France to stay in Mali until stability restored

BAMAKO/DUBAI (Reuters) - France pledged on Tuesday to keep troops in Mali until stability returned to the West African country, raising the specter of a long campaign against al Qaeda-linked rebels who held their ground despite a fifth day of air strikes.

Paris has poured hundreds of soldiers into Mali and carried out 50 bombing raids since Friday in the Islamist-controlled northern half of the country, which Western and regional states fear could become a base for terrorist attacks in Africa and Europe.

Defense Minister Jean-Yves Le Drian said that, despite French air support, Malian forces had not been able to dislodge Islamist fighters from the central Malian towns of Konna or Diabaly, just 350 km (220 miles) northeast of Bamako.

A column of French armored vehicles rolled northward from the dusty riverside capital of Bamako towards rebel lines on Tuesday, the first major northward deployment of ground troops. A military official declined to comment on their objective.

Thousands of African soldiers are due to take over the offensive. Regional armies are scrambling to accelerate an operation which was initially not expected until September and has been brought forward by France's surprise bombing campaign aimed at stopping a rebel advance on a strategic town last week.

President Francois Hollande, on a visit to the United Arab Emirates during which he sought Gulf states' financial backing for the African-led mission, suggested France would retain a major role in its former colony for months to come.

"We have one goal. To ensure that when we leave, when we end our intervention, Mali is safe, has legitimate authorities, an electoral process and there are no more terrorists threatening its territory," Hollande told a news conference.

Paris has said it plans to deploy 2,500 soldiers to bolster the Malian army and work with the intervention force provided by West African states.

AFRICAN TROOPS

West African Defense chiefs met in Bamako on Tuesday to approve plans for the swift deployment of 3,300 regional troops, foreseen in a United Nations-backed intervention plan. After failing to reach a final agreement, they adjourned their talks until Wednesday.

Nigeria pledged to deploy soldiers within 24 hours, and Belgium said it was sending transport planes and helicopters to help, but West Africa's armies need time to become operational.

Mali's north, a vast and inhospitable area of desert and rugged mountains the size of Texas, was seized last year by an Islamist alliance combining al Qaeda's north African wing AQIM with splinter group MUJWA and the home-grown Ansar Dine rebels.

Any delay in following up on the French air bombardments of Islamist bases and fuel depots with a ground offensive could allow the insurgents to slip away into the desert and mountains, regroup and counter-attack.

The rebels, who French officials say are mobile and well armed, have shown they can hit back, dislodging government forces from Diabaly on Monday.

Residents said the town was still under Islamist control on Tuesday despite a number of air strikes that shook houses.

An eye witness near Segou, to the south, told Reuters he had seen 20 French Special Forces soldiers driving toward Diabaly.

In Konna, whose seizure on Thursday sparked French involvement, residents said Islamist fighters were camped just outside town. Army troops had also withdrawn after entering the town on Saturday.

Malians have largely welcomed the French intervention, having seen their army suffer a series of defeats by the rebels.

"With the arrival of the French, we have started to see the situation on the front evolve in our favor," said Aba Sanare, a resident of Bamako.

QUESTIONS OVER READINESS

Aboudou Toure Cheaka, a senior regional official in Bamako, said the West African troops would be on the ground in a week.

The original timetable for the 3,300-strong U.N.-sanctioned African force - to be backed by western logistics, money and intelligence services - did not initially foresee full deployment before September due to logistical constraints.

Senegal, Burkina Faso, Niger, Nigeria and Guinea have all offered troops. Col. Mohammed Yerima, spokesman for Nigeria's Defense ministry, said the first 190 soldiers would be dispatched within 24 hours.

But Nigeria, which is due to lead the mission, has already cautioned that even if some troops arrive in Mali soon, their training and equipping will take more time.

Sub-Saharan Africa's top oil producer, which already has peacekeepers in Sudan's Darfur and is fighting a bloody and difficult insurgency at home against Islamist sect Boko Haram, could struggle to deliver on its troop commitment of 900 men.

One senior government adviser in Nigeria said the Mali deployment was stretching the country's military.

"The whole thing's a mess. We don't have any troops with experience of those extreme conditions, even of how to keep all that sand from ruining your equipment. And we're facing battle-hardened guys who live in those dunes," said the adviser, who asked not to be named.

FRENCH LINING UP SUPPORT

France, which has repeatedly said it has abandoned its role as policeman of its former African colonies, said on Monday that the U.S., Canada, Denmark and Germany had also offered logistical support.

Fabius has said Gulf Arab states would help the Mali campaign, while Belgium said on Tuesday it would send two C130 transport planes and two medical helicopters following a request from Paris.

A meeting of donors for the operation was expected to be held in Addis Ababa at the end of January.

Security experts have warned that the multinational intervention in Mali, couched in terms of a campaign by governments against "terrorism", could provoke a jihadist backlash against France and the West, and African allies.

U.S. officials have warned of links between AQIM, Boko Haram in Nigeria and al Shabaab Islamic militants fighting in Somalia.

Al Shabaab, which foiled a French effort at the weekend to rescue a French secret agent it was holding hostage, urged Muslims around the world to rise up against what it called "Christian" attacks against Islam.

"Our brothers in Mali, show patience and tolerance and you will win. War planes never liberate a land," Sheikh Ali Mohamud Rage, al Shabaab's spokesman, said on a rebel-run website.

U.S. officials said Washington was sharing information with French forces in Mali and considering providing logistics, surveillance and airlift capability.

"We have made a commitment that al Qaeda is not going to find any place to hide," U.S. Defense Secretary Leon Panetta told reporters as he began a visit to Europe. Panetta later said the U.S. had no plans to send troops to Mali.

One U.S. military source said the haphazard nature of French involvement reminded him of the U.S. entry into Afghanistan.

"I don't know what the French endgame is for this," the source said. "Air strikes are fine, but pretty soon you run out of easy targets. Then what do you do? What do you do when they head up into the mountains?"

(Additional reporting by Elizabeth Pineau and Raissa Kasolowsky in Abu Dhabi, Felix Onuah in Abuja and Tim Cocks in Lagos, Abdi Sheikh in Mogadishu, Michelle Nichols and Louis Charbonneau at the United Nations,; Richard Valdmanis in Dakar, Joe Bavier in Abidjan, Jan Vermeylen in Brussels; Writing by Pascal Fletcher, Daniel Flynn and David Lewis; editing by Richard Valdmanis, Giles Elgood and Will Waterman)

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Tennis: Nadal said to be targeting Brazil Open

SAO PAULO: Spanish tennis star Rafael Nadal, out of action since the middle of last season because of injury, could return to the court at next month's ATP Brazil Open in Sao Paulo, organisers said Tuesday.

A statement from tournament sponsors DGW Comunicacion, which recently was involved with a Roger Federer exhibition appearance in Brazil, said the event will "mark the return to the circuit of one of world tennis' top stars".

And Luis Felipe Tavares, chairman of sports company Koch Tavares, told Estado de Sao Paulo daily that "a name such as Nadal will definitely whip up a lot of interest".

Contacted by AFP, the company had not made any further comment by Tuesday afternoon.

Nadal, currently ranked fourth in the world, has won 11 Grand Slams but injuries have dogged him and the 26-year-old Spaniard has not played since June.

He had to miss the Australian Open because of a stomach virus while a succession of knee injuries have plagued his career.

Nadal, who had been widely expected to return to action at the end of February, won the Brazil Open in 2005.

- AFP/jc

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Centre fine tunes blueprint for anti-Red operations in four states

NEW DELHI: Staring at a fight-to-finish war against Red Ultras in the next two years, the Centre on Tuesday fine-tuned the scheme to create anti-Naxal special forces in four states - Bihar, Chhattisgarh, Jharkhand and Odisha - on the lines of Greyhounds of Andhra Pradesh to fight Maoists and pitched for a deadline to deploy commandos on ground to step up operation.

The specialized forces — capable of hot pursuit across inter-state borders — will be set up with personnel fully trained in guerilla warfare and required infrastructure within six months.

On Tuesday, the department of expenditure under the finance ministry approved Rs 280 crore for setting up these forces, where the Centre will spend 75% of the sum and the rest (25%) will be borne by the state concerned.

The home ministry, which has already decided to deploy 10,000 more paramilitary personnel in Maoist-affected areas over the months, also set guidelines for the specialized force and decided to fund infrastructure, weaponry and equipment needed to fill the critical gap.

An official said, "This step is being initiated in the background of the success achieved by the elite commando force of Andhra Pradesh. It is also decided to upgrade the Greyhounds under the existing Scheme for Special Infrastructure (SSI)".

The official said that the special forces will be set up in such a manner that it will be capable of staying and operating in interior and inhospitable terrain\jungles for at least a week at a stretch with a view to take on extremists in their strongholds.

Trained to reach inaccessible, remote forest areas throughout a state in the shortest possible time and conduct swift operations, the forces will have instructions to travel "mostly by road or on foot" to avoid landmines in the Red zones.

In order to ensure effectiveness of the scheme by adhering to set guidelines, the home ministry also put certain conditions before states like Chhattisgarh, Odisha Bihar which already have special force of its own to fight Maoists.

In its notes to the states, the ministry said, "The special force of the state concerned has to be upgraded as per the approved guidelines on the lines of Greyhounds. Even if a special force has been raised in some form in states, they are required to be reoriented through the entire process mentioned in the guidelines".

The ministry has asked states to give a "written undertaking" that they will strictly adhere to these guidelines. "Only states providing such an undertaking will be considered for funding under the scheme," said the ministry.

Besides, the states have been asked to raise a "highly professional, well trained and motivated Special Task Force (STF) - headed by an officer of the rank of additional director general or inspector general of police with adequate operational experience — to monitor training, infrastructure and induction of personnel as per guidelines. It will also ensure 60% special allowance to the commandos as incentive and rewards as well as out of turn promotions for conspicuous acts of bravery".

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Risk to all ages: 100 kids die of flu each year

NEW YORK (AP) — How bad is this flu season, exactly? Look to the children.

Twenty flu-related deaths have been reported in kids so far this winter, one of the worst tolls this early in the year since the government started keeping track in 2004.

But while such a tally is tragic, that does not mean this year will turn out to be unusually bad. Roughly 100 children die in an average flu season, and it's not yet clear the nation will reach that total.

The deaths this year have included a 6-year-old girl in Maine, a 15-year Michigan student who loved robotics, and 6-foot-4 Texas high school senior Max Schwolert, who grew sick in Wisconsin while visiting his grandparents for the holidays.

"He was kind of a gentle giant" whose death has had a huge impact on his hometown of Flower Mound, said Phil Schwolert, the Texas boy's uncle.

Health officials only started tracking pediatric flu deaths nine years ago, after media reports called attention to children's deaths. That was in 2003-04 when the primary flu germ was the same dangerous flu bug as the one dominating this year. It also was an earlier than normal flu season.

The government ultimately received reports of 153 flu-related deaths in children, from 40 states, and most of them had occurred by the beginning of January. But the reporting was scattershot. So in October 2004, the government started requiring all states to report flu-related deaths in kids.

Other things changed, most notably a broad expansion of who should get flu shots. During the terrible 2003-04 season, flu shots were only advised for children ages 6 months to 2 years.

That didn't help 4-year-old Amanda Kanowitz, who one day in late February 2004 came home from preschool with a cough and died less than three days later. Amanda was found dead in her bed that terrible Monday morning, by her mother.

"The worst day of our lives," said her father, Richard Kanowitz, a Manhattan attorney who went on to found a vaccine-promoting group called Families Fighting Flu.

The Centers for Disease Control and Prevention gradually expanded its flu shot guidance, and by 2008 all kids 6 months and older were urged to get the vaccine. As a result, the vaccination rate for kids grew from under 10 percent back then to around 40 percent today.

Flu vaccine is also much more plentiful. Roughly 130 million doses have been distributed this season, compared to 83 million back then. Public education seems to be better, too, Kanowitz observed.

The last unusually bad flu season for children, was 2009-10 — the year of the new swine flu, which hit young people especially hard. As of early January 2010, 236 flu-related deaths of kids had been reported since the previous August.

It's been difficult to compare the current flu season to those of other winters because this one started about a month earlier than usual.

Look at it this way: The nation is currently about five weeks into flu season, as measured by the first time flu case reports cross above a certain threshold. Two years ago, the nation wasn't five weeks into its flu season until early February, and at that point there were 30 pediatric flu deaths — or 10 more than have been reported at about the same point this year. That suggests that when the dust settles, this season may not be as bad as the one only two years ago.

But for some families, it will be remembered as the worst ever.

In Maine, 6-year-old Avery Lane — a first-grader in Benton who had recently received student-of-the-week honors — died in December following a case of the flu, according to press reports. She was Maine's first pediatric flu death in about two years, a Maine health official said.

In Michigan, 15-year-old Joshua Polehna died two weeks ago after suffering flu-like symptoms. The Lake Fenton High School student was the state's fourth pediatric flu death this year, according to published reports.

And in Texas, the town of Flower Mound mourned Schwolert, a healthy, lanky 17-year-old who loved to golf and taught Sunday school at the church where his father was a youth pastor.

Late last month, he and his family drove 16 hours to spend the holidays with his grandparents in Amery, Wis., a small town near the Minnesota state line. Max felt fluish on Christmas Eve, seemed better the next morning but grew worse that night. The family decided to postpone the drive home and took him to a local hospital. He was transferred to a medical center in St. Paul, Minn., where he died on Dec. 29.

He'd been accepted to Oklahoma State University before the Christmas trip. And an acceptance letter from the University of Minnesota arrived in Texas while Max was sick in Minnesota, his uncle said.

Nearly 1,400 people attended a memorial service for Max two weeks ago in Texas.

"He exuded care and love for other people," Phil Schwolert said.

"The bottom line is take care of your kids, be close to your kids," he said.

On average, an estimated 24,000 Americans die each flu season, according to the Centers for Disease Control and Prevention. People who are elderly and with certain chronic health conditions are generally at greatest risk from flu and its complications.

The current vaccine is about 60 percent effective, and is considered the best protection available. Max Schwolert had not been vaccinated, nor had the majority of the other pediatric deaths.

Even if kids are vaccinated, parents should be watchful for unusually severe symptoms, said Lyn Finelli of the CDC.

"If they have influenza-like illness and are lethargic, or not eating, or look punky — or if a parent's intuition is the kid doesn't look right and they're alarmed — they need to call the doctor and take them to the doctor," she advised.

___

CDC advice on kids: http://www.cdc.gov/flu/protect/children.htm

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Arias Called Ex-Boyfriend 4 Times After Killing Him

Jodi Arias tried to cover her tracks after killing her ex-boyfriend, Travis Alexander, by making a flurry of phone calls to his cell phone and hacking into his voice mailbox, prosecutors alleged today.

Phone records presented in court today showed Arias persistently calling Alexander in the days before the killing. Ten calls were made from Arias' cell phone to Alexander's cell phone in the days leading up to his death, Verizon Wireless records expert Jody Citizen testified. Many of the calls were forwarded by Alexander straight to voice mail, Citizen said.

After Arias killed Alexander around 5:30 p.m. on June 4, 2008. , Arias called his phone four more times. The first call was made just hours after the killing at 11:37 p.m., the records showed. At least one of the calls was made as late as June 15, nearly a week after Alexander's body was found by friends.

At one point, Arias dialed into his voice mail system for 16 minutes, which indicated she was accessing his voice mail messages, Citizen said.

"If a person is in his phone for 16 minutes and they're not leaving a message what is going on?" prosecutor Juan Martinez asked.

Jodi Arias Murder Trial: Interrogation Tapes Played in Court Watch Video

"Somebody is listening to messages," Citizen answered.

See Full Coverage of Jodi Arias Trial

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Arias' attorneys, who argue that she killed her ex-boyfriend out of self-defense, said that she could have been recording a message, and then listening to it and deleting it before recording again, accounting for the 16 minutes spent on the voice mail system.

"On Verizon, is it possible to change your voice mail, to erase it and do it over again?" defense attorney Kirk Nurmi asked Citizen. "Could someone have been doing that for a 16 minute phone call?"

"Yes," Citizen said.

Nurmi pointed out that phone records showed that two days before his death Alexander also called Arias, initiating two phone calls that lasted nearly 20 minutes and more than 40 minutes in the middle of the night.

The defense has said that Alexander was controlling and abusive toward Arias and was a "sexual deviant" whom she had to kill in self defense.

The prosecution, however, alleges that Arias was obsessed with Alexander, stalked him, and killed him out of jealousy after spending the afternoon having sex with him and taking naked photos of one another. She is accused of stabbing Alexander 27 times, slashing his throat, and shooting him in the head.

Arias could face the death penalty if convicted.

The jury returned to court today for the seventh day of testimony in the murder trial, after watching a series of graphic sexual photos of Arias and Alexander displayed on Monday, including the last photos of Alexander alive. The photos show both individuals lying naked on Alexander's bed, separately, and then Alexander naked in the shower.

The final photo shows a body part covered in blood around 5:30 p.m., which the prosecution alleges is when the attack on Alexander began and the camera fell to the floor.

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Mali Islamists counter attack, promise France long war

BAMAKO/PARIS (Reuters) - Al Qaeda-linked Islamist rebels launched a counteroffensive in Mali on Monday after four days of French air strikes on their northern strongholds, seizing the central town of Diabaly and promising to drag France into a brutal Afghanistan-style war.

France, which has poured hundreds of troops into the capital Bamako in recent days, carried out more air strikes on Monday in the vast desert area seized last year by an Islamist alliance grouping al Qaeda's north African wing AQIM alongside Mali's home-grown MUJWA and Ansar Dine militant groups.

"France has opened the gates of hell for all the French," said Oumar Ould Hamaha, a spokesman for MUJWA, which has imposed strict sharia, Islamic law, in its northern fiefdom of Gao. "She has fallen into a trap which is much more dangerous than Iraq, Afghanistan or Somalia," he told Europe 1 radio.

Paris is determined to shatter Islamist domination of the north of its former colony, an area many fear could become a launchpad for terrorism attacks on the West and a base for coordination with al Qaeda in Yemen, Somalia and North Africa.

The French defense ministry said it aimed to deploy 2,500 soldiers in the West African state to bolster the Malian army and work with a force of 3,300 West African troops from the immediate region foreseen in a U.N.-backed intervention plan.

The United States, which has operated a counter-terrorism training program in the region, said it was sharing information with French forces and considering providing logistics, surveillance and airlift capability.

"We have a responsibility to go after al Qaeda wherever they are," Defense Secretary Leon Panetta told reporters heading with him on a week-long tour of European capitals.

As French aircraft bombarded mobile columns of Islamist fighters, other fighters launched a counter-attack to the southwest of recent clashes, dislodging government forces from the town of Diabaly, just 350 km (220 miles) northeast of Bamako. French and Malian troops attempting to retake the town were battling Islamists shouting 'Allahu akbar', residents said.

The rebels infiltrated the town overnight from the porous border region with Mauritania, home to AQIM camps housing well-equipped and trained foreign fighters. A spokesman for Ansar Dine said its fighters took Diabaly, working with AQIM members.

Dozens of Islamist fighters died on Sunday when French rockets hit a fuel depot and a customs house being used as a headquarters. The U.N. said an estimated 30,000 people had fled the fighting, joining more than 200,000 already displaced.

France, which has repeatedly said it has abandoned its role as the policeman of its former African colonies, convened a U.N. Security Council meeting for Monday to discuss the Mali crisis.

The European Union announced it would hold an extraordinary meeting of its foreign ministers in Brussels this week to discuss speeding up a EU training mission to help the Malian army and other direct support for the Bamako government.

French Foreign Minister Laurent Fabius said France would do everything to ensure that regional African troops were deployed quickly to follow up on the French military action, which was launched to block a push southwards by the Islamist rebels.

"ORGANISED AND FANATICAL"

"We knew that there would be a counter-attack in the west because that is where the most determined, the most organized and fanatical elements are," French Defense Minister Jean-Yves Le Drian told France's BFM TV.

France has said its sudden intervention on Friday, responding to an urgent appeal from Mali's president, stopped the Islamists from seizing the dusty capital of Bamako.

President Francois Hollande says Operation Serval - named after an African wildcat - is solely aimed at supporting the 15-nation West African bloc ECOWAS which received U.N. backing in December for a military intervention to dislodge the rebels.

Hollande's robust intervention has won plaudits from Western leaders and has also shot down domestic criticism which portrayed him as spineless and indecisive.

Under pressure from Paris, regional states have said they hope to send in their forces this week. Military chiefs from ECOWAS nations will meet in Bamako on Tuesday but regional powerhouse Nigeria, which is due to lead the mission, has cautioned that training and deploying troops will take time.

Two decades of peaceful elections had earned Mali a reputation as a bastion of democracy in turbulent West Africa but that image unraveled after a military coup in March left a power vacuum for MNLA Tuareg rebels to seize the desert north.

MUJWA, an AQIM splinter group drawing support from Arabs and other ethnic groups, took control of Gao, the main city of the north, from the Tuaregs in June, shocking Mali's liberal Muslim majority with amputation of hands for theft under sharia.

Malian Foreign Minister Tyeman Coulibaly said the situation had become "untenable" in the north. "Every day, we were hearing about feet and hands being cut off, girls being raped, cultural patrimony being looted," he told the French weekly Paris Match.

ISLAMISTS DESTROY TIMBUKTU SHRINES

Last week's drive toward Bamako appeared to have been led by Ansar Dine, founded by renegade Tuareg separatist commander Iyad ag Ghali in his northern fiefdom of Kidal.

The group has said that the famed shrines of ancient desert trading town Timbuktu - a UNESCO world heritage site - were un-Islamic and idolatrous. Much of the area's religious heritage has now been destroyed, sparking international outrage.

France's intervention raises the threat for eight French hostages held by al Qaeda allies in the Sahara and for 30,000 French expatriates living in neighboring, mostly Muslim states.

Concerned about reprisals at home, France has tightened security at public buildings and on public transport.

However, top anti-terrorist judge, Marc Trevidic, played down the imminence of the risk, telling French media: "They're not very organized right now ... It could be a counter attack later on after the defeat on the ground. It's often like that."

Military analysts warn that if French action was not followed up by a robust deployment of ECOWAS forces, with logistical and financial support from NATO, then the whole U.N.-mandated Mali mission was unlikely to succeed.

"The French action was an ad-hoc measure. It's going to be a mess for a while, it depends on how quickly everyone can come on board," said Hussein Solomon, a professor at the University of the Free State, South Africa.

(Additional reporting by Emmanuel Jarry, Brian Love and Catherine Bremer in Paris, Justyna Pawlak and Adrian Croft in Busssels and Louis Charbonneau in New York; writing by Daniel Flynn; editing by Pascal Fletcher)

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Bernanke urges Congress to lift debt ceiling

WASHINGTON: US Federal Reserve Chairman Ben Bernanke on Monday urged Congress to raise the nation's borrowing limit as Democrats and Republicans battle over the federal budget.

"It's very, very important that Congress take the necessary action to raise the debt ceiling to avoid the situation where the government doesn't pay its bills," Bernanke said at a University of Michigan forum.

The United States ran up against its current borrowing limit of US$16.4 trillion at the end of 2012, but the Treasury says it is using "extraordinary measures" to extend the limit until late February.

"The right way to deal with this problem... is for Congress to do what it needs to do," Bernanke said.

"The way to address it is to have a sensible plan for spending and a sensible plan for revenue."

Earlier on Monday US President Barack Obama delivered a stern warning to rival Republicans against using the debt ceiling as leverage to get more spending cuts, saying the failure to raise it would sew financial chaos.

Congress's refusal to raise the debt limit beyond its current level of US$16.4 trillion could delay key government payments.

Obama warned that this could include Social Security checks and veterans benefits, paychecks to troops, air traffic controllers, and the honouring of contracts with small businesses.

- AFP/jc

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LoC killings may delay NIA visit to Pakistan

MUMBAI: The National Investigation Agency's (NIA) plan to visit Pakistan to collect voice samples of the 26/11 terror attack conspirators and the Pakistan's judicial commission's likely visit to Mumbai next month to cross-examine four witnesses may be delayed following the tension after the killings of two Indian soldiers.

The NIA was planning to visit Pakistan collect the voice samples of six Laskhar-e-Taiba operatives—Sayyed Hafeez, Zaki Ur Rahman Lakhvi, Abu Kahafa, Abdul Rahman, Sajid Majid and Zarar Shah— who were arrested in Pakistan.

Sources said the killings of two army jawans last week at the LOC by the Pakistan army has dampened the spirit of mutual talks and cross investigations. "Till recently, the security establishments of the two countries were exchanging notes through the ministry of external affairs. Now the establishments will have to wait till the situation becomes normal," said a senior government official.

A police official said though there was no word from Pakistan cancelling its commission's visit, the Indian government is no mood to send the NIA to Pakistan in the wake of the tension.

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Hospitals crack down on workers refusing flu shots

CHICAGO (AP) — Patients can refuse a flu shot. Should doctors and nurses have that right, too? That is the thorny question surfacing as U.S. hospitals increasingly crack down on employees who won't get flu shots, with some workers losing their jobs over their refusal.

"Where does it say that I am no longer a patient if I'm a nurse," wondered Carrie Calhoun, a longtime critical care nurse in suburban Chicago who was fired last month after she refused a flu shot.

Hospitals' get-tougher measures coincide with an earlier-than-usual flu season hitting harder than in recent mild seasons. Flu is widespread in most states, and at least 20 children have died.

Most doctors and nurses do get flu shots. But in the past two months, at least 15 nurses and other hospital staffers in four states have been fired for refusing, and several others have resigned, according to affected workers, hospital authorities and published reports.

In Rhode Island, one of three states with tough penalties behind a mandatory vaccine policy for health care workers, more than 1,000 workers recently signed a petition opposing the policy, according to a labor union that has filed suit to end the regulation.

Why would people whose job is to protect sick patients refuse a flu shot? The reasons vary: allergies to flu vaccine, which are rare; religious objections; and skepticism about whether vaccinating health workers will prevent flu in patients.

Dr. Carolyn Bridges, associate director for adult immunization at the federal Centers for Disease Control and Prevention, says the strongest evidence is from studies in nursing homes, linking flu vaccination among health care workers with fewer patient deaths from all causes.

"We would all like to see stronger data," she said. But other evidence shows flu vaccination "significantly decreases" flu cases, she said. "It should work the same in a health care worker versus somebody out in the community."

Cancer nurse Joyce Gingerich is among the skeptics and says her decision to avoid the shot is mostly "a personal thing." She's among seven employees at IU Health Goshen Hospital in northern Indiana who were recently fired for refusing flu shots. Gingerich said she gets other vaccinations but thinks it should be a choice. She opposes "the injustice of being forced to put something in my body."

Medical ethicist Art Caplan says health care workers' ethical obligation to protect patients trumps their individual rights.

"If you don't want to do it, you shouldn't work in that environment," said Caplan, medical ethics chief at New York University's Langone Medical Center. "Patients should demand that their health care provider gets flu shots — and they should ask them."

For some people, flu causes only mild symptoms. But it can also lead to pneumonia, and there are thousands of hospitalizations and deaths each year. The number of deaths has varied in recent decades from about 3,000 to 49,000.

A survey by CDC researchers found that in 2011, more than 400 U.S. hospitals required flu vaccinations for their employees and 29 hospitals fired unvaccinated employees.

At Calhoun's hospital, Alexian Brothers Medical Center in Elk Grove Village, Ill., unvaccinated workers granted exemptions must wear masks and tell patients, "I'm wearing the mask for your safety," Calhoun says. She says that's discriminatory and may make patients want to avoid "the dirty nurse" with the mask.

The hospital justified its vaccination policy in an email, citing the CDC's warning that this year's flu outbreak was "expected to be among the worst in a decade" and noted that Illinois has already been hit especially hard. The mandatory vaccine policy "is consistent with our health system's mission to provide the safest environment possible."

The government recommends flu shots for nearly everyone, starting at age 6 months. Vaccination rates among the general public are generally lower than among health care workers.

According to the most recent federal data, about 63 percent of U.S. health care workers had flu shots as of November. That's up from previous years, but the government wants 90 percent coverage of health care workers by 2020.

The highest rate, about 88 percent, was among pharmacists, followed by doctors at 84 percent, and nurses, 82 percent. Fewer than half of nursing assistants and aides are vaccinated, Bridges said.

Some hospitals have achieved 90 percent but many fall short. A government health advisory panel has urged those below 90 percent to consider a mandatory program.

Also, the accreditation body over hospitals requires them to offer flu vaccines to workers, and those failing to do that and improve vaccination rates could lose accreditation.

Starting this year, the government's Centers for Medicare & Medicaid Services is requiring hospitals to report employees' flu vaccination rates as a means to boost the rates, the CDC's Bridges said. Eventually the data will be posted on the agency's "Hospital Compare" website.

Several leading doctor groups support mandatory flu shots for workers. And the American Medical Association in November endorsed mandatory shots for those with direct patient contact in nursing homes; elderly patients are particularly vulnerable to flu-related complications. The American Nurses Association supports mandates if they're adopted at the state level and affect all hospitals, but also says exceptions should be allowed for medical or religious reasons.

Mandates for vaccinating health care workers against other diseases, including measles, mumps and hepatitis, are widely accepted. But some workers have less faith that flu shots work — partly because there are several types of flu virus that often differ each season and manufacturers must reformulate vaccines to try and match the circulating strains.

While not 100 percent effective, this year's vaccine is a good match, the CDC's Bridges said.

Several states have laws or regulations requiring flu vaccination for health care workers but only three — Arkansas, Maine and Rhode Island — spell out penalties for those who refuse, according to Alexandra Stewart, a George Washington University expert in immunization policy and co-author of a study appearing this month in the journal Vaccine.

Rhode Island's regulation, enacted in December, may be the toughest and is being challenged in court by a health workers union. The rule allows exemptions for religious or medical reasons, but requires unvaccinated workers in contact with patients to wear face masks during flu season. Employees who refuse the masks can be fined $100 and may face a complaint or reprimand for unprofessional conduct that could result in losing their professional license.

Some Rhode Island hospitals post signs announcing that workers wearing masks have not received flu shots. Opponents say the masks violate their health privacy.

"We really strongly support the goal of increasing vaccination rates among health care workers and among the population as a whole," but it should be voluntary, said SEIU Healthcare Employees Union spokesman Chas Walker.

Supporters of health care worker mandates note that to protect public health, courts have endorsed forced vaccination laws affecting the general population during disease outbreaks, and have upheld vaccination requirements for schoolchildren.

Cases involving flu vaccine mandates for health workers have had less success. A 2009 New York state regulation mandating health care worker vaccinations for swine flu and seasonal flu was challenged in court but was later rescinded because of a vaccine shortage. And labor unions have challenged individual hospital mandates enacted without collective bargaining; an appeals court upheld that argument in 2007 in a widely cited case involving Virginia Mason Hospital in Seattle.

Calhoun, the Illinois nurse, says she is unsure of her options.

"Most of the hospitals in my area are all implementing these policies," she said. "This conflict could end the career I have dedicated myself to."

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Online:

R.I. union lawsuit against mandatory vaccines: http://www.seiu1199ne.org/files/2013/01/FluLawsuitRI.pdf

CDC: http://www.cdc.gov

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

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Poll: After Newtown, Most Back Some Gun Controls

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A majority of Americans favor such gun control measures as banning assault weapons and expanding background checks on those who buy guns and ammunition, with support for banning high-capacity ammunition magazines at a new high in ABC News/Washington Post polls.

With Vice President Joe Biden set to present recommendations that were prompted by the Newtown, Conn., school shootings last month, this latest poll shows overwhelming support for certain moves: Eighty-eight percent favor background checks on firearms buyers at gun shows; 76 percent support checks on buyers of ammunition and 71 percent back a new federal database that would track all gun sales.

For full results, charts and tables, CLICK HERE

Sixty-five percent also support banning high-capacity ammunition magazines, a high in three ABC/Post polls to test the idea since early 2011, and up by 6 percentage points since just after the Newtown shootings. Among other suggestions, 58 percent favor banning the sale of so-called assault weapons, 55 percent support the National Rifle Association’s call for armed guards in schools and 51 percent would ban semi-automatic handguns.

Notably, support for the most popular of these measures – expanded background checks, a gun database and banning high-capacity magazines – includes a majority of people who live in gun-owning households, a group that accounts for 44 percent of all adults in this country.

The intensity of support for all these proposals is also notable; “strong” support for each measure outstrips strong opposition, in most cases by overwhelming margins (save the two less-popular items, armed school guards and a semi-automatic handgun ban). For instance, 50 percent “strongly” favor banning assault weapons, twice the number who strongly opposes it. And 76 percent strongly support background checks at gun shows, while only 8 percent say they’re are strongly opposed.

Fifty-five percent in this poll, produced for ABC by Langer Research Associates, express worry about a mass shooting in their own communities, and 52 percent say the Newtown shootings have made them more likely to support some forms of gun control.

As noted, support for banning high-capacity magazines is at a new high in polling since 2011. But there’s no consistent change on other proposals. Support for background checks on gun show buyers is essentially the same as it was in the late 1990s; support for banning assault weapons is numerically up from its low in 2009  but still well below its levels in the mid- to late 1990s; and support for banning semi-automatic handguns has been essentially steady in recent years.

ACTION – Looking ahead to the possibility of legislative action, most Americans give the issue at least a high priority for the president and Congress to address, but not “the highest,” and more give greater priority to  ”addressing gun violence” (68 percent) than specifically “enacting stricter gun control laws” (59 percent).

While they reach majorities, both of these are lower on the list than other top-shelf issues, including the economy, cutting federal spending, restructuring the tax system and slowing the rate of growth in spending on Social Security and Medicare.

The higher priority for “addressing gun violence” versus “enacting stricter gun control laws” (in a split-sample test) likely reflects some compunctions about whether gun control measures will work. The public, for instance, divides on whether stricter gun laws or armed guards in schools would be more effective (43-41 percent), and as many or more blame gun violence on inadequate treatment of the mentally ill, and on irresponsibility among gun owners, as on other causes.

FACTORS – Many factors receive broad blame for gun crimes. Leading the list, more than eight in 10 see inadequate treatment of the mentally ill, inadequate background checks and lack of individual responsibility by gun owners as contributors to gun violence, and more than half, in each case, say these contribute “a great deal” to the problem.

Sixty-nine to 73 percent also see the availability of semi-automatic handguns, high-capacity ammunition clips and assault weapons as contributors – yet as many say the same about the prevalence of violence in TV programs, movies and video games. The fewest numerically, 38 percent, believe violence in the media contributes “a great deal” to gun violence.

There are three items on which more people say the issue contributes to gun violence than favor legislative action: Sixty-nine percent see access to semi-automatic handguns as a contributor, versus 51 percent who favor banning such weapons; 73 percent say assault weapons are a contributor, versus 58 percent who favor banning those; and 70 percent see high-capacity magazines as a factor in gun violence, while slightly fewer, 65 percent, would ban them. The gaps apparently exist at least in part because support for action is lower among those who see these as contributing “somewhat” but not a great deal to gun violence – a group that includes more pro-gun individuals, such as people in gun-owning households, men and political conservatives.

GROUPS – There are striking differences among groups on some, but not all, gun control issues. Support for gun control measures generally is higher among women than men, with the gap peaking on a ban on semi-automatic handguns, supported by 60 percent of women versus 40 percent of men.

In addition to the expected partisan and ideological divisions, support for gun control also is higher in several cases among senior citizens vs. the youngest adults, among city dwellers vs. those in suburbs or rural areas, in Democratic-voting blue states vs. more-Republican red states, and in non-gun households vs. those in which someone owns a firearm. There also are regional divisions, with support for gun control typically highest in the Northeast and lowest in the South.

These differences, however, generally fade on the issues on which agreement is most broad – background checks, a gun database and banning high-capacity magazines.

Patterns are different in support for armed guards in schools; this idea is more popular with conservatives versus liberals (63 versus 44 percent), in red versus blue states (67 versus 49 percent) and among Republicans versus Democrats and independents (65 versus 52 percent). It also gets more support from parents with minor children, 62 percent, versus 51 percent among other adults. In the biggest gap, the proposal for armed school guards is nearly 30 points more popular with people who see the NRA’s leadership favorably than among those who see it unfavorably, 69 versus 40 percent.

There are other differences among groups that inform views on gun control. Women, for instance, are 13 points more apt than men to say the Newtown shootings have made them more likely to support some forms of gun control, and 16 points more likely to be worried that a mass shooting could occur in their own area. That worry is a prime factor in support for stricter gun laws.

THE NRA – While recent polls have found the NRA to be popular overall with a majority of Americans, this survey finds a less positive assessment of the association’s leadership -  more see it unfavorably than favorably by an 8-point margin, 44 versus 36 percent, although many don’t know enough to say.

There’s a mixed result on the NRA’s influence on gun policy; on the one hand more, 38 percent, say it has too much influence versus too little (24 percent) or about the right amount (30 percent). At the same time, that makes a majority, netted, saying its influence is too little or about right.

The NRA’s leadership, naturally, has far more support among people in gun-owning versus non-gun-owning households – a 52 percent versus 22 percent favorable rating. Similarly, 49 percent in non-gun households say the NRA has too much influence over gun laws. In gun households 27 percent, agree.

METHODOLOGY – This ABC News/Washington Post poll was conducted by telephone Jan. 10-13, 2013, among a random national sample of 1,001 adults, including landline and cell-phone-only respondents. Results have a margin of sampling error of 3.5 points, including design effect. Partisan divisions are 33-24-37 percent, Democrats-Republicans-independents.

The survey was produced for ABC News by Langer Research Associates of New York, N.Y., with sampling, data collection and tabulation by Abt-SRBI of New York, N.Y.

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