Flu Kills 4 Seniors, Sickens 700 in Boston

An early and nasty flu season has prompted a public health emergency in Boston, where health officials say 700 people have been diagnosed with the cold-weather virus. Four Bostononians -- all elderly -- have died from flu.

"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.

This time last year the city had seen only 70 cases of influenza, The Associated Press reported. And with flu activity likely to extend into March or even April, the number will only grow.

Menino said the city is working with health care centers to offer free flu vaccines, and he urged anyone with flu-like symptoms to stay home from work or school.

"This is not only a health concern, but also an economic concern for families," he said in the statement. "I'm urging residents to get vaccinated if they haven't already."

Eighteen people have died from flu in Massachusetts, one of 41 states battling widespread influenza outbreaks. Emergency rooms across the country have been overwhelmed with flu patients, turning away some of them and others with non-life-threatening conditions for lack of space.

The proportion of people seeing their doctor for flu-like symptoms jumped to 5.6 percent from 2.8 percent in the past month, according to the CDC.

U.S. Emergency Rooms Inundated With Flu Patients Watch Video

Earliest Flu Season in a Decade: 80 Percent of Country Reports Severe Symptoms Watch Video

Northwestern Memorial Hospital in Chicago reported a 20 percent increase in flu patients every day. Northwestern Memorial was one of eight hospitals on bypass Monday and Tuesday, meaning it asked ambulances to take patients elsewhere if they could do so safely.

Dr. Besser's Tips to Protect Yourself From the Flu

Most of the hospitals have resumed normal operations, but could return to the bypass status if the influx of patients becomes too great.

"Northwestern Memorial Hospital is an extraordinarily busy hospital, and oftentimes during our busier months, in the summer, we will sometimes have to go on bypass," Northwestern Memorial's Dr. David Zich said. "We don't like it, the community doesn't like it, but sometimes it is necessary."

A tent outside Lehigh Valley Hospital in Salisbury Township, Pa., was set up to tend to the overflowing number of flu cases.

A hospital in Ohio is requiring patients with the flu to wear masks to protect those who are not infected.

State health officials in Indiana have reported seven deaths. Five of the deaths occurred in people older than 65 and two younger than 18. The state will release another report later today.

Doctors are especially concerned about the elderly and children, where the flu can be deadly.

"Our office in the last two weeks has exploded with children," Dr. Gayle Smith, a pediatrician in Richmond, Va., said

It is the earliest flu season in a decade and, ABC News Chief Medical Editor Dr. Besser says, it's not too late to protect yourself from the outbreak.

"You have to think about an anti-viral, especially if you're elderly, a young child, a pregnant woman," Besser said.

"They're the people that are going to die from this. Tens of thousands of people die in a bad flu season. We're not taking it serious enough."

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Pruney fingers give us better grip underwater

WHY do our fingers do prune impressions when soaked? It could be an adaptation that gives us better grip underwater.

Fingers and toes wrinkle in water after about 5 minutes due to the constriction of blood vessels. This reduction in volume pulls the skin inward, but as the skin's surface area cannot change, it wrinkles. A study in 2011 showed that wrinkles form a pattern of channels that divert water away from the fingertip – akin to rain treads on tyres. The team thought that this could aid grip.

To find out, Tom Smulders and his team at Newcastle University, UK, timed people as they transferred wet or dry objects from one box to another with and without wrinkled fingers.

With wrinkles, wet objects were transferred about 12 per cent faster than with unwrinkled fingers. The time it took to transfer dry objects was the same regardless of wrinkles.

So why aren't our digits always prune-like? "With wrinkles, less of your skin surface touches the object, so there may be issues of sensitivity," Smulders suggests.

Journal reference: Royal Society Biology Letters, DOI: 10.1098/rsbl.2012.0999.

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Relatives sob as US massacre 911 calls heard in court

CENTENNIAL, Colorado: Relatives wept in court Tuesday as frantic 911 calls were played from a US theater shooting that killed 12 people last year, as prosecutors closed their case for the alleged gunman to face trial.

The court heard how suspected killer James Holmes purchased more than 6,000 rounds of ammunition in the months before last July's shooting in Colorado, and rigged up elaborate booby-traps at his apartment.

Defense lawyers will call witnesses Wednesday, the third day of hearings, to decide if there is enough evidence for Holmes to go on trial. They are expected to highlight his mental instability as a possible reason he should not do so.

In the first of 41 harrowing emergency calls made in a 10-minute period in Colorado, 30 loud booms could be heard in less than half-a-minute, making it difficult for the 911 dispatcher to distinguish what was being said.

In another, six minutes after the first call was logged at 12:38 am, 14-year-old Kaylan Bailey told the emergency operator her two cousins had been shot, and that one of them did not appear to be breathing.

"We need to start CPR (cardio-pulmonary resuscitation) on your cousin who's not breathing," said the operator.

"I can't hear you," responded Bailey, as chaos unfolded in the theater in Aurora, where Holmes -- clad in body armor and a mask -- threw at least one smoke-bomb type device before opening fire in the early hours of July 20.

The hearings opened Monday with officers choking back tears as they recalled scenes after the slaughter, which left 12 dead and 58 injured by gunshots at a packed midnight screening of the Batman film "The Dark Knight Rises."

The Aurora massacre revived the perennial US debate over gun control -- an issue re-ignited even more intensely by last month's shooting of 20 young children at a Connecticut elementary school.

Tuesday's hearing heard testimony from federal firearms supervisor Steven Beggs that Holmes made at least 16 purchases from May to July 2012 including four firearms, incendiary devices and almost 6,300 rounds of ammunition.

Holmes's lawyers could argue that he is mentally unfit to stand trial.

Defense attorney Tamara Brady asked Beggs: "Is there any process in Colorado to screen out purchases by a severely mentally ill person?"

"No," replied Beggs, who detailed the purchases made online and in person by Holmes.

FBI bomb technician Garrett Gumbinner said Holmes told investigators after being arrested that he had booby-trapped his apartment, in an attempt to draw emergency responders away from the theater shooting site.

Officers found a trip wire at the door of his home, rigged to set off flame and sparks that would catch the gasoline-soaked carpet and go on fire.

There were six-inch fireworks shells filled with improvised thermite, a hot-burning explosive.

"You can't put it out with water," Gumbinner told judge William Sylvester. There were also three containers of improvised napalm, 11 bottles of gasoline and other chemicals intended to act as fire accelerants, he said.

There were three systems in the apartment intended to initiate the explosive devices, including one linked to a trash bag near the apartment dumpster by a remote control.

Curious behavior by Holmes during police questioning was also recounted: At one point he tried to stick a metal staple into a power socket. At another he played hand puppets with gloves that had been put on him to preserve evidence.

Prosecutors are trying to build up their case that the shootings were a premeditated act of mass murder, and identifying Holmes as the lone shooter.

Supporting that strategy, Aurora police officer Tom Welton testified that Holmes made postings on two dating websites earlier in July, asking "Will you visit me in prison?"

Prosecutors wrapped up their evidence in the hearing by listing all the victims by name, the injuries they suffered and the charges -- more than 160 in all -- filed on behalf of each.

-AFP/ac

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Opinion: Time for tough talk with Karzai

The last time Presidents Obama and Karzai met was in May in Kabul, when they signed a pact regarding U.S. troop withdrawal.

STORY HIGHLIGHTS

• Afghan President Karzai meeting with President Obama in Washington this week


• Felbab-Brown: Afghan politics are corrupt; army not ready for 2014 troop pullout


• She says Taliban, insurgents, splintered army, corrupt officials are all jockeying for power


• U.S. needs to commit to helping Afghan security, she says, and insist corruption be wiped out

Editor's note: Vanda Felbab-Brown is a senior fellow in foreign policy at the Brookings Institution. Her latest book is "Aspiration and Ambivalence: Strategies and Realities of Counterinsurgency and State-Building in Afghanistan."

(CNN) -- Afghan President Hamid Karzai is meeting this week with President Obama in Washington amid increasing ambivalence in the United States about what to do about the war in Afghanistan.

Americans are tired of the war. Too much blood and treasure has been spent. The White House is grappling with troop numbers for 2013 and with the nature and scope of any U.S. mission after 2014. With the persisting corruption and poor governance of the Afghan government and Karzai's fear that the United States is preparing to abandon him, the relationship between Kabul and Washington has steadily deteriorated.

As the United States radically reduces its mission in Afghanistan, it will leave behind a stalled and perilous security situation and a likely severe economic downturn. Many Afghans expect a collapse into civil war, and few see their political system as legitimate.

Karzai and Obama face thorny issues such as the stalled negotiations with the Taliban. Recently, Kabul has persuaded Pakistan to release some Taliban prisoners to jump-start the negotiations, relegating the United States to the back seat. Much to the displeasure of the International Security Assistance Force, the Afghan government also plans to release several hundred Taliban-linked prisoners, although any real momentum in the negotiations is yet to take place.

Vanda Felbab-Brown

Washington needs to be careful that negotiations are structured in a way that enhances Afghanistan's stability and is not merely a fig leaf for U.S. and NATO troop departure. Countering terrorism will be an important U.S. interest after 2014. The Taliban may have soured on al Qaeda, but fully breaking with the terror group is not in the Taliban's best interest. If negotiations give the insurgents de facto control of parts of the country, the Taliban will at best play it both ways: with the jihadists and with the United States.

Negotiations of a status-of-forces agreement after 2014 will also be on the table between Karzai and Obama. Immunity of U.S. soldiers from Afghan prosecution and control over detainees previously have been major sticking points, and any Afghan release of Taliban-linked prisoners will complicate that discussion.

Karzai has seemed determined to secure commitments from Washington to deliver military enablers until Afghan support forces have built up. The Afghan National Security Forces have improved but cannot function without international enablers -- in areas such as air support, medevac, intelligence and logistical assets and maintenance -- for several years to come. But Washington has signaled that it is contemplating very small troop levels after 2014, as low as 3,000. CNN reports that withdrawing all troops might even be considered.

Everyone is hedging their bets in light of the transition uncertainties and the real possibility of a major security meltdown after 2014. Afghan army commanders are leaking intelligence and weapons to insurgents; Afghan families are sending one son to join the army, one to the Taliban and one to the local warlord's militia.

Patronage networks pervade the Afghan forces, and a crucial question is whether they can avoid splintering along ethnic and patronage lines after 2014. If security forces do fall apart, the chances of Taliban control of large portions of the country and a civil war are much greater. Obama can use the summit to announce concrete measures -- such as providing enablers -- to demonstrate U.S. commitment to heading off a security meltdown. The United States and international security forces also need to strongly focus on countering the rifts within the Afghan army.

Assisting the Afghan army after 2014 is important. But even with better security, it is doubtful that Afghanistan can be stable without improvements in its government.

Afghanistan's political system is preoccupied with the 2014 elections. Corruption, serious crime, land theft and other usurpation of resources, nepotism, a lack of rule of law and exclusionary patronage networks afflict governance. Afghans crave accountability and justice and resent the current mafia-like rule. Whether the 2014 elections will usher in better leaders or trigger violent conflict is another huge question mark.

Emphasizing good governance, not sacrificing it to short-term military expediencies by embracing thuggish government officials, is as important as leaving Afghanistan in a measured and unrushed way -- one that doesn't jeopardize the fledgling institutional and security capacity that the country has managed to build up.

Karzai has been deaf and blind to the reality that reducing corruption, improving governance and allowing for a more pluralistic political system are essential for Afghanistan's stability. His visit provides an opportunity to deliver the message again -- and strongly.

Follow us on Twitter @CNNOpinion

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The opinions in this commentary are solely those of Vanda Felbab-Brown.

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AP: Gov. Richardson pressing N. Korea to open Internet

Former New Mexico Gov. Bill Richardson is interviewed by journalists after arriving at Pyongyang International Airport in Pyongyang, North Korea, Monday, Jan. 7, 2013. Richardson arrived in the North Korean capital with Executive Chairman of Google Eric Schmidt, and called the trip a private humanitarian visit. / AP Photo/Kim Kwang Hyon

PYONGYANG, North Korea Former New Mexico Gov. Bill Richardson said Wednesday that his delegation is pressing North Korea to put a moratorium on missile launches and nuclear tests and to allow more cell phones and an open Internet for its citizens.

12 Photos

Google exec. visits North Korea

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Bill Richardson, Eric Schmidt arrive in North Korea

Richardson told The Associated Press in an exclusive interview in Pyongyang that the group is also asking for fair and humane treatment for an American citizen detained in North Korea.

"The citizens of the DPRK (North Korea) will be better off with more cell phones and an active Internet. Those are the three messages we've given to a variety of foreign policy officials, scientists" and government officials, Richardson said.

He is accompanied by Google Executive Chairman Eric Schmidt and Google Ideas think tank Director Jared Cohen on what Richardson has called a private, humanitarian trip. Schmidt, who is the highest-profile U.S. business executive to visit North Korea since leader Kim Jong Un took power a year ago, has not spoken publicly about the reasons behind the journey to North Korea.

The high-profile visit comes just weeks after North Korea launched a long-range rocket to send a satellite into space. Washington has condemned the launch as a banned test of missile technology.

Schmidt, who oversaw Google's expansion into a global Internet giant, speaks frequently about the importance of providing people around the world with Internet access and technology. Google now has offices in more than 40 countries, including all three of North Korea's neighbors: Russia, South Korea and China, another country criticized for systematic Internet censorship.

He and Cohen have collaborated on a book about the Internet's role in shaping society called "The New Digital Age" that comes out in April.

Using science and technology to build North Korea's beleaguered economy was the highlight of a New Year's Day speech by leader Kim Jong Un.

New red banners promoting slogans drawn from Kim's speech line Pyongyang's snowy streets, and North Koreans are still cramming to study the lengthy speech. It was the first time in 19 years for North Koreans to hear their leader give a New Year's Day speech. During the rule of late leader Kim Jong Il, state policy was distributed through North Korea's three main newspapers.

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Holmes Played Childish Games After Aurora Carnage

As police confronted the movie theater carnage and a massive booby trap left behind by accused Aurora gunman James Holmes, the suspect loopily played with hand puppets, tried to stick a metal staple in an electrical socket and clamly flipped a styrofoam cup, according to court testimony today.

Holmes, 25, displayed the bizarre behavior once he was in custody and taken to Aurora police headquarters after the shooting that left 12 people dead and dozens injured, the lead investigator in the case testified today.

While being cross examined by Colorado public defender Daniel King, Police Detective Craig Appel was asked about the observations of two Aurora officers assigned to watch over Holmes in an interrogation room.

Appel said that to preserve possible gunshot residue, police had placed paper bags over Holmes' hands. One officer, King said, noted in a report that Holmes began moving his hands "in a talking puppet motion."

Click here for full coverage of the Aurora movie theater shooting.

King asked if Appel was also aware that the officer "observed Holmes take a staple out of the table and tried to stick it in an electrical socket?" Appel confirmed Holmes' actions.

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The officers also noted that they watched as Holmes began playing with an empty styrofoam cup, trying to "flip it" on the table.

While Holmes was carrying out his childish antics, police were puzzling over a complex booby trap Holmes had left behind in his apartment, according to testimony.

A gasoline-soaked carpet, loud music and a remote control car were part of Holmes' plan to trick someone into triggering a blast that would destroy his apartment and lure police to the explosion while he shot up a movie theater in Aurora, Colo., according to court testimony.

FBI agent Garrett Gumbinner told the court that he interviewed Holmes on July 20, hours after he killed 12 and wounded 58 during the midnight showing of "The Dark Knight Rises."

"He said he rigged the apartment to explode to get law enforcement to send resources to his apartment instead of the theater," Gumbinner said.

His plan failed to prompt someone into triggering the bombs.

Gumbinner said Holmes had created two traps that would have set off the blast.

The apartment was rigged with a tripwire at the front door connected to a mixture of chemicals that would create heat, sparks and flame. Holmes had soaked the carpet with a gasoline mixture that was designed to be ignited by the tripwire, Gumbinner said.

"It would have caused fire and sparks," the agent said, and "would have made the entire apartment explode or catch fire."

Holmes had set his computer to play 25 minutes of silence followed by loud music that he hoped would cause a disturbance loud enough that someone would call police, who would then respond and set off the explosion by entering the apartment.

Gumbinner said Holmes also told him he rigged a fuse between three glass jars that would explode. He filled the jars with a deadly homemade chemical mixture that would burn so hot it could not be extinguished with water.

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World's oldest pills treated sore eyes

In ancient Rome, physicians treated sore eyes with the same active ingredients as today. So suggests an analysis of pills found on the Relitto del Pozzino, a cargo ship wrecked off the Italian coast in around 140 BC.

"To our knowledge, these are the oldest medical tablets ever analysed," says Erika Ribechini of the University of Pisa in Italy, head of a team analysing the relics. She thinks the disc-shaped tablets, 4 centimetres across and a centimetre thick, were likely dipped in water and dabbed directly on the eyes.

The tablets were mainly made of the zinc carbonates hydrozincite and smithsonite, echoing the widespread use of zinc-based minerals in today's eye and skin medications. Ribechini says there is evidence that Pliny the Elder, the Roman physician, prescribed zinc compounds for these uses almost 250 years after the shipwreck in his seminal medical encyclopaedia, Naturalis Historia.

The tablets were also rich in plant and animal oils. Pollen grains from an olive tree suggest that olive oil was a key ingredient, just like it is today in many medical and beauty creams, says Ribechini.

The tablets were discovered in a sealed tin cylinder called a pyxis (see image above). The tin must have been airtight to protect its contents from oxygen corrosion.

"Findings of such ancient medicines are extremely rare, so preservation of the Pozzino tablets is a very lucky case," says Ribechini.

The cargo of the wreck, discovered in 1989, is rich in other medical equipment, including vials and special vessels for bloodletting. This suggests that one of the passengers may have been a physician.

Journal reference: PNAS, DOI: 10.1073/pnas.1216776110

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Hagel draws fire as Obama's Pentagon pick

WASHINGTON: US President Barack Obama named Chuck Hagel on Monday to lead the Pentagon, setting up an ugly confirmation battle as Republican opponents said he was too hard on Israel and too soft on Iran.

Obama's choice of John Brennan to replace scandal-tainted David Petraeus as CIA chief was seen as more straightforward despite the counter-terrorism czar's defense of "enhanced interrogation techniques" and the US drone war.

The second term revamp of the president's national security team was expected to win ultimate approval but several leading Republicans signaled they would make it tough for Hagel even though he is one of their own.

Obama paid particular tribute to retiring Pentagon chief Leon Panetta before giving ringing endorsements to the "outstanding" Hagel and Brennan and urging the Senate not to dally in confirming their important appointments.

"Chuck Hagel is the leader that our troops deserve. He is an American patriot," the president said, heaping praise on a war hero who was awarded two Purple Heart medals for his bravery as a soldier in Vietnam.

"When Chuck was hit by shrapnel, his brother saved him. When his brother was injured by a mine, Chuck risked his life to pull him to safety. To this day, Chuck bears the scars -- and the shrapnel -- from the battles he fought in our name," Obama said.

Some Republicans have never forgiven him for his outspoken criticism of ex-president George W. Bush's handling of the Iraq war, and his closeness to the Democratic president sees him regarded by others as a traitor.

But Obama, who wants to be remembered as a leader who ended wars abroad to set about the tricky task of nation-building at home following a crippling recession, described Hagel as someone perfectly fitted to that mold.

"Maybe most importantly, Chuck knows that war is not an abstraction. He understands that sending young Americans to fight and bleed in the dirt and mud, that's something we only do when it's absolutely necessary," he said.

Administration appointments are often tense affairs in the United States as confirmation hearings provide senators with opportunities to turn away unwanted candidates or score cheap political points, or both.

Hagel, 66, known for a fiercely independent streak and a tendency to speak bluntly, is expected to get particularly rough treatment due to his criticism of America's "Jewish lobby" and opposition to some Iran sanctions.

Republican Senator Lindsey Graham said Hagel would be "the most antagonistic defense secretary towards the state of Israel in our nation's history."

Another Republican senator, John Cornyn of Texas, said he would oppose the nomination, charging it would be the "worst possible message we could send to our friend Israel and the rest of our allies in the Middle East."

But in an interview with The Lincoln Journal Star, a newspaper in his home state of Nebraska, Hagel hit back at his critics.

There is "not one shred of evidence that I'm anti-Israeli, not one vote (of mine) that matters that hurt Israel," he said.

If confirmed by the Senate, Hagel will have to manage major cuts to military spending while wrapping up the US war effort in Afghanistan and preparing for worst-case scenarios in Iran or Syria.

Serving as an enlisted man who never joined the officer ranks, Hagel carries a particular empathy for the unheralded infantry "grunts" in the field.

As he grapples with budget pressures, the former sergeant will likely try to shield frontline troops from the effect of spending cuts.

In his typical straight-shooting fashion, Hagel has called the Defense Department "bloated" and said that "the Pentagon needs to be pared down."

Obama, smarting from watching Susan Rice -- reportedly his first choice to succeed Hillary Clinton as secretary of state -- fold her bid in the face of Republican opposition, pressed hard for the Senate to approve Hagel.

"He would be the first person of enlisted rank to serve as secretary of defense. One of the few secretaries who had been wounded in war and the first Vietnam veteran to lead the department," Obama said, calling his appointment "historic."

Brennan, 57, may get an easier ride but is sure to face questions over his support for the use of certain "enhanced interrogation techniques" under the Bush administration and for his staunch defense of the US drone program.

The 25-year Central Intelligence Agency veteran, an Arabic-speaking Middle East expert, replaces Petraeus, who resigned in November after confessing to an extramarital affair with his biographer Paula Broadwell.

Obama highlighted what he called Brennan's incredible work ethic, saying "John is legendary even in the White House" and reminding everyone of a now-famous quote from August 2010.

Asked if he got any down time or was all work and no play, Brennan replied: "I don't do down time."

In a moment of levity at the White House event, the avuncular 74-year-old Panetta drew loud laughs when he said he would be retiring to his walnut farm and "dealing with a different set of nuts."

- AFP/ac

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Cyanide poisoning kills lottery winner

Urooj Khan, 46, won $1 million before taxes on an Illinois lottery scratch ticket in June.

STORY HIGHLIGHTS

• Urooj Khan, 46, won $1 million before taxes on an Illinois lottery scratch ticket


• He died suddenly weeks later; authorities first ruled his death "natural"


• Revisiting the case, they found he died of "cyanide toxicity," a medical examiner says


• Chicago police are investigating, but haven't made any arrests

(CNN) -- One day, Urooj Khan literally jumped for joy after scoring a $1 million winner on an Illinois lottery scratch ticket.

The next month, he was dead.

The Cook County medical examiner's office initially ruled Khan's manner of death natural. But after being prompted by a relative, the office revisited the case and eventually determined there was a lethal amount of cyanide in Khan's system.

"That ... led us to issue an amended death certificate that (established) cyanide toxicity as the cause of death, and the manner of death as homicide," Chief Medical Examiner Dr. Steve Cina said Monday.

Why did Khan, an Indian immigrant who was described as a well-liked, hardworking and successful businessman, die? And who is responsible?

Finding that out is now up to the Chicago police. No arrests have been made.

"We are investigating it as a murder, and we're working closely with the medical examiner's office," Chicago police spokeswoman Melissa Stratton said Monday.

On June 26, Khan was all smiles at a 7-Eleven in the Rogers Park section of Chicago. Surrounded by his wife, daughter and friends, he held an oversized $1 million check and recalled his joy upon playing the "$3 million Cash Jackpot!" game, where tickets sell for $30 apiece.

"I scratched the ticket, then I kept saying, 'I hit a million!' over and over again," the 46-year-old Khan said, according to a press release from the Illinois Lottery.

"I jumped two feet in the air, then ran back into the store and tipped the clerk $100."

The plan, he explained, was to use the money for his mortgage, paying off bills, a donation to St. Jude Children's Research Hospital and investing more in his dry cleaning businesses.

"Winning the lottery means everything to me," Khan said.

He would have to wait a few weeks to collect his actual winnings, which amounted after taxes to about $425,000. According to CNN affiliate WGN, that check was issued July 19, but Khan never got to spend it.

The next night, Khan came home, ate dinner and went to bed, according to an internal police department document obtained by the Chicago Tribune. His family later heard him screaming and took him to a local hospital, where he was later pronounced dead, the paper reported, citing the document.

That's where the Cook County medical examiner's office came in, investigating Khan's death because it was "sudden and unexpected," Cina said.

At the time, there were no allegations of foul play or evidence of trauma. So, following the office's policy, Khan's body underwent what Cina described as an "external examination (and) basic toxicology testing," neither of which turned up anything abnormal.

So the medical examiner ruled Khan had died of arterial sclerotic cardiovascular disease -- which encompasses incidents like heart attacks, strokes and aortic ruptures -- and that his manner of death was natural, according to Cina.

A few days later, a family member approached the doctor who had examined the body "and said they felt uncomfortable that it was being ruled a natural and they suggested that we look into it further," the chief medical examiner said.

"So we did that," he added. "Forensics is not a static field. If new evidence comes to light, we'll revisit cases."

That meant more in-depth toxicology tests. In early September, new screening results came back indicating cyanide in Khan's blood. With that, the official manner of death was changed from natural to pending, Cina said, and Chicago police got involved.

In late November, a more detailed blood analysis came back showing "a lethal level of cyanide" and Khan's death became a murder case.

Chicago police haven't offered details, including a possible motive, about what they call an "ongoing investigation." Talking briefly with CNN affiliate WBBM and the Tribune, Khan's widow described her husband as kind and exemplary.

Jimmy Goreel, who runs the 7-Eleven where the winning lottery ticket was sold, offered similarly glowing comments about Khan.

"I would never think that anybody ... would hurt him," Goreel told WGN. "(He was a) nice person, very hopeful and gentle (and) very hardworking."

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Chicago lottery winner died from poisoning

CHICAGO With no signs of trauma and nothing to raise suspicions, the sudden death of a Chicago man just as he was about to collect nearly $425,000 in lottery winnings was initially ruled a result of natural causes.

Nearly six months later, authorities have a mystery on their hands after medical examiners, responding to a relative's pleas, did an expanded screening and determined that Urooj Khan, 46, died shortly after ingesting a lethal dose of cyanide. The finding has triggered a homicide investigation, the Chicago Police Department said Monday.

"It's pretty unusual," said Cook County Medical Examiner Stephen Cina, commenting on the rarity of cyanide poisonings. "I've had one, maybe two cases out of 4,500 autopsies I've done."

In June, Khan, who owned a number of dry cleaners, stopped in at a 7-Eleven near his home in the West Rogers Park neighborhood on the city's North Side and bought a ticket for an instant lottery game.

Ashur Oshana, the convenience store clerk, told The Associated Press on Monday that Khan said he had sworn off gambling after returning from the hajj, a Muslim pilgrimage, in Saudi Arabia. Khan said he wanted to lead a better life, Oshana said, but Khan bought the tickets that day and scratched off the winner in the store.

"Right away he grabbed my hand," Oshana said. "He kissed my hand and kissed my head and gave me $100. He was really happy."

Khan recalled days later at an Illinois Lottery ceremony in which he was presented with an oversized check that he jumped up and down in the store and repeatedly shouted, "I hit a million!"

"Winning the lottery means everything to me," he said at the June 26 ceremony, also attended by his wife, Shabana Ansari; their daughter, Jasmeen Khan; and several friends. He said he would put some of his winnings into his businesses and donate some to a children's hospital.

Instead of the full $1 million over installments, Khan opted to take his winnings in a lump sum of just over $600,000. After taxes, the winnings amounted to about $425,000, said lottery spokesman Mike Lang. The check was issued from the state Comptroller's Office on July 19, the day before Khan died, but was cashed on Aug. 15, Lang said. If a lottery winner dies, the money typically goes to his or her estate, Lang said.

Khan was pronounced dead July 20 at a hospital, but Cina would not say where Khan was when he fell ill, citing the ongoing investigation.

No signs of trauma were found on Khan's body during an external exam and no autopsy was done because, at the time, the Cook County Medical Examiner's Office didn't generally perform them on those 45 and older unless the death was suspicious, Cina said. The cutoff age has since been raised to age 50.

A basic toxicology screening for opiates, cocaine and carbon monoxide came back negative, and the death was ruled a result of the narrowing and hardening of coronary arteries.

Cyanide can get into the body by being inhaled, swallowed or injected. Deborah Blum, an expert on poisons who has written about the detectives who pioneered forensic toxicology, said the use of cyanide in killings has become rare in part because it is difficult to obtain and normally easy to detect, often leaving blue splotches on a victim's skin.

"The thing about it is that it's not one of those poisons that's tasteless," Blum said. "It has a really strong, bitter taste, so you would know you had swallowed something bad if you had swallowed cyanide. But if you had a high enough dose it wouldn't matter, because ... a good lethal does will take you out in less than five minutes."

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