Quadruple Amputee Gets Two New Hands on Life

It's the simplest thing, the grasp of one hand in another. But Lindsay Ess will never see it that way, because her hands once belonged to someone else.

Growing up in Texas and Virginia, Lindsay, 29, was always one of the pretty girls. She went to college, did some modeling and started building a career in fashion, with an eye on producing fashion shows.

Then she lost her hands and feet.

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When she was 24 years old, Lindsay had just graduated from Virginia Commonwealth University's well-regarded fashion program when she developed a blockage in her small intestine from Crohn's Disease. After having surgery to correct the problem, an infection took over and shut down her entire body. To save her life, doctors put her in a medically-induced coma. When she came out of the coma a month later, still in a haze, Lindsay said she knew something was wrong with her hands and feet.

"I would look down and I would see black, almost like a body that had decomposed," she said.

The infection had turned her extremities into dead tissue. Still sedated, Lindsay said she didn't realize what that meant at first.

"There was a period of time where they didn't tell me that they had to amputate, but somebody from the staff said, 'Oh honey, you know what they are going to do to your hands, right?' That's when I knew," she said.

After having her hands and feet amputated, Lindsay adapted. She learned how to drink from a cup, brush her teeth and even text on her cellphone with her arms, which were amputated just below the elbow.

"The most common questions I get are, 'How do you type,'" she said. "It's just like chicken-pecking."

PHOTOS: Lindsay Ess Gets New Hands

Despite her progress, Lindsay said she faced challenges being independent. Her mother, Judith Aronson, basically moved back into her daughter's life to provide basic care, including bathing, dressing and feeding. Having also lost her feet, Lindsay needed her mother to help put on her prosthetic legs.

"I've accepted the fact that my feet are gone, that's acceptable to me," Lindsay said. "My hands [are] not. It's still not. In my dreams I always have my hands."

Through her amputation recovery, Lindsay discovered a lot of things about herself, including that she felt better emotionally by not focusing on the life that was gone and how much she hated needing so much help but that she also truly depends on it.

"I'm such an independent person," she said. "But I'm also grateful that I have a mother like that, because what could I do?"

Lindsay said she found that her prosthetic arms were a struggle.

"These prosthetics are s---," she said. "I can't do anything with them. I can't do anything behind my head. They are heavy. They are made for men. They are claws, they are not feminine whatsoever."

For the next couple of years, Lindsay exercised diligently as part of the commitment she made to qualify for a hand transplant, which required her to be in shape. But the tough young woman now said she saw her body in a different way now.

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Damascus blames "terrorists" for petrol station blast

BEIRUT (Reuters) - Syria on Friday said a car bomb at a crowded petrol station in Damascus on Thursday night was set off by "terrorists", a term it uses for rebels seeking to topple President Bashar al-Assad.

The bomb killed 11 people and wounded 40 at a station packed with Syrians queuing for fuel, which has become scarce in the 21-month insurgency against Assad, in the second petrol station attack in the capital this week, opposition activists said.

"Terrorists ... blew up an explosive device at Qassioun Petrol Station near Hamish Hospital in Barzeh, Damascus, martyring several civilians," state news agency SANA said.

The United Nations says more than 60,000 people have been killed in the civil war, the longest, bloodiest conflict born from uprisings across the Arab world in the past two years.

Dozens of people were incinerated in an air strike as they waited for fuel at another Damascus petrol station on Wednesday, according to opposition sources.

The semi-official al-Ikhbariya television station aired its own footage from Barzeh, indicating the attack struck a government-held area. Barzeh's residents include members of the Sunni Muslim majority and religious and ethnic minorities.

The rebels hold a crescent of suburbs on the southern and eastern edges of Damascus, which have come under bombardment by government forces. Rebel forces also seized territory in Syria's north and east during advances in the second half of 2012.

The war pits rebels, mainly from the Sunni Muslim majority, against a government supported by members of Assad's Shi'ite-derived Alawite sect and some members of other minorities who fear revenge if he falls. Assad's family has ruled for 42 years since his father seized power in a coup.

Fighting has forced 560,000 Syrians to flee to neighboring countries, according to the U.N.

Lebanon, a country which has so far tried to distance itself from the conflict next door for fear it will inflame sectarian tensions, approved a plan to start registering 170,000 Syrian refugees and ask international donors for $180 million in aid.

"The Lebanese state will register the refugees...and guarantee aid and protection for the actual refugees in Lebanon," Social Affairs Minister Wael Abu Faour said after a six-hour cabinet session on Thursday night.

Most Sunni-ruled Arab states, as well as the West and Turkey have called for Assad to step down. He is supported by Russia and Shi'ite Iran.

ARMY WITHDRAWAL?

A Lebanese citizen who crossed into Syria through a mountainous frontier region said the army appeared to have withdrawn from several border posts and villages in the area.

Rebels controlled a line of border towns and villages north of the capital Damascus, stretching about 40 km (25 miles) from Yabroud south to Rankus, said the man, who did not want to be named and visited Syria on Wednesday and Thursday.

Rebels in the area reported that some of Assad's forces have pulled back to defend the main north-south highway linking Syria's main cities of Damascus, Homs, Hama and Aleppo, while others were sent to reinforce the northern approach to Damascus.

"The border is controlled by the Free Syrian Army rebels," he said on Friday, adding he had crossed through mountainous terrain, covered in parts by more than a meter of snow.

(Additional reporting by Dominic Evans in Beirut and Khaled Yacoub Oweis in Amman; Editing by Jason Webb)

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Delhi gang-rape victim's boyfriend speaks out

NEW DELHI: The boyfriend of a 23-year-old woman who died after a brutal gang rape on a New Delhi bus spoke out Friday for the first time about the savage attack that has sparked protests across the nation and his own trauma over his inability to save her.

The 28-year-old man, who suffered a fractured leg and other injuries in the attack, has been deeply traumatised and is currently at his parents' home in rural northern India where he is taking time out from his job at a software firm in New Delhi.

"What can I say? The cruelty I saw should not be seen ever. I tried to fight against the men but later I begged them again and again to leave her," he told AFP in an interview by phone from Gorakhpur, a town in Uttar Pradesh state.

On December 16, the couple had been out to watch a movie and decided to get into a private bus when several rickshaws had refused to drive them back to the victim's home in a New Delhi suburb.

Once in the bus, he was attacked and his girlfriend was gang-raped by six allegedly drunk men, including the driver, who also violated her with an iron bar causing immense internal damage that would lead to her death last weekend.

The horrifying crime has appalled India and brought simmering anger about widespread crime against women to the boil amid angry calls for better protection by police and changed social attitudes.

The boyfriend, who asked not to be named, also recounted how passersby had failed to come to their rescue after they were thrown out of the moving vehicle at the end of their nearly hour-long ordeal.

He was also critical of police for failing to be sensitive to his and his girlfriend's mental condition and also raised questions about the emergency care given in the public hospital where she was admitted.

"A passerby found us (after the attack), but he did not even give my friend his jacket. We waited for the police to come and save us," he told AFP.

The police have since arrested six suspects for the crime -- five men and a minor believed to be aged 17 -- who were charged with murder, rape and kidnapping in a city court on Thursday.

"I was not very confident about getting into the bus but my friend was running late, so we got into it. This was the biggest mistake I made and after that everything went out of control."

The driver of the bus then made lewd remarks and his accomplices joined him "to taunt" the couple, the boyfriend said.

He said he told the driver to stop the bus, but by then his accomplices had locked the two doors.

"They hit me with a small stick and dragged my friend to a seat near the driver's cabin."

After that the "driver and the other men raped my friend and hit her in the worst possible ways in the most private parts of her body".

"I cannot tell you what I feel when I think of it. I shiver in pain," he said.

He said the police who came to their rescue took his girlfriend to a government hospital, but failed to take into account his injuries and mental trauma.

"I was treated like an object by the police.... They wanted all the help to solve the case even before getting me the right treatment. Nobody witnessed the trauma I suffered," he said.

- AFP/jc

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Involve panchayati raj institutions in food delivery: NHRC

KOCHI: National Human Rights Commission (NHRC) has written to chief secretaries of all states to ensure that the system of food delivery be firmed up by active involvement of Panchayati Raj institutions.

"It is mandatory not just to have food as matter of right but also to ensure proper nutrition. Schemes are already available but we have to see and remove the discrepancies in existing schemes. Providing food should not be based on only quantity but on calories of energy", NHRC has recommended.

"There is need to dovetail with employment generation schemes and other interventions to ensure sustainable livelihood", it added.

The Commission had constituted a core group on Right to Food, comprising experts from across the country. Later a small group was constituted to crystallize the recommendations and suggestions made by the core group. This happened after NHRC took cognizance of starvation deaths in Kalahandi, Bolangir and Koraput districts of Odisha as starvation constitutes a gross denial and violation of right to life.

NHRC also had a day-long national conference on 'Right to Food' in New Delhi on Friday to analyse the right to food in terms of availability, accessibility, adequacy and sustainability; existing situation in the country regarding fulfilment and realization of the right to food; examination of the programme and policies being followed in realizing right to food; and steps to create awareness on the importance of the right to food.

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Indian court to rule on generic drug industry

NEW DELHI (AP) — From Africa's crowded AIDS clinics to the malarial jungles of Southeast Asia, the lives of millions of ill people in the developing world are hanging in the balance ahead of a legal ruling that will determine whether India's drug companies can continue to provide cheap versions of many life-saving medicines.

The case — involving Swiss drug maker Novartis AG's cancer drug Glivec — pits aid groups that argue India plays a vital role as the pharmacy to the poor against drug companies that insist they need strong patents to make drug development profitable. A ruling by India's Supreme Court is expected in early 2013.

"The implications of this case reach far beyond India, and far beyond this particular cancer drug," said Leena Menghaney, from the aid group Doctors Without Borders. "Across the world, there is a heavy dependence on India to supply affordable versions of expensive patented medicines."

With no costs for developing new drugs or conducting expensive trials, India's $26 billion generics industry is able to sell medicine for as little as one-tenth the price of the companies that developed them, making India the second-largest source of medicines distributed by UNICEF in its global programs.

Indian pharmaceutical companies such as Cipla, Cadila Laboratories and Lupin have emerged over the past decade as major sources of generic cancer, malaria, tuberculosis and AIDS drugs for poor countries that can't afford to pay Western prices.

The 6-year-old case that just wrapped up in the Supreme Court revolves around a legal provision in India's 2005 patent law that is aimed at preventing companies from getting fresh patents for making only minor changes to existing medicines — a practice known as "evergreening."

Novartis' argued that a new version of Glivec — marketed in the U.S. as Gleevec — was a significant change from the earlier version because it was more easily absorbed by the body.

India's Patent Controller turned down the application, saying the change was an obvious development, and the new medicine was not sufficiently distinct from the earlier version to warrant a patent extension.

Patient advocacy groups hailed the decision as a blow to "evergreening."

But Western companies argued that India's generic manufacturers were cutting the incentive for major drug makers to invest in research and innovation if they were not going to be able to reap the exclusive profits that patents bring.

"This case is about safeguarding incentives for better medicines so that patients' needs will be met in the future," says Eric Althoff, a Novartis spokesman.

International drug companies have accused India of disregarding intellectual property rights, and have pushed for stronger patent protection that would weaken India's generics industry.

Earlier this year, an Indian manufacturer was allowed to produce a far cheaper version of the kidney and liver cancer treatment sorefinib, manufactured by Bayer Corp.

Bayer was selling the drug for about $5,600 a month. Natco, the Indian company, said its generic version would cost $175 a month, less than 1/30th as much. Natco was ordered to pay 6 percent in royalties to Bayer.

Novartis says the outcome of the new case will not affect the availability of generic versions of Glivec because it is covered by a grandfather clause in India's patent law. Only the more easily absorbed drug would be affected, Althoff said, adding that its own generic business, Sandoz, produces cheap versions of its drugs for millions across the globe.

Public health activists say the question goes beyond Glivec to whether drug companies should get special protection for minor tweaks to medicines that others could easily have uncovered.

"We're looking to the Supreme Court to tell Novartis it won't open the floodgates and allow abusive patenting practices," said Eldred Tellis, of the Sankalp Rehabilitation Centre, a private group working with HIV patients.

The court's decision is expected to be a landmark that will influence future drug accessibility and price across the developing world.

"We're already paying very high prices for some of the new drugs that are patented in India," said Petros Isaakidis, an epidemiologist with Doctors Without Borders. "If Novartis' wins, even older medicines could be subject to patenting again, and it will become much more difficult for us in future to provide medicines to our patients being treated for HIV, hepatitis and drug resistant TB."

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Senate Swears in Historic 20th Female Senator

Today the Senate will make history, swearing in a record-breaking 20 female senators -- four Republicans and 16 Democrats -- in office.

As the 113th Congress is sworn in today on Capitol Hill, ABC "World News" anchor Diane Sawyer has an exclusive joint interview with the historic class of female senators.

Diane Sawyer's complete interview will air on "World News" and "Nightline" tonight.

"I can't tell you the joy that I feel in my heart to look at these 20 gifted and talented women from two different parties, different zip codes to fill this room," Sen. Barbara Mikulksi, D-Md., said while surrounded by the group of women senators. "In all of American history only 16 women had served. Now there are 20 of us."

Senator-elect Deb Fischer, R-Neb., today becomes the first women to be elected as a senator in Nebraska.

"It was an historic election," Fischer said, "But what was really fun about it were the number of mothers and fathers who brought their daughters up to me during the campaign and said, "Can we get a picture? Can we get a picture?' Because people realize it and -- things do change, things do change."

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The women senators all agree that women will be getting things done in this new Congress, a sign of optimism felt for the new Congress, after the bruising battles of the 112th Congress.

"We're in force and we're in leadership positions, but it's not just the position that we hold. I can tell you this is a can-do crowd," Mikulski said of both Democrats and Republican senators in the room. "We are today ready to be a force in American politics."

And while the number of women in the Senate today makes history, many of the women agreed that they want to keep fighting to boost those numbers.

Sen. Barbara Boxer, D-Calif., said that women are still "underrepresented" in the Senate.

"I think that until we get to 50, we still have to fight because it's still a problem," Boxer said. "I think this class as you look around, Republicans and Democrats. ... I think that because of this new class and the caliber of the people coming and the quality of the people coming, I think that hopefully in my lifetime -- and I really do hope and pray this is the case -- we will see 50 percent. "

No Sorority Here, Even With the Will to Work Together

The cooperation does not make them a "sorority," Sen. Dianne Feinstein, D-Calif., says. There are real differences in ideology and personality and they don't want their gender to define them as senators.

But the women also admit that they believe having more women in the room would help in fierce negotiations, compromise and legislating on Capitol Hill, traits they say do not come as naturally to their male colleagues in the Senate. That sentiment enjoys bipartisan support among the women of the Senate.

"What I find is with all due deference to our male colleagues, that women's styles tend to be more collaborative," Sen. Susan Collins, R-Maine, said.

Sen. Claire McCaskill, D-Mo., said by nature women are "less confrontational." Sen-elect Mazie Hirono, D-Hawaii, says that women are "problem solvers."

Sen. Amy Klobuchar, D-Minn., says that women have a camaraderie which helps in relationships that are key to negotiations on Capitol Hill, something she says comes natural to women more than men.

"I think there's just a lot of collaboration between the women senators and... advice and really standing up for each other that you don't always see with the men," she said.

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Syria rebels in push to capture air base

AZAZ, Syria (Reuters) - Rebels battled on Thursday to seize an air base in northern Syria, part of a campaign to fight back against the air power that has given President Bashar al-Assad's forces free rein to bomb rebel-held towns.

More than 60,000 people have been killed in the 21-month-old uprising and civil war, the United Nations said this week, sharply raising the death toll estimate in a conflict that shows no sign of ending.

After dramatic advances over the second half of 2012, the rebels now hold wide swathes of territory in the north and east, but are limited in exerting control because they cannot protect towns and villages from Assad's helicopters and jets.

Hundreds of fighters from rebel groups were attempting to storm the Taftanaz air base, near the northern highway that links Syria's two main cities, Aleppo and the capital Damascus.

Rebels have been besieging air bases across the north in recent weeks, in the hope this will reduce the government's power to carry out air strikes and resupply loyalist-held areas.

A rebel fighter speaking from near the Taftanaz base overnight said the base's main sections were still in loyalist hands but insurgents had managed to infiltrate and destroy a helicopter and a fighter jet on the ground.

The northern rebel Idlib Coordination Committee said the rebels had detonated a car bomb inside the base.

The government's SANA news agency said the base had not fallen and that the military had "strongly confronted an attempt by the terrorists to attack the airport from several axes, inflicting heavy losses among them and destroying their weapons and munitions".

Rami Abdulrahman, head of the opposition-aligned Syrian Observatory for Human Rights which monitors the conflict from Britain, said as many as 800 fighters were involved in the assault, including Islamists from Jabhat al-Nusra, a powerful group that Washington considers terrorists.

Taftanaz is mainly a helicopter base, used for missions to resupply army positions in the north, many of which are cut off by road because of rebel gains, as well as for dropping crude "barrel bombs" of explosives on rebel-controlled areas.

"WHAT IS THE FAULT OF THE CHILDREN?"

Near Minakh, another northern air base that rebels have surrounded, government forces have retaliated by regularly shelling and bombing nearby towns.

In the town of Azaz, where the bombardment has become a near nightly occurrence, shells hit a family house overnight. Zeinab Hammadi said her two wounded daughters, aged 10 and 12, had been rushed across the border to Turkey, one with her brain exposed.

"We were sleeping and it just landed on us in the blink of an eye," she said, weeping as she surveyed the damage.

Family members tried to salvage possessions from the wreckage, men lifting out furniture and children carrying out their belongings in tubs.

"He (Assad) wants revenge against the people," said Abu Hassan, 33, working at a garage near the destroyed house. "What is the fault of the children? Are they the ones fighting?"

Opposition activists said warplanes struck a residential building in another rebel-held northern town, Hayyan, killing at least eight civilians.

Video footage showed men carrying dismembered bodies of children and dozens of people searching for victims in the rubble of the destroyed building, shouting "God is greatest". The provenance of the video could not be independently confirmed.

In addition to their tenuous grip on the north, the rebels also hold a crescent of suburbs on the edge of Damascus, which have come under bombardment by government forces that control the center of the capital.

On Wednesday, according to opposition activists, dozens of people were incinerated in an inferno caused by an air strike on a petrol station in a Damascus suburb where residents were lining up for precious fuel.

The civil war in Syria has become the longest and bloodiest of the conflicts that rose out of uprisings across the Arab world in the past two years.

Assad's family has ruled for 42 years since his father seized power in a coup. The war pits rebels, mainly from the Sunni Muslim majority, against a government supported by members of Assad's Shi'ite-derived Alawite minority sect and some members of other minorities who fear revenge if he falls.

The West, most Sunni-ruled Arab states and Turkey have called for Assad to leave power. He is supported by Russia and Shi'ite Iran.

(Additional reporting by Khaled Yacoub Oweis in Amman and Dominic Evans in Beirut; Writing by Peter Graff; Editing by Ruth Pitchford)

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Football: Balotelli and Mancini clash in training-ground row

LONDON: Mario Balotelli's future at Manchester City was cast into doubt once again on Thursday after photographs emerged showing him in an apparent training-ground bust-up with manager Roberto Mancini.

Media reports claimed that Mancini lost his temper with his Italian compatriot after Balotelli made a reckless challenge on team-mate Scott Sinclair at the club's Carrington training base on the edge of Manchester.

The pictures, published widely in the British media, show Mancini gripping Balotelli's orange bib in an apparent rage, before the two men are separated by members of City's coaching staff.

An eye-witness, quoted in local newspaper the Manchester Evening News, said: "Mancini ran at him -- he was furious. He grabbed hold of him and appeared to try and throw him on the floor.

"It looked like Mario was too strong and he couldn't get him down. Then all the coaches ran in to separate them but Mancini was having none of it. He kept trying to break free and have a go at him again."

Balotelli was also pictured walking to his car in the car park after the end of the session.

The Italy striker, 22, has been a recurrent source of controversy ever since arriving in Manchester from Inter Milan in 2010.

He has twice been dropped from City's match-day squad this season and Mancini has repeatedly warned him that he is in danger of wasting his talent.

In December, Balotelli dropped legal action against City after taking them to a Premier League tribunal in an attempt to overturn a fine of two weeks' wages over his poor disciplinary record last season.

Mancini also chastised him after a sloppy performance in City's 3-2 loss to Manchester United in last month's Manchester derby, in which he was substituted in the 52nd minute.

"I love Mario like a guy, and as a player, but I think it's important for him to start to think about his job if he wants to play well," said Mancini.

"When you have a player with Mario's quality, you can't believe that he throws his quality out of the window.

"I've seen players in my life with fantastic quality who ended up with nothing and I don't want Mario to finish like these players, because it will be bad for him."

Balotelli is yet to play since that game, with a virus having ruled him out of City's festive fixtures, but he could feature in Saturday's FA Cup third-round tie against second-tier Watford.

- AFP/jc

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Mumbai underworld angle to attack on Geelani in 2005?

NEW DELHI: There was also a Mumbai underworld angle involving gangster Chhota Rajan aides to the shooting at S A R Geelani before the Samjhauta Express accused Rajender Chaudhary allegedly confessed to the National Investigation Agency (NIA) that it was the handiwork of Hindu fanatics. The underworld angle, revealed to Mumbai Crime Branch in 2005 itself, was, however, never explored further.

Accused and later acquitted in the 2001 Parliament attack case, Geelani was shot at in Vasant Vihar in February 2005. Five months later, in June 2005, Mumbai Crime Branch arrested Rajan's two close aides - Vickey Malhotra and Farid Tanasha - from here in connection with a case of extortion.

During interrogation, Tanansha told Crime Branch officers that he had not only helped Indian agencies reach Afzal Guru, prime accused in the Parliament attack case, but also engineered the attack on Geelani.

Sources say Tanasha, who was gunned down by his rivals in 2010, was close to certain sections of the Indian intelligence apparatus who used him to sabotage activities of underworld don Dawood Ibrahim. He had allegedly even been sent to Pakistan to organize Dawood's killing but failed to carry it out. His arrest, says sources, in fact caused a lot of friction between the Mumbai Police and the intelligence set up.

The news of Tanasha owning up to the attack, however, found its way to the Mumbai media, even though this fact was never taken on record in his statement by Mumbai Crime Branch. Sources said that it happened because of two reasons: first, the revelation was not relevant to the case being investigated by the Mumbai Crime Branch and second, in absence of any evidence Tanasha could not be believed given most underworld entities are given to bragging.

"The entire Rajan gang found its ideological mores from what they called 'patriotic killings'. This meant that they would go after 1993 blast accused Dawood Ibrahim's men or those found involved in Islamic terror. In lieu, they would get protection from Indian agencies. They never missed a chance to score this 'patriotic' point either by killing someone found to be anti-national or by owning up to the killing of that person, even if falsely. Thus, it is quite possible that they tried killing Geelani, but it is equally possible that they were merely claiming it", said a senior Mumbai Police official.

During NIA interrogation, sources said, Rajender Chaudhary has confessed to having been involved in the shooting at Geelani. He has said that he was riding a bike while another Samjhauta blast accused Lokesh Sharma was riding pillion when at Vasant Vihar, Sharma shot at Geelani from the running bike.

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Flu? Malaria? Disease forecasters look to the sky

NEW YORK (AP) — Only a 10 percent chance of showers today, but a 70 percent chance of flu next month.

That's the kind of forecasting health scientists are trying to move toward, as they increasingly include weather data in their attempts to predict disease outbreaks.

In one recent study, two scientists reported they could predict — more than seven weeks in advance — when flu season was going to peak in New York City. Theirs was just the latest in a growing wave of computer models that factor in rainfall, temperature or other weather conditions to forecast disease.

Health officials are excited by this kind of work and the idea that it could be used to fine-tune vaccination campaigns or other disease prevention efforts.

At the same time, experts note that outbreaks are influenced as much, or more, by human behavior and other factors as by the weather. Some argue weather-based outbreak predictions still have a long way to go. And when government health officials warned in early December that flu season seemed to be off to an early start, they said there was no evidence it was driven by the weather.

This disease-forecasting concept is not new: Scientists have been working on mathematical models to predict outbreaks for decades and have long factored in the weather. They have known, for example, that temperature and rainfall affect the breeding of mosquitoes that carry malaria, West Nile virus and other dangerous diseases.

Recent improvements in weather-tracking have helped, including satellite technology and more sophisticated computer data processing.

As a result, "in the last five years or so, there's been quite an improvement and acceleration" in weather-focused disease modeling, said Ira Longini, a University of Florida biostatistician who's worked on outbreak prediction projects.

Some models have been labeled successes.

In the United States, researchers at Johns Hopkins University and the University of New Mexico tried to predict outbreaks of hantavirus in the late 1990s. They used rain and snow data and other information to study patterns of plant growth that attract rodents. People catch the disease from the droppings of infected rodents.

"We predicted what would happen later that year," said Gregory Glass, a Johns Hopkins researcher who worked on the project.

More recently, in east Africa, satellites have been used to predict rainfall by measuring sea-surface temperatures and cloud density. That's been used to generate "risk maps" for Rift Valley fever — a virus that spreads from animals to people and in severe cases can cause blindness or death. Researchers have said the system in some cases has given two to six weeks advance warning.

Last year, other researchers using satellite data in east Africa said they found that a small change in average temperature was a warning sign cholera cases would double within four months.

"We are getting very close to developing a viable forecasting system" against cholera that can help health officials in African countries ramp up emergency vaccinations and other efforts, said a statement by one of the authors, Rita Reyburn of the International Vaccine Institute in Seoul, South Korea.

Some diseases are hard to forecast, such as West Nile virus. Last year, the U.S. suffered one of its worst years since the virus arrived in 1999. There were more than 2,600 serious illnesses and nearly 240 deaths.

Officials said the mild winter, early spring and very hot summer helped spur mosquito breeding and the spread of the virus. But the danger wasn't spread uniformly. In Texas, the Dallas area was particularly hard-hit, while other places, including some with similar weather patterns and the same type of mosquitoes, were not as affected.

"Why Dallas, and not areas with similar ecological conditions? We don't really know," said Roger Nasci of the Centers for Disease Control and Prevention. He is chief of the CDC branch that tracks insect-borne viruses.

Some think flu lends itself to outbreak forecasting — there's already a predictability to the annual winter flu season. But that's been tricky, too.

Seasonal flu reports come from doctors' offices, but those show the disease when it's already spreading. Some researchers have studied tweets on Twitter and searches on Google, but their work has offered a jump of only a week or two on traditional methods.

In the study of New York City flu cases published last month in the Proceedings of the National Academy of Sciences, the authors said they could forecast, by up to seven weeks, the peak of flu season.

They designed a model based on weather and flu data from past years, 2003-09. In part, their design was based on earlier studies that found flu virus spreads better when the air is dry and turns colder. They made calculations based on humidity readings and on Google Flu Trends, which tracks how many people are searching each day for information on flu-related topics (often because they're beginning to feel ill).

Using that model, they hope to try real-time predictions as early as next year, said Jeffrey Shaman of Columbia University, who led the work.

"It's certainly exciting," said Lyn Finelli, the CDC's flu surveillance chief. She said the CDC supports Shaman's work, but agency officials are eager to see follow-up studies showing the model can predict flu trends in places different from New York, like Miami.

Despite the optimism by some, Dr. Edward Ryan, a Harvard University professor of immunology and infectious diseases, is cautious about weather-based prediction models. "I'm not sure any of them are ready for prime time," he said.

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