US flu outbreak claims at least 18 lives

WASHINGTON: The United States was in the grip Thursday of a deadly influenza outbreak that has hit harder and earlier than in previous years, and has claimed the lives of at least 18 children.

"It looks like the worst year we had since 2003-2004," said Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases.

Fauci said this year's influenza strain, which has sickened thousands across the country, is particularly severe.

"The type of flu is one that generally is more serious. It's the H3N2 variety, which is historically more serious than we see with other types of virus," he said.

The epidemic, which broke out at the beginning of December, has caused some 2,200 hospitalizations across the United States, federal health officials said.

Particularly hard hit has been the northeastern city of Boston, where officials have declared a public health emergency.

City officials there said there so far have been about 700 confirmed cases of flu, almost 10 times the number from this time last year.

"This is the worst flu season we've seen since 2009, and people should take the threat of flu seriously," Boston Mayor Thomas Menino said in a statement.

"I'm urging residents to get vaccinated if they haven't already. It's the best thing you can do to protect yourself and your family. If you're sick, please stay home from work or school," he said.

Joe Bresee, chief of the Epidemiology and Prevention Branch of the Centers for Disease Control and Prevention's Influenza division, said officials don't yet know how much worse this year's outbreak will get.

"While we can't say for certain how severe this season will be, we can say that a lot of people are getting sick with influenza and we are getting reports of severe illness and hospitalizations," he said.

US states, particularly in the northeast of the country, have seen a sharp spike in emergency room visits from patients reporting flu-like symptoms, according to the federal CDC in Atlanta.

In Allentown, Pennsylvania, one hospital had to erect a large outdoor tent to admit and treat the large number of flu sufferers.

Health officials said that the flu vaccine is a good match for the strain of influenza circulating around the nation, and confers about 60 per cent to 65 per cent protection against the illness.

"You might get the flu but it will likely be less severe if you are vaccinated," Fauci said.

- AFP/ck

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Motor vehicle trader dies on H1N1 in Amritsar

TARN TARAN: A motor vehicle trader of Booh Hawelian village in Tarn Taran district died of swine flu in Amritsar on Thursday. Joga Singh, 26, was admitted in Guru Nanak Dev Hospital in the wee hours of Thursday and shifted to isolation ward after he tested H1N1 positive. District epidemiologist, civil hospital, Tarn Taran,. Swaranjit Singh Dhawan said the deceased had undertaken a business trip of Moga and other places about 10 days back and had not been feeling well after that. Initially, he had taken treatment at a private hospital in Amritsar.

Undertrial escapes from court complex: An undertrial lodged in Gurdaspur jail escaped after dodging the policemen accompanying him at district court complex on Thursday. According to reports, Avtar Singh was brought to the complex under police security for a court appearance. Police have registered a case and begun investigations.

Father, son arrested with opium, poppy husk: Jalandhar (rural) police have arrested a father-son duo with opium, poppy husk and a revolver from Shahkot area. SSP Yurinder Singh Hayer said police had intercepted a jeep stolen from Chandigarh on a tip off and arrested Pooran Singh and his son Jodh Singh of Bhoepur village of Shahkot subdivision. SP(D) Rajinder Singh said Pooran was convicted in an NDPS case and sentenced to 10 years imprisonment but was out on bail after spending four and half years in jail.

2 youth caught with 1kg gold: Shambu police arrested two Mathura-based residents and seized 1kg gold from their possession when they failed to show any documents. A team led by SHO Manjit Singh had laid a naka on the Punjab and Haryana border and were checking a PRTC bus around 4.30pm, when two young men became nervous when asked about their destination. A search revealed seizure of gold worth Rs 40 lakhs from their possession. The accused have been identified as Sandip Kumar and Ghanaiya Sharma. They were taking the gold from Mathura to Patiala.

Meet discusses steps to check wastage: At a conference organized by at the National Institute of Food Technology Entrepreneur and Management in Sonipat on Thursday, experts blamed lack of skilled manpower and shortage of infrastructure for wastage of up to 40% of food produced in India every year. They stressed on the need for skilled manpower of around 35 lakh people in the next seven years for food processing industry, besides creating cold storage chains across the country to cut down the wastage. Minister of state for agriculture and food processing industries Tariq Anwar said that FDI in retail sector had been allowed with the conditions to invest 50% of the total money on creating infrastructure like cold storages and processing units.

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Google and Twitter Help Track Influenza Outbreaks

This flu season could be the longest and worst in years. So far 18 children have died from flu-related symptoms, and 2,257 people have been hospitalized.

Yesterday Boston Mayor Thomas Menino declared a citywide public health emergency, with roughly 700 confirmed flu cases—ten times the number the city saw last year.

"It arrived five weeks early, and it's shaping up to be a pretty bad flu season," said Lyn Finelli, who heads the Influenza Outbreak Response Team at the Centers for Disease Control and Prevention (CDC).

Boston isn't alone. According to the CDC, 41 states have reported widespread influenza activity, and in the last week of 2012, 5.6 percent of doctor's office visits across the country were for influenza-like illnesses. The severity likely stems from this year's predominant virus: H3N2, a strain known to severely affect children and the elderly. Finelli notes that the 2003-2004 flu season, also dominated by H3N2, produced similar numbers. (See "Are You Prepped? The Influenza Roundup.")

In tracking the flu, physicians and public health officials have a host of new surveillance tools at their disposal thanks to crowdsourcing and social media. Such tools let them get a sense of the flu's reach in real time rather than wait weeks for doctor's offices and state health departments to report in.

Pulling data from online sources "is no different than getting information on over-the-counter medication or thermometer purchases [to track against an outbreak]," said Philip Polgreen, an epidemiologist at the University of Iowa.

The most successful of these endeavors, Google Flu Trends, analyzes flu-related Internet search terms like "flu symptoms" or "flu medication" to estimate flu activity in different areas. It tracks flu outbreaks globally.

Another tool, HealthMap, which is sponsored by Boston Children's Hospital, mines online news reports to track outbreaks in real time. Sickweather draws from posts on Twitter and Facebook that mention the flu for its data.

People can be flu-hunters themselves with Flu Near You, a project that asks people to report their symptoms once a week. So far more than 38,000 people have signed up for this crowdsourced virus tracker. And of course, there's an app for that.

Both Finelli, a Flu Near You user, and Polgreen find the new tools exciting but agree that they have limits. "It's not as if we can replace traditional surveillance. It's really just a supplement, but it's timely," said Polgreen.

When people have timely warning that there's flu in the community, they can get vaccinated, and hospitals can plan ahead. According to a 2012 study in Clinical Infectious Diseases, Google Flu Trends has shown promise predicting emergency room flu traffic. Some researchers are even using a combination of the web database and weather data to predict when outbreaks will peak.

As for the current flu season, it's still impossible to predict week-to-week peaks and troughs. "We expect that it will last a few more weeks, but we can never tell how bad it's going to get," said Finelli.

Hospitals are already taking precautionary measures. One Pennsylvania hospital erected a separate emergency room tent for additional flu patients. This week, several Illinois hospitals went on "bypass," alerting local first responders that they're at capacity—due to an uptick in both flu and non-flu cases—so that patients will be taken to alternative facilities, if possible.

In the meantime, the CDC advises vaccination, first and foremost. On the bright side, the flu vaccine being used this year is a good match for the H3N2 strain. Though Finelli cautions, "Sometimes drifted strains pop up toward the end of the season."

It looks like there won't be shortages of seasonal flu vaccine like there have been in past years. HealthMap sports a Flu Vaccine Finder to make it a snap to find a dose nearby. And if the flu-shot line at the neighborhood pharmacy seems overwhelming, more health departments and clinics are offering drive-through options.

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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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Jack Lew, sensitive scribbler

Go ahead and mock White House Chief of Staff Jacob “Jack” Lew for his odd, loopy signature — the one likely to grace dollar bills if, as expected, he becomes Treasury secretary. But be gentle with him, please.

It turns out the hard-charging Lew probably has a softer side, according to one handwriting analyst.

The roundness of the characters in Lew’s impossible-to-read John Hancock indicates he just might be the cuddly sort, says
Kathi McKnight
, a professional graphologist — that is, someone who gleans people’s personality traits from their writing. Such strokes are common among those who prefer a “softer” approach to problem-solving, she says.

The signers of the Constitution, by contrast, used very strong, angular lettering, McKnight notes — not that leaders throughout history haven’t used circular strokes like Lew’s. Like who? “Well, Princess Di had very loopy writing,” she says.

And the fact that Lew’s signature is illegible may mean that he wants to keep his true identity unknown. “People with illegible signatures . . . like to keep some things private,” she says.

Perhaps Lew will want to spruce up his signature before it makes its prime-time debut, as his predecessor did. The current Treasury secretary, Timothy Geithner, told NPR last year that he had to work on his penmanship to make his name legible enough to befit its place on U.S. currency.

The chosen

When is a nominee a nominee? Sounds like the kind of question philosophy grad students could spend hours chewing over (along the lines of chestnuts like “What is truth?” and “Is there a God?”), but this conundrum has a bit more practical application.

Although President Obama stood in the East Room of the White House and proudly declared former senator Chuck Hagel (R-Neb.) to be his nominee for secretary of defense — and a few weeks before that, Sen. John Kerry (D-Mass.) as his secretary of state — neither man can properly be called a “nominee.” That’s because a nominee isn’t actually a nominee until the president sends official nomination papers (really serious stuff, too — we’re talking heavy, old-fashioned parchment in an envelope with a wax seal) to the Senate.

Oh, the Senate isn’t in session, you say? Well, that shouldn’t hamper the process. After all, it’s not as if the White House messenger would just leave a note on the closed chamber door like the UPS man delivering a package. The secretary of the Senate has the power to receive messages when the body is not in session.

And so far, the old-school parchment hasn’t arrived. Not that that’s stopping everyone (including the Loop) from using the “nominee” nomenclature to describe Kerry and Hagel. It seems that’s a colloquial term.

But until it’s officially official, perhaps should we call them “presumptive nominees”? Maybe “nominees in waiting”? “Pre-noms?”

Too cold for fire?

If you think the air in Washington is a tad brisk, you’ll need more than mittens in Seoul, South Korea, where it’s been so cold that the U.S. Embassy recently had to postpone its annual Christmas-tree bonfire.

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SIA to recruit & train intern cabin crew from polys

SINGAPORE: Singapore Airlines (SIA) is working closely with three polytechnics to recruit and train cabin crew, as part of efforts to attract the best talent.

It has special programmes with Nanyang Polytechnic, Republic Polytechnic and Temasek Polytechnic, covering recruitment activities.

It's also starting an internship-recruitment programme to hire and train selected students to become full-time cabin crew.

These are provided under Memoranda of Understanding (MOUs) that the carrier signed with the three polytechnics on Thursday.

Besides recruitment, the MOUs also cover areas of potential cooperation such as curriculum development in service, operations, safety and security.

SIA will also work with the polytechnics on continued education programmes for cabin crew.

SIA employs about 7,500 cabin crew. New crew undergo an extensive 15-week training programme in areas such as service delivery, customer relations, deportment, security and safety.

- CNA/ck

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TOI Social Impact Awards: Kudos for solo work & team effort

The National Institute of Open Schooling was an instant choice. The sheer scale of operations — NIOS gave 5 lakh out-of-school students the chance to get an education in 2011-12 — ensured its selection as a winner in the government category. If NIOS was about scale, Sarvodaya Kanya Vidyalaya No.2 of Zeenat Mahal won admiration for the determination with which its turnaround was achieved. Facing shutdown at one point, this Urdu-medium school became one of the top performing government schools in Delhi.

There was unanimity among the jury that NIOS and the Sarvodaya school deserved a joint award — if one was a shining example of macro intervention, the other showed what can be achieved with micro-level efforts.

There was some debate about whether the turnaround of the Sarvodaya school, catering mostly to Muslim girls in the Walled City of Delhi, was sustainable as it seemed largely the effort of one principal. However, JM Lyngdoh pointed out it was difficult to imagine a principal could turn a school around on her own. "It's very difficult to turn around something from nothing. Others at the school also must have worked to make it possible," he added. Sunita Narain pointed out that the school was a micro effort but a very important and challenging one in a very difficult place.

In the corporate category, the jury was not impressed with the finalists and decided they would award none. They felt the claims by the corporate houses were not backed by enough evaluation of their initiatives. It sparked a debate about the need for private investment in education. Jury chairman Naresh Chandra said that from his stint as finance secretary of Rajasthan he knew states did not have the budget for school expansion, even with an educational cess. He clarified he wasn't biased against government schools as both his schooling and college education have been in government institutions. Some of the jury felt private capital ought to be used to strengthen the existing system such as improving sports facilities.

The award for NGOs went to Room to Read. The organization works with rural and urban slum communities, establishing libraries in schools and publishing original children's books in seven languages to encourage the habit of reading. They have established over 4,000 libraries in India. Syeda Hameed said the Room to Read model seemed both scaleable and practical. Aruna Roy, who was familiar with the organization's work, said it was functioning well and had helped make the concept of libraries familiar to children.

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Embryonic Sharks Freeze to Avoid Detection

Jane J. Lee

Although shark pups are born with all the equipment they'll ever need to defend themselves and hunt down food, developing embryos still stuck in their egg cases are vulnerable to predators. But a new study finds that even these baby sharks can detect a potential predator, and play possum to avoid being eaten.

Every living thing gives off a weak electrical field. Sharks can sense this with a series of pores—called the ampullae of Lorenzini—on their heads and around their eyes, and some species rely on this electrosensory ability to find food buried in the seafloor. (See pictures of electroreceptive fish.)

Two previous studies on the spotted catshark (Scyliorhinus canicula) and the clearnose skate (Raja eglanteria)—a relative of sharks—found similar freezing behavior in their young. But new research by shark biologist and doctoral student Ryan Kempster at the University of Western Australia has given scientists a more thorough understanding of this behavior.

It all started because Kempster wanted to build a better shark repellent. Since he needed to know how sharks respond to electrical fields, Kempster decided to use embryos. "It's very hard to test this in the field because you need to get repeated responses," he said. And you can't always get the same shark to cooperate multiple times. "But we could use embryos because they're contained within an egg case."

Cloaking Themselves

So Kempster got his hands on 11 brownbanded bamboo shark (Chiloscyllium punctatum) embryos and tested their reactions to the simulated weak electrical field of a predator. (Popular pictures: Bamboo shark swallowed whole—by another shark.)

In a study published today in the journal PLoS One, Kempster and his colleagues report that all of the embryonic bamboo sharks, once they reached later stages of development, reacted to the electrical field by ceasing gill movements (essentially, holding their breath), curling their tails around their bodies, and freezing.

A bamboo shark embryo normally beats its tail to move fresh seawater in and out of its egg case. But that generates odor cues and small water currents that can give away its position. The beating of its gills as it breathes also generates an electrical field that predators can use to find it.

"So it cloaks itself," said neuroecologist Joseph Sisneros, at the University of Washington in Seattle, who was not involved in the study. "[The embryo] shuts down any odor cues, water movement, and its own electrical signal."

Sisneros, who conducted the previous clearnose skate work, is delighted to see that this shark species also reacts to external electrical fields and said it would be great to see whether this is something all shark, skate, and ray embryos do.

Marine biologist Stephen Kajiura, at Florida Atlantic University, is curious to know how well the simulated electrical fields compare to the bamboo shark's natural predators—the experimental field was on the higher end of the range normally given off.

"[But] they did a good job with [the study]," Kajiura said. "They certainly did a more thorough study than anyone else has done."

Electrifying Protection?

In addition to the freezing behavior he recorded in the bamboo shark embryos, Kempster found that the shark pups remembered the electrical field signal when it was presented again within 40 minutes and that they wouldn't respond as strongly to subsequent exposures as they did initially.

This is important for developing shark repellents, he said, since some of them use electrical fields to ward off the animals. "So if you were using a shark repellent, you would need to change the current over a 20- to 30-minute period so the shark doesn't get used to that field."

Kempster envisions using electrical fields to not only keep humans safe but to protect sharks as well. Shark populations have been on the decline for decades, due partly to ending up as bycatch, or accidental catches, in the nets and on the longlines of fishers targeting other animals.

A 2006 study estimated that as much as 70 percent of landings, by weight, in the Spanish surface longline fleet were sharks, while a 2007 report found that eight million sharks are hooked each year off the coast of southern Africa. (Read about the global fisheries crisis in National Geographic magazine.)

"If we can produce something effective, it could be used in the fishing industry to reduce shark bycatch," Kempster said. "In [America] at the moment, they're doing quite a lot of work trying to produce electromagnetic fish hooks." The eventual hope is that if these hooks repel the sharks, they won't accidentally end up on longlines.

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Arias Caught Lying to Cops in Recorded Phone Calls

Jodi Arias blatantly lied to police who asked her about Travis Alexander's death, telling them in recorded phone calls that she kept trying to call and message Alexander the week of his death but never heard back from him.

The phone calls were played as evidence during the fourth day of Arias' trial, in which she is charged with murder and could face the death penalty if convicted of killing Alexander in a "depraved and heinous" way. Arias has admitted to killing her former boyfriend, but claims it was self-defense.

During the phone conversations played in court, Arias can be heard telling Mesa, Ariz., detective Esteban Flores that she last talked to Alexander on Tuesday night, June 3, 2008, around 10 p.m. She had been in Los Angeles, about to leave to go to Utah to visit a new love interest, she said.

After June 3, he stopped calling her back, she said.

Photos of Key Players and Evidence in the Jodi Arias Murder Trial

"On Tuesday night (I talked to him), it was brief though, 10 o'clock maybe. I'd say 10 p.m. or 9 - 9:30. I was calling people because I was bored on the road. He was nice and cordial, but kind of acting like he had hurt feelings," she said.

"I may have called him Wednesday, from the road, and I sent him a couple of text messages, and a couple of pictures," she said, though Alexander didn't pick up and his voice mailbox was full. "That's unusual. He deletes all of his messages. I didn't want to be obsessive about it because we're not together anymore and I didn't like to call too much."

According to court records, Arias, 32, actually went to Alexander's home on in Mesa on Wednesday morning. There, the pair had sex and took graphic photos of one another with Alexander's camera.

Then, Arias is believed to have killed Alexander, 30, in his shower by stabbing him, slashing his throat from ear to ear, and shooting him in the head.

In the phone conversations, Arias told Flores that she considered calling Alexander's friends when he stopped returning her calls on Wednesday, but didn't want to act like "his mother."

Alexander's friends found his body five days later with stab wounds and a bullet wound, lying in blood in his home.

Flores asked Arias if she ever considered buying a gun, she said she was too scared of handguns.

Jodi Arias/Myspace | ABC News

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"I've looked into handguns. I have a list of things I'm scared of that I'm trying to overcome," she said. "I got that from Travis, you know, to push yourself out of your comfort zone, and do things you're afraid of. But handguns are expensive and not really in my price range right now."

Arias is accused of stealing her grandmother's handgun and using it to shoot Alexander in the head during the attack.
The detective interviewed Arias by phone multiple times in June after Alexander's body was discovered by his friends on June 9.

Arias was indicted on July 9, 2008, and changed her story again before her arraignment, telling a TV news station that she was at Alexander's house when he was killed and witnessed two intruders kill him.

After she was arraigned, Arias told police she killed Alexander, but did it in self-defense. Arias's attorneys have said that Alexander was controlling and abusive toward Arias, and described him as a "sexual deviant."

In earlier testimony in court today, Arias's new love interest, Ryan Burns, testified that Arias showed up to his house on the morning of Thursday, Dec. 5, just 24 hours after she killed Alexander.

There, the pair cuddled, kissed, and watched movies, according to Burns.

Burns, who met Arias at a business conference in spring, 2008, said he exchanged frequent long phone calls and online conversations with Arias before inviting her to come visit him in West Jordan, Utah, in June. Arias lived in California at the time.

She arrived at Burns's home 24 hours after she was expected there, telling him that she got lost, drove the wrong way on a freeway for a few hours, fell asleep for awhile, and then got lost again, Burns testified today.

She never told him that she had confronted Alexander with a knife or gun and ended up killing him just hours before their date.

When she arrived, the pair quickly got physical, he testified.

"We went back to my house. We talked for awhile, and agreed that we were going to watch a movie. At some point we were talking and we kissed. Every time we started kissing it got a little more escalated. Our clothes never came off, but at some point she was kissing my neck, I was kissing hers, but our clothes never came off," he said.

Burns said that both he and Arias stopped kissing at the time, though they again became physically involved later in the evening when Arias climbed on top of Burns and began kissing him. Burns said that they stopped kissing because he did not want her to "regret the visit" because of her Mormon beliefs about sex.

He also told prosecutors upon questioning that Arias was physically strong.

"She's very fit," he said, describing their encounter when she climbed on top of him. "She's very strong. She has close to a six pack (of abs)."

Prosecutors likely asked about the strength of Arias because in testimony Tuesday Maricopa County medical examiner Kevin Horn said Alexander was stabbed so forcefully that the blade chipped his skull and his neck was cut all the way back to the spinal cord.

Burns, who is also a Mormon, said he noticed two bandages on Arias's hand when she arrived at his house, which she told him she got when a glass broke at her place of employment, Margaritaville.

During her visit, the pair also went to a business meeting and went out with Burns' friends where Burns described Arias as acting "shy" and a "little awkward."

"She was fine, she was laughing about simple little things like any other person. I never once felt like anything was wrong during the day. With a crowd she was a little awkward in social areas, but one on one she was very talkative and excitable," he said.

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Obama criticized for visiting Afghan intelligence official at U.S. hospital

On Dec. 20, President Obama made another in a series of semi-regular trips to Walter Reed National Military Medical Center, where he met privately with 10 wounded U.S. service members — and a high-ranking Afghan government official who had recently been admitted.

Asadullah Khalid, the head of Afghanistan’s intelligence agency, suffered severe abdominal injuries in a suicide attack in Kabul on Dec. 5. According to the State Department, he had been granted entry to the United States in mid-December for medical treatment at the request of Afghan President Hamid Karzai’s administration.

The White House did not publicly announce that Obama had visited Khalid, but Afghan news outlets reported on the brief meeting. And a snapshot purportedly showing Obama standing by Khalid’s bedside — the spy chief wearing splints on his forearms and a bandage on his face — made the rounds on social media.

A leading U.S. human rights organization said it is outraged by the president’s decision to greet Khalid, who has been accused of abuses including torture and drug trafficking even as he distinguished himself as a Karzai ally and anti-Taliban figure in his native Kandahar.

“Even if your administration determined that humanitarian arguments justified his entry for medical treatment, a presidential visit to his bedside . . . was a major misstep,” Kenneth Roth, executive director of Human Rights Watch, wrote Dec. 23 in a letter to Obama, who is scheduled to meet with Karzai at the White House on Friday.

The president’s visit “created the impression that the United States is not concerned about his record of brutality and the abuse and corruption ordinary Afghans have suffered at his hands,” Roth wrote in the letter, a copy of which was obtained by The Washington Post.

Khalid’s standing as head of the National Directorate of Security illustrates the often conflicted nature of the U.S. military effort in Afghanistan, which relies on the intelligence and partnership of local officials who have tangled alliances and employ questionable tactics.

“Given the reasons we’re in Afghanistan and the primacy of the counterterror mission, obliviously the head of the intelligence agency is going to play a very critical role” and is someone the United States would go to great lengths to help, said a senior administration official, who spoke on the condition of anonymity.

Khalid is a longtime U.S. ally who climbed the ranks of the Afghan government with ease, even as allegations mounted against him. He was governor of Ghazni and Kandahar provinces before becoming minister for border and tribal affairs and one of Karzai’s most trusted cabinet ministers.

White House national security spokesman Tommy Vietor said Obama thinks “it was appropriate” to check on Khalid’s condition.

“Mr. Khalid and the team he oversees work closely with the United States to protect Afghan citizens and American civilians and military service members in Afghanistan,” he said.

Vietor noted that the White House confirmed that Obama had met with Khalid on the day of the president’s visit to Walter Reed when a Washington Post reporter asked about it.

Khalid also recently received a visit from Defense Secretary Leon E. Panetta, according to Afghan media, which published a photo of the two together at the hospital. Pentagon officials said Panetta visited Jan. 4.

There is precedent for foreign government officials — even those surrounded by controversy — to be allowed into the country for medical treatment. Early last year, Ali Abdullah Saleh, then the president of Yemen, was granted a medical visa, even as human rights officials denounced abuses during his rule.

State Department officials said Khalid was not granted a visa, but rather admitted under the Department of Homeland Security’s “parole” process, which grants temporary stays for foreign nationals under emergency conditions.

Patrick Ventrell, a spokesman for the State Department, would not directly address allegations against Khalid but said rights allegations are a regular issue of discussion with the Karzai government.

It is not clear when Khalid will leave the United States. Karzai was scheduled to visit him Tuesday afternoon.

Kevin Sieff in Kabul contributed to this report.

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