treatment.

The gunman had as many as 20 rounds of ammunition in his pocket, the sheriff said.

When the shots were fired, the teacher tried to get the more than two dozen students out a back door and also engaged the shooter in conversation to distract him, Youngblood said. A campus supervisor responding to a call of shots fired also began talking to the gunman.

"They talked him into putting that shotgun down. He in fact told the teacher, `I don't want to shoot you,' and named the person that he wanted to shoot," Youngblood said.

"The heroics of these two people goes without saying. ... They could have just as easily ... tried to get out of the classroom and left students and they didn't," the sheriff said. "They knew not to let him leave the classroom with that shotgun."

The shooter didn't show up for first period then interrupted the class of 28 students.

Investigators had not yet had a chance to interview the student and so had no immediate word on a motive or whether the attacker had a previous disciplinary record. Nor did they know where he got the shotgun.

The wounded student was flown to a hospital in Bakersfield. Officials said a female student was hospitalized with possible hearing damage because the shotgun was fired close to her ear, and another girl received minor injuries during the scramble to flee when she fell over a table.

Officials said there's usually an armed officer on campus but the person wasn't there because he was snowed in. Taft police officers arrived within 60 seconds of first reports.

The shooting happened on the second floor of the school's science building around 9 a.m., according to CBS affiliate KBAK in Bakersfield.

As word spread, Dayna Hopper rushed to the school to pick up her son Joseph Sorensen, 16, and daughter, Cheryle Pryor, 15, who had called from Cheryle's cellphone.

"I panicked. I wanted to puke and just get here," Dayna Hopper told The Bakersfield Californian.

KERO-TV Bakersfield reported that the station received phone calls from people inside the school who hid in closets.

The bell had just rung at a nearby school when teachers began shouting for students to get inside buildings, and the principal used an intercom to tell students to stay inside, Felicity Reich, 13, a student at Lincoln Junior High School, told the newspaper.

Shaken, she held the hand of her mother, Ellie Reich, as she spoke.

About 900 students are enrolled at the high school, which includes 9th through 12th grades. Authorities went room by room through the school and expected to spend the day checking backpacks to make sure no other weapons were on campus.

Masses of parents headed to the school football field to find their children, and officials at other schools took action to protect their students as well, the newspaper said.

Wilhelmina Reum, whose daughter Alexis Singleton is a fourth-grader at a nearby elementary school, got word of the attack while she was about 35 miles away in Bakersfield and immediately sped back to Taft.

"I just kept thinking this can't be happening in my little town," she told The Associated Press.

"I was afraid I was going to get hurt," Alexis said. "I just wanted my mom to get here so I could go home."

The Taft shooting came less than a month after a gunman massacred 20 children and six women at Sandy Hook Elementary School in Newtown, Conn., then killed himself.

That shooting prompted President Barack Obama to promise new efforts to curb gun violence. Vice President Joe Biden, who was placed in charge of the initiative, said he would deliver new policy proposals to the president by next week.

At the state Capitol, Assembly Speaker John Perez, D-Los Angeles, said the thoughts and prayers of legislators were with the people at the Taft school.

"It really is just another very sad moment as we deal with the ongoing reality of gun violence that has captured so much of our attention this last year," Perez said.

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Hero Teacher Talks Shooter into Dropping Gun

A California high school teacher is being hailed a hero for talking a 16-year-old shooter into putting down his gun and turning himself in after opening fire on a classroom and wounding another student, police said.

The student victim was taken to a nearby hospital and remains in critical but stable condition, Kern County Sheriff Donny Youngblood told reporters on Thursday.

The teacher, whose name has not yet been officially released by authorities, helped evacuate nearly two dozen students out a door at Taft Union High School in Taft, Calif., while calmly engaging the young gunman, who is a student at Taft Union, in conversation.

Chris McCullah/The Californian/ZUMA

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The teacher and a campus supervisor, who responded to the gunfire and arrived at the classroom, helped convince the teenager to stop shooting.

"They talked him into putting the shotgun down," Youngblood said.

The shooting began around 9 a.m. in the school's science building and sheriff's deputies were on the scene within one minute of the call. An armed security guard who is typically at the school was not on campus because he had been snowed in, the sheriff said.

Two other students received minor injuries: One reported hearing loss and the other fell over a table. The teacher was shot with a pellet, but refused medical treatment, according to police.

The school's 900 students were evacuated from the building and many of them were met by parents within minutes of the first 911 calls.

Today's shooting comes less than month after 20-year-old Adam Lanza opened fire on an elementary school in Newtown, Conn. killing 20 children and six adults.

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Hints of new dark force seen in galactic smash-ups

Colliding clusters of galaxies may hold clues to a mysterious dark force at work in the universe. This force would act only on invisible dark matter, the enigmatic stuff that makes up 86 per cent of the mass in the universe.

Dark matter famously refuses to interact with ordinary matter except via gravity, so theorists had assumed that its particles would be just as aloof with each other. But new observations suggest that dark matter interacts significantly with itself, while leaving regular matter out of the conversation.

"There could be a whole class of dark particles that don't interact with normal matter but do interact with themselves," says James Bullock of the University of California, Irvine. "Dark matter could be doing all sorts of interesting things, and we'd never know."

Some of the best evidence for dark matter's existence came from the Bullet cluster, a smash-up in which a small galaxy cluster plunged through a larger one about 100 million years ago. Separated by hundreds of light years, the individual galaxies sailed right past each other, and the two clusters parted ways. But intergalactic gas collided and pooled on the trailing ends of each cluster.

Mass maps of the Bullet cluster showed that dark matter stayed in line with the galaxies instead of pooling with the gas, proving that it can separate from ordinary matter. This also hinted that dark matter wasn't interacting with itself, and was affected by gravity alone.

Musket shot

Last year William Dawson of the University of California, Davis and colleagues found an older set of clusters seen about 700 million years after their collision. Nicknamed the Musket Ball cluster, this smash-up told a different tale. When Dawson's team analysed the concentration of matter in the Musket Ball, they found that galaxies are separated from dark matter by about 19,000 light years.

"The galaxies outrun the dark matter. That's what creates the offset," Dawson said. "This is fitting that picture of self-interacting dark matter." If dark matter particles do interact, perhaps via a dark force, they would slow down like the gas.

This new picture could solve some outstanding mysteries in cosmology, Dawson said this week during a meeting of the American Astronomical Society in Long Beach, California. Non-interacting dark matter should sink to the cores of star clusters and dwarf galaxies, but observations show that it is more evenly distributed. If it interacts with itself, it could puff up and spread outward like a gas.

So why doesn't the Bullet cluster show the same separation between dark matter and galaxies? Dawson thinks it's a question of age – dark matter in the younger Bullet simply hasn't had time to separate.

New window

The idea complements a previous study that saw evidence for dark forces at work in the Bullet cluster. In 2007 Glennys Farrar of New York University and colleagues said that the smaller cluster was moving too fast for gravity alone to be responsible. They suggested that some mysterious force related to dark matter might be hurrying it along.

Still, two clusters is not a lot to go on. Dawson, Bullock and colleagues are following up with about 20 more galactic collisions to see if they show any unusual behaviours. "I really think that we're almost to the point where we have enough observational data in hand," Dawson said. "We could close the book on self-interacting dark matter."

If the new force does exist, we might soon be able to see its effects on things influenced by dark matter, such as the behavior of black holes or the masses of the first stars, says Douglas Finkbeiner of Harvard University in Cambridge, Massachusetts, who was not involved in the new study.

"The simple thing isn't always the right thing, so I really appreciate that Will is trying to look into these other possibilities," he says.

Louis Strigari of Stanford University in California agrees. "Self-interacting dark matter is worth pursuing because we're still very ignorant," he said. "We're desperate to understand what dark matter is, so any new window is welcome."

If you would like to reuse any content from New Scientist, either in print or online, please contact the syndication department first for permission. New Scientist does not own rights to photos, but there are a variety of licensing options available for use of articles and graphics we own the copyright to.

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EU leaders want UK in union, but not treaty change

LONDON: European leaders on Wednesday stressed the importance of keeping Britain in the EU, but said they opposed treaty changes demanded by Prime Minister David Cameron.

"Britain is an essential part of the EU," Irish Prime Minister Enda Kenny said during a conference in Dublin marking the beginning of his country's six-month presidency of the bloc.

"Great Britain has great value and is a very important member of the EU," added EU President Herman Van Rompuy.

The two leaders highlighted the importance of the union for British businesses, saying that it was essential for them that Britain remained a full and active member.

A majority of Britons favour severing all ties with the union, according to polls, and Cameron is expected to deliver a speech within the next few days spelling out his views on the country's relationship with Brussels.

He insisted last year that he supported Britain's membership, but that he wanted to negotiate a "new agreement" which would allow it to opt out of certain directives.

Kenny and Van Rompuy both repeated their opposition to any treaty changes.

"I don't see a reopening of the treaties, I don't see an issue in treaty change for any individual countries," said the Irish prime minister.

Irish Deputy Prime Minister Eamon Gilmore stressed that the top concern of European citizens, "whether from Liverpool or Limerick", was unemployment.

Van Rompuy reiterated that it would be possible to change the treaties after the 2014 European elections, but added that he strongly supported deeper EU integration as opposed to an "a la carte" union.

He pointed out that there was already scope for increasing EU partnership.

"We don't need, at this stage, a treaty change," he said. "We can deliver for a deeper EU within the treaties."

- AFP/jc

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Wash your hands! Flu spreads fiercely across the U.S.

STORY HIGHLIGHTS

• Boston mayor declares a public health emergency because of flu


• Massachusetts General Hospital alone has already counted 532 cases of flu among patients


• It's not too late to get a flu vaccine


• In most cases, flu patients don't need to go to the emergency room

(CNN) -- The flu has been spreading fiercely across the United States, with more than half of states reporting widespread activity. The season has started earlier, and cases are more severe than last year, health officials say.

The latest Centers for Disease Control and Prevention flu advisory report, which covers the week of December 23 to 29, suggests that 41 states have widespread influenza activity, which was an increase of 31 states from the previous week. The CDC will issue an update on the flu situation Friday.

There have so far been 2,257 hospitalizations associated with laboratory-confirmed flu virus, the CDC report said. Among children, there have been 18 deaths reported during this season.

In Massachusetts, one of the 29 states that the CDC has identified as having high activity of influenza-like illness, Boston Mayor Thomas Menino declared a public health emergency in the city because of the flu.

Since October 1, there have been 700 confirmed influenza cases among Boston residents, according to Menino's office; that's 10 times more than were seen in all of last year's flu season.

Menino is collaborating with the Boston Public Health Commission and community health centers to offer free vaccination clinics this weekend. The mayor urged residents to stay home from work or school if they are sick, and to get their flu shots.

"This is the worst flu season we've seen since 2009, and people should take the threat of flu seriously," Menino said in a statement. More than 4% of emergency department visits at Boston hospitals are from flu cases, up from 1% during non-flu season.

Experts: Flu spreading faster than usual

Massachusetts General Hospital has already counted 532 cases of flu among patients, which is more than the hospital saw in any of the previous three flu seasons, said spokeswoman Kristen Stanton.

Signs posted throughout the hospital discourage anyone from visiting who has a cough or fever, she said, and anyone who does visit with those symptoms must wear a mask and perform hand hygiene. All staff must wear a mask when providing care for possible flu cases. Any staff member who has not been vaccinated must wear a mask while caring for any patient.

Pennsylvania has had 22 flu-related deaths so far this season, according to data from the state's Department of Health. Most of these deaths occurred among people older than 65, but the fatalities included two individuals younger than 50 who were otherwise healthy.

Lehigh Valley Hospital-Cedar Crest in Allentown, Pennsylvania, set up a heated tent outside the hospital to serve as a clinic. Anyone with mild flu symptoms can be treated quickly and discharged, isolated from more serious cases. The hospital has been seeing an additional 80 to 100 patients with flu-like symptoms daily, officials told CNN affiliate WPVI.

In Michigan, there have been four pediatric deaths related to the flu, said Angela Minicuci, public information officer for the Michigan Department of Community Health.

Dr. David Zich, internal medicine and emergency medicine physician at Northwestern Memorial Hospital in Chicago, said this is the worst flu season he's seen in his 12 years at his hospital, in terms of the concentration of patients.

Northwestern Memorial Hospital is on "bypass," which happens when it is beyond capacity because of an influx of patients, such as during flu season.

That means advanced-life support ambulances with patients who are stable are referred to the next closest hospital, no more than five minutes away, Zich said, and transfers are not accepted from outside hospitals. For everyone else, they are open for business.

"The majority of flu patients are sent home, with very little else done, so we can handle that," he said.

FDA approves new type of flu shot

Why so many cases?

Zich theorizes that one reason there are so many flu cases is that the heart of the flu season coincided with the December holiday season, meaning many people were already sleep-deprived from parties and were more likely to get sick.

Those who went to gatherings of family or friends may have already begun to feel sick, and spread the virus to others. People are generally contagious the day before symptoms start, and for five days after becoming sick, according to the Centers for Disease Control and Prevention.

Last flu season was light, but this year has brought with it some "ominous signs," Dr. Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases at the National Institutes of Health, told CNN's Wolf Blitzer Tuesday.

Flu cases started going up early, toward the end of November and the beginning of December, he said.

"And it went up on a pretty steep trajectory," he said. "The last time we saw that happen that way was the flu season of 2003 and 2004, which turned out to be a bad flu season.'

The type of flu that is going around is called H3N2, which is often linked to more serious disease compared to other flu varieties, Fauci said.

But there's good news: That type of flu matches up well to the vaccine that is being distributed and given out throughout the United States.

People may get more complications from this particular strain of H3N2, "which may make them ill for a longer period of time," Dr. Michael Jhung, medical epidemiologist in the influenza division at CDC, told CNN's Mary Snow.

Best new ways to avoid the cold and flu

"But symptoms typically last up to seven days for a normal infection, a noncomplicated infection with influenza," he said. "And we usually see that from year to year regardless of what strains are circulating."

In a "light" year, a few thousand people may still die, but a particularly serious year could see up to 49,000 deaths from the flu, Fauci said. "There's an average of about 200,000 hospitalizations and there's a lot of economic burdens."

Protect yourself

If you haven't gotten an annual flu vaccine, it's not too late, doctors say. To further protect yourself, try to avoid anyone who is sneezing and coughing, and wash your hands. Also, exercise and eat healthy foods, Zich said.

Most flu patients should not go to an emergency room, Zich said. They will likely be sent home, as there is very little that can be done for them. A fever as high as 103 degrees Fahrenheit is common in the flu.

Patients with normal flu symptoms should get a lot of rest and take painkillers to help with muscle aches, Zich said. "In five to seven days, you're going to be feeling yourself again," he said.

But there are scenarios in which going to a hospital is necessary. If a patient is short of breath, or can't keep fluids down because of nausea, these are signs of a problem that needs immediate attention, as vomiting or sweating from fever can lead to dehydration, Zich said.

Flu can be deadly, even in healthy kids

An otherwise healthy person will not get much benefit from antiviral medications designed to treat symptoms that the flu causes, Zich said. The side effects from both oseltamivir (Tamiflu) and zanamivir (Relenza) include nausea.

The CDC recommends that people who have a higher risk of complications from the flu receive antiviral treatment. These include people with chronic illnesses such as pulmonary, cardiovascular and neurological conditions, as well as anyone 65 years and older and children under age 2.

What many people don't know is that the flu vaccine becomes less effective as you get older or develop other medical problems, Zich said. The flu shot relies on the body's antibodies against the flu, so if the immune system is already compromised, it will not work as well.

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