Flu season strikes early and, in some places, hard

NEW YORK (AP) — From the Rocky Mountains to New England, hospitals are swamped with people with flu symptoms. Some medical centers are turning away visitors or making them wear face masks, and one Pennsylvania hospital set up a tent outside its ER to deal with the feverish patients.

Flu season in the U.S. has struck early and, in many places, hard.

While flu normally doesn't blanket the country until late January or February, it is already widespread in more than 40 states, with about 30 of them reporting some major hot spots. On Thursday, health officials blamed the flu for the deaths of 20 children so far.

Whether this will be considered a bad season by the time it has run its course in the spring remains to be seen.

"Those of us with gray hair have seen worse," said Dr. William Schaffner, a flu expert at Vanderbilt University in Nashville.

The evidence so far points to a moderate season, Schaffner and others say. It looks bad in part because last year was unusually mild and because the main strain of influenza circulating this year tends to make people sicker and really lay them low.

David Smythe of New York City saw it happen to his 50-year-old girlfriend, who has been knocked out for about two weeks. "She's been in bed. She can't even get up," he said.

Also, the flu's early arrival coincided with spikes in a variety of other viruses, including a childhood malady that mimics flu and a new norovirus that causes vomiting and diarrhea, or what is commonly known as "stomach flu." So what people are calling the flu may, in fact, be something else.

"There may be more of an overlap than we normally see," said Dr. Joseph Bresee, who tracks the flu for the Centers for Disease Control and Prevention.

Most people don't undergo lab tests to confirm flu, and the symptoms are so similar that it can be hard to distinguish flu from other viruses, or even a cold. Over the holidays, 250 people were sickened at a Mormon missionary training center in Utah, but the culprit turned out to be a norovirus, not the flu.

Flu is a major contributor, though, to what's going on.

"I'd say 75 percent," said Dr. Dan Surdam, head of the emergency department at Cheyenne Regional Medical Center, Wyoming's largest hospital. The 17-bed emergency room saw its busiest day ever last week, with 166 visitors.

The early onslaught has resulted in a spike in hospitalizations. To deal with the influx and protect other patients from getting sick, hospitals are restricting visits from children, requiring family members to wear masks and banning anyone with flu symptoms from maternity wards.

One hospital in Allentown, Pa., set up a tent this week for a steady stream of patients with flu symptoms. But so far "what we're seeing is a typical flu season," said Terry Burger, director of infection control and prevention for the hospital, Lehigh Valley Hospital-Cedar Crest.

On Wednesday, Boston declared a public health emergency, with the city's hospitals counting about 1,500 emergency room visits since December by people with flu-like symptoms.

All the flu activity has led some to question whether this year's flu shot is working. While health officials are still analyzing the vaccine, early indications are that it's about 60 percent effective, which is in line with what's been seen in other years.

The vaccine is reformulated each year, based on experts' best guess of which strains of the virus will predominate. This year's vaccine is well-matched to what's going around. The government estimates that between a third and half of Americans have gotten the vaccine.

In New York City, 57-year-old Judith Quinones skipped getting a flu shot this season and suffered her worst case of flu-like illness in years. She was laid up for nearly a month with fever and body aches. "I just couldn't function," she said.

But her daughter got the vaccine. "And she got sick twice," Quinones said.

Europe is also suffering an early flu season, though a milder strain predominates there. Flu reports are up, too, in China, Japan, the West Bank, the Gaza Strip, Algeria and the Republic of Congo. Britain has seen a surge in cases of norovirus.

On average, about 24,000 Americans die each flu season, according to the CDC. That's an estimate — the agency does not keep a running tally of adult flu deaths each year, only for children. Some state health departments do keep count, and they've reported dozens of flu deaths so far.

Flu usually peaks in midwinter. Symptoms can include fever, cough, runny nose, head and body aches and fatigue. Some people also suffer vomiting and diarrhea, and some develop pneumonia or other severe complications.

Most people with flu have a mild illness and can help themselves and protect others by staying home and resting. But people with severe symptoms should see a doctor. They may be given antiviral drugs or other medications to ease symptoms.

Flu vaccinations are recommended for everyone 6 months or older. Of the 20 children killed by the flu this season, only two were fully vaccinated.

___

AP Medical Writer Maria Cheng in London contributed to this report.

___

Online:

CDC flu: http://www.cdc.gov/flu/index.htm

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Restored funding for prescription drug-monitoring program urged

California Atty. Gen. Kamala D. Harris on Thursday called on Gov. Jerry Brown to restore funding to a prescription drug-monitoring program that health experts say is key to combating drug abuse and overdose deaths in the state.

Harris' appeal to restore funding to CURES, as it is known, follows an article in The Times last month that reported that the system, once heralded as an invaluable tool, had been severely undermined by budget cuts and was not being used to its full potential.

The CURES database contains detailed information on prescription narcotics, including the names of patients, the doctors prescribing the drugs and the pharmacies that dispense them. The system was designed to help physicians detect "doctor-shopping" patients who dupe multiple physicians into prescribing drugs such as OxyContin, Vicodin and Xanax.

Harris' request followed Brown's unveiling of a proposed $97.7-billion budget, which projects a surplus — a feat that has been accomplished only one time in the last decade. With California's fiscal condition improving, Harris said it was up to the state to make sure the money was "spent wisely."

"This includes smart investments that benefit Californians, such as restoring funding for the state's prescription drug-monitoring program," she said in a statement.

Brown's office had no comment.

The governor's budget does increase Harris' Department of Justice general fund allocation by 4.5% to $174.3 million, but it does not earmark money for CURES. Harris could seek legislative authority to spend some of her budget on the program.

"We are going to have a discussion on the funding and where the money will come from," said Lynda Gledhill, a spokeswoman for Harris.

CURES is the nation's oldest and largest prescription drug-monitoring program and once served as a model for other states. Today, it has fallen behind similar programs elsewhere. CURES data could be used to monitor physicians whose prescribing puts patients at risk. But it is not.

The U.S. Centers for Disease Control recommends that states use such data to keep tabs on doctors, and at least half a dozen states do so.

As part of spending cuts aimed at maintaining the state's solvency amid a deep recession, Brown gutted the Bureau of Narcotics Enforcement, which ran CURES, in 2011, shortly after Harris succeeded him as attorney general. Harris kept the program alive with about $400,000 in revenue from the Medical Board of California and other licensing boards. But it is down to one employee and has no enforcement capacity.

State officials have estimated it would cost about $2.8 million to make CURES more accessible and easier to use, and $1.6 million more per year to keep it running. However, officials say the program — with little or no additional financial resources — could now be used to identify potentially rogue doctors.

Bob Pack, an Internet entrepreneur, has advocated using CURES more vigorously to track reckless physicians and pharmacies as well as doctor-shopping patients. He became active on the issue after a driver high on painkillers and alcohol struck and killed his two young children in the Bay Area suburb of Danville in 2003.

Pack, who helped design an online portal to give physicians and pharmacists immediate access to CURES, said he was happy to see Harris ask Brown to restore funds for the program.

"But that's only a request," he said. "No one knows if that's really going to happen. Meanwhile, doctors are continuing to over-prescribe and thousands of Californians are dying from prescription drug overdoses. I hope this … has some bite to it."

An aide to Harris said restoring the CURES program is a high priority.

"She's committed to fixing the database and making it as strong as possible," said Travis LeBlanc, special assistant attorney general. "When we have limited resources and in a budget crunch, we need to focus our resources and use it in smart, efficient ways, and [CURES] is one of those," he said.

lisa.girion@latimes.com

scott.glover@latimes.com

Times staff writer Hailey Branson-Potts contributed to this report.

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HP Cloud Ushers in 2013 and GA Compute Service with Reduced Pricing

HP Cloud Services is continuously working to increase efficiency in our datacenters, so we can pass these efforts along to our customers via enhanced enterprise-class service and/or lower prices.  As a result, HP Cloud Services is starting the New Year by permanently lowering the prices on Linux instances of HP Cloud Compute by 12.5% and Object Storage by as much as 25%. 

Furthermore, to celebrate our Compute service’s move to General Availability (GA), we are offering a time-limited 40% discount on all Windows and Linux instances until March 31st, 2013.  We’re doing this to make it even easier for new and existing customers to try our new GA service and perform their initial integration work. You can read more about our differentiated, industry-leading SLA at “Under the Hood of HP Cloud Services SLAs” and about what we’re doing behind the scenes to actually deliver on and surpass our SLAs at “How HP Cloud Services Became Enterprise Class.” 

It’s worth noting that we also recently moved HP Cloud Block Storage to public beta and added several major new features, including bootable persistent volumes and enhancements in volume backup to object storage, as detailed here.  HP Cloud Block Storage is being discounted by 50% while in public beta, so now is the perfect time to give it a test drive if you haven’t already!

You can sign up now to start exploring our enterprise-class cloud.  For ongoing news about our new services, pricing and special offers, follow us on Twitter @hpcloud, subscribe to this blog, and follow our Facebook page.

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What's Got Tom Colicchio & Gail Simmons Spinning Out of Control?

Caught in the Act

01/11/2013 at 06:00 AM EST

Tom Colicchi & Gail Simmons

Larry Busacca/Getty

From Top Chef to top cyclist!

Top Chef judges chef Tom Colicchio and Gail Simmons kicked off 2013 on a healthy note by they visiting SoulCycle's Tribeca location on Wednesday.

"While Gail was upfront wearing a SoulCycle t-shirt, Tom was in the back wearing black shorts, an Under Armour tank and a do-rag," an onlooker tells PEOPLE.

The co-judges are no strangers to the cycling craze, the source adds. "They both spin on a regular basis" and "spin together regularly when they're filming Top Chef".

After powering through the last song of the class – Beyoncé's "Halo" – Colicchio stopped to chat with Food & Wine magazine publisher Christina Grdovic.

Here's to hoping for a Quickfire Competition on a bike!

– Lesley Messer

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IHT Rendezvous: The Last Man Asian Literary Prize

HONG KONG — The five shortlisted novels of what will be the last Man Asian Literary Prize were announced last evening at the Man Group’s offices here. The British investment firm will end its support of Asia’s most prominent literary prize after the final award is given at a black-tie dinner in March.

As usually happens, the shortlist announcement drew about two dozen people from the city’s relatively small English-language literary scene: a few publishers, agents and journalists mostly from the foreign or English-language press. With rather less fanfare than the Man Booker gets, we stood around a screen to watch Maya Jaggi, a literary critic and head of the judging panel, read the list via a video link from London, from what looked like an office cubicle.

Man’s involvement lent clout to the prize when it was introduced in Hong Kong in 2007 — it is often incorrectly referred to as the Asian Booker — and the $30,000 purse is extraordinarily generous in a region without many literary awards. More importantly, it gave global exposure to Asian authors writing in Asian languages. The 2011 winner, “Please Look After Mom” by the South Korean novelist Kyung-sook Shin, went on to sell two million copies worldwide.

Initially, the Man Asia accepted unpublished manuscripts (which it no longer does) and focused on unearthing unknown regional talent, like the Filipino writer Miguel Syjuco in 2008.

But as the prize grew in prominence, so have its recipients, causing more crossover with international awards. The Guardian called this year the “Booker re-match,” as two of the works shortlisted for the Man Asia – “The Garden of Evening Mists” by the Malaysian author Tan Twan Eng and “Narcopolis,” a debut novel by the Indian poet Jeet Thayil – were also shortlisted for the Man Booker.

Another author shortlisted for the Man Asia, Orhan Pamuk, was given the 2006 Nobel Prize in Literature. His submission, “Silent House,” is a 30-year-old Turkish-language novel that had only recently been published in English. Rounding out the short list are “Between Clay and Dust” by the Pakistani author Musharraf Ali Farooqi and “The Briefcase” by Hiromi Kawakami of Japan.

All but one – “Between Clay and Dust,” from the Delhi-based Aleph Book Company – are from Western publishers.

The prize’s organizers say that they have been in talks with potential new sponsors for months, after it was announced in October that Man would no longer support it.

“We have decided to concentrate our arts sponsorship on the world-leading Man Booker prize, where our support is about to go into its twelfth year,” David Waller, a Man Group spokesman, said at the time.

A new title sponsor is expected to be announced in April, and most chatter has been over whether it will be an Asian organization this time. It brings up a larger question:

Does Asia’s literary scene still need Western financing, publishing houses and publicity to succeed?

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Retooling Pap test to spot more kinds of cancer

WASHINGTON (AP) — For years, doctors have lamented that there's no Pap test for deadly ovarian cancer. Wednesday, scientists reported encouraging signs that one day, there might be.

Researchers are trying to retool the Pap, a test for cervical cancer that millions of women get, so that it could spot early signs of other gynecologic cancers, too.

How? It turns out that cells can flake off of tumors in the ovaries or the lining of the uterus, and float down to rest in the cervix, where Pap tests are performed. These cells are too rare to recognize under the microscope. But researchers from Johns Hopkins University used some sophisticated DNA testing on the Pap samples to uncover the evidence — gene mutations that show cancer is present.

In a pilot study, they analyzed Pap smears from 46 women who already were diagnosed with either ovarian or endometrial cancer. The new technique found all the endometrial cancers and 41 percent of the ovarian tumors, the team reported Wednesday in the journal Science Translational Medicine.

This is very early-stage research, and women shouldn't expect any change in their routine Paps. It will take years of additional testing to prove if the so-called PapGene technique really could work as a screening tool, used to spot cancer in women who thought they were healthy.

"Now the hard work begins," said Hopkins oncologist Dr. Luis Diaz, whose team is collecting hundreds of additional Pap samples for more study and is exploring ways to enhance the detection of ovarian cancer.

But if it ultimately pans out, "the neat part about this is, the patient won't feel anything different," and the Pap wouldn't be performed differently, Diaz added. The extra work would come in a lab.

The gene-based technique marks a new approach toward cancer screening, and specialists are watching closely.

"This is very encouraging, and it shows great potential," said American Cancer Society genetics expert Michael Melner.

"We are a long way from being able to see any impact on our patients," cautioned Dr. Shannon Westin of the University of Texas MD Anderson Cancer Center. She reviewed the research in an accompanying editorial, and said the ovarian cancer detection would need improvement if the test is to work.

But she noted that ovarian cancer has poor survival rates because it's rarely caught early. "If this screening test could identify ovarian cancer at an early stage, there would be a profound impact on patient outcomes and mortality," Westin said.

More than 22,000 U.S. women are diagnosed with ovarian cancer each year, and more than 15,000 die. Symptoms such as pain and bloating seldom are obvious until the cancer is more advanced, and numerous attempts at screening tests have failed.

Endometrial cancer affects about 47,000 women a year, and kills about 8,000. There is no screening test for it either, but most women are diagnosed early because of postmenopausal bleeding.

The Hopkins research piggybacks on one of the most successful cancer screening tools, the Pap, and a newer technology used along with it. With a standard Pap, a little brush scrapes off cells from the cervix, which are stored in a vial to examine for signs of cervical cancer. Today, many women's Paps undergo an additional DNA-based test to see if they harbor the HPV virus, which can spur cervical cancer.

So the Hopkins team, funded largely by cancer advocacy groups, decided to look for DNA evidence of other gynecologic tumors. It developed a method to rapidly screen the Pap samples for those mutations using standard genetics equipment that Diaz said wouldn't add much to the cost of a Pap-plus-HPV test. He said the technique could detect both early-stage and more advanced tumors. Importantly, tests of Paps from 14 healthy women turned up no false alarms.

The endometrial cancers may have been easier to find because cells from those tumors don't have as far to travel as ovarian cancer cells, Diaz said. Researchers will study whether inserting the Pap brush deeper, testing during different times of the menstrual cycle, or other factors might improve detection of ovarian cancer.

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Irvine City Council overhauls oversight, spending on Great Park

Capping a raucous eight-hour-plus meeting, the Irvine City Council early Wednesday voted to overhaul the oversight and spending on the beleaguered Orange County Great Park while authorizing an audit of the more than $220 million that so far has been spent on the ambitious project.

A newly elected City Council majority voted 3 to 2 to terminate contracts with two firms that had been paid a combined $1.1 million a year for consulting, lobbying, marketing and public relations. One of those firms — Forde & Mollrich public relations — has been paid $12.4 million since county voters approved the Great Park plan in 2002.

"We need to stop talking about building a Great Park and actually start building a Great Park," council member Jeff Lalloway said.

The council, by the same split vote, also changed the composition of the Great Park's board of directors, shedding four non-elected members and handing control to Irvine's five council members.

The actions mark a significant turning point in the decade-long effort to turn the former El Toro Marine base into a 1,447-acre municipal park with man-made canyons, rivers, forests and gardens that planners hoped would rival New York's Central Park.

The city hoped to finish and maintain the park for years to come with $1.4 billion in state redevelopment funds. But that money vanished last year as part of the cutbacks to deal with California's massive budget deficit.

"We've gone through $220 million, but where has it gone?" council member Christina Shea said of the project's initial funding from developers in exchange for the right to build around the site. "The fact of the matter is the money is almost gone. It can't be business as usual."

The council majority said the changes will bring accountability and efficiencies to a project that critics say has been larded with wasteful spending and no-bid contracts. For all that has been spent, only about 200 acres of the park has been developed and half of that is leased to farmers.

But council members Larry Agran and Beth Krom, who have steered the course of the project since its inception, voted against reconfiguring the Great Park's board of directors and canceling the contracts with the two firms.

Krom has called the move a "witch hunt" against her and Agran. Feuding between liberal and conservative factions on the council has long shaped Irvine politics.

"This is a power play," she said. "There's a new sheriff in town."

The council meeting stretched long into the night, with the final vote coming Wednesday at 1:34 a.m. Tensions were high in the packed chambers with cheering, clapping and heckling coming from the crowd.

At one point council member Lalloway lamented that he "couldn't hear himself think."

During public comments, newly elected Orange County Supervisor Todd Spitzer chastised the council for "fighting like schoolchildren." Earlier this week he said that if the Irvine's new council majority can't make progress on the Great Park, he would seek a ballot initiative to have the county take over.

And Spitzer angrily told Agran that his stewardship of the project had been a failure.

"You know what?" he said. "It's their vision now. You're in the minority."

mike.anton@latimes.com

rhea.mahbubani@latimes.com

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Could Alex Jones’s “revolution” actually happen?

Piers Morgan had it easy. Radio show host and author Alex Jones threatened the rest of us with a ”revolution” if the government decides to confiscate guns from the homes and glove compartments of law-abiding Americans. It’s almost too easy to dismiss Jones as a fringe figure, especially since fringe ideas make their way into the mainstream with (exciting? alarming?) frequency these days. So let’s take him seriously.

Let’s accept his premise. Actually, let’s dismiss it first but then turn around and accept it for the sake of argument. The government has not the means nor the mechanism nor the credibility to confiscate 100,000 guns, much less 600,000,000. And those in the government doing the confiscating would be neighbors and relatives of the confiscatory victims: police officers, national guard members, Army reservists. Of course, Jones might say that their intent is bad enough. But “they” — the Obama administration, I assume — have no such intentions, and never did.

But OK. Let’s say that the government tries to confiscate guns and “the people” attempt to revolt.  No doubt that civil disobedience can spring up rather spontaneously and even be organized very quickly, but if rioting were to somehow break out in American cities, it would be isolated and theoretically containable. Organizing a “revolt” would require extensive planning, including the massive transportation of citizens from their homes to wherever the rally points were, a communications infrastructure, and leaders. The same Open Source culture that would make it difficult for the government to plan a confiscation in secret makes it just as unlikely for citizens to plan a feasible response to that confiscation in secret.

One of Jones’s obsessions, which, I confess, I share, is the militarization of the American homeland, and he is not promulgating a conspiracy here. The military has expanded its presence on American soil, and crucially, has expanded the way it is organized to respond to mass contingency events of any kind, including natural disasters and rioting. The U.S. Northern Command does receive intelligence briefings about domestic disturbances from the FBI and DHS, so commanders would be somewhat prepared to deploy troops. Thousands would come from the standing Army, but the bulk would be drawn from state National Guard detachments. It is exceedingly difficult to picture weekend warriors following blind orders en masse to detain or harm U.S. citizens when local police resources are stretched. The government has the power of command and control, but the people have the power of fellow-feeling. The government’s response to any real revolt would probably be quite restrained. There’d be too much attention paid to every movement of every tank to act harshly. The strategy to contain any “revolt” might therefore depend on a period of people letting out their energies and then returning to their normal business. 

Ah, but what if the government controls the communication nodes?  Well, corporations do; I assume Jones would have them immediately bend to a secret executive order shutting down serves and clouds and services like Twitter, but even if corporations agreed to do this, together, it would take days to get even a fraction of the telecom infrastructure offline. Maybe the government would order a mass power outage. But that’s why so many Americans have generators in the first place!  Although government “boards” comprising major telecom and infrastructure executives do exist, the most they’ve ever contemplated doing is to shut down a narrow slice of an infected communications node. These days, they’re focused on the cyber threat.  In the early days of civil defense planning, when there were a few television networks an AT&T had its monopoly, the threat of a government takeover of TV, radio and telephones was technically feasible. Today it is not. Actually, it does not make sense. What’s turned on really cannot be turned off.

But wait. if Jones’s “revolution” is to succeed, he needs to take over the government, because he’d need to dominate communications as well, unless he assumes that his movement would be organic and immune to arguments from elected officials asking for stability and calm.

An objective of anyone who wants to take over the government would be a seizure of the Emergency Broadcast System, which allows the President to speak to the nation through almost any mechanism of communication at any time. The EBS lives at Mt. Weather, the massive FEMA bunker in Virginia, but it can be activated and controlled from at least a dozen other places, including the briefcase of the Emergency Actions officer who travels with the President.  A coordinated violent action to seize control of this key portal would require an incredible amount of prior planning.

Assuming even that the government’s response to isolated-turned-mass rioting is uneven, the President would be able to address Americans anytime he wants. In theory, Jones’s followers could try to take over every broadcast entity in America, or could try and jam the broadcasts using sophisticated electronic warfare technology available to the military, but once again, the practicalities are not possible.

Because there will be no revolt over gun control, because there will not be and cannot be a mass confiscation of guns, playing with these ideas is fanciful and fodder for a sequel to Seven Days in May. Heck, we haven’t even addressed the FEMA concentration camps (which don’t exist).  But that isn’t to say that nothing discussed above will ever be relevant. It is much easier to imagine a small-scale revolt, a series of pre-planned violent protests against the powers that be, perhaps because the political system seems so non-responsive to the worries of people who listen to Alex Jones.  It would not take much to make Americans nervous about the government’s ability to restore law and order. And that frission itself is probably the most unknowable of all these factors.

Patriotic citizens aren’t supposed to speculate about these extremely unlikely events, but the government certainly thinks about them. So maybe we should too.

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Whoa! Check Out Taylor Swift’s Sexy Breakover!

Stylewatch
Style News Now

01/09/2013 at 09:30 PM ET

Steve Granitz/WireImage

Don’t worry about changing your relationship status on Facebook, Taylor, since this dress sends the message loud and clear.

For her first official appearance after breaking up with One Direction’s Harry Styles, the newly single star showed a side of her we’ve never seen at the People’s Choice Awards in L.A. on Tuesday night.

Clad in a plunging white gown with cap sleeves, plus turquoise danglers and an intense smoky eye, Swift created quite a buzz when she hit the red carpet.

PHOTOS: SEE MORE PEOPLE’S CHOICE AWARDS RED CARPET STYLE!

Swift has been venturing away from her signature sparkly princess dresses and taking more fashion risks lately, but this is her most revealing look yet.

Now if only she could stay sans boyfriend long enough to keep up this sexy style streak … Tell us: Do you like Swift’s hot new look?

–Jennifer Cress

RELATED: TAYLOR SWIFT GETS KANYE’D … AGAIN!

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Iranian Captives Freed in Major Prisoner Exchange in Syria

ISTANBUL — More than 2,000 prisoners incarcerated by the Syrian authorities were being released on Wednesday in return for 48 Iranians freed by rebels after five months in captivity, Turkish and Iranian news reports said, in what appeared to be the biggest prisoner swap since the uprising against President Bashar al-Assad began almost two years ago.

The exchange, brokered by Turkey and Qatar, came days after Mr. Assad warned on Sunday that he would not abandon the fight against armed adversaries pressing on the approaches to the Syrian capital, Damascus, and brushed aside calls for him to quit.

The swap started in more than one location near Damascus after months of diplomatic efforts that also involved the Humanitarian Relief Foundation, an Islamist-leaning aid organization based in Istanbul and widely known as I.H.H., according to Bulent Yildirim, the head of the foundation.

“Some of our friends are with the opposition groups, and we are heading to the area where the prisoners are to be released,” Mr. Yildirim told Turkey’s semiofficial Anatolian news Agency.

He added, “Efforts under the Turkish and Qatari mediation continue, while the exchange started at several locations where prisoners were kept.”

Mr. Yildirim told Reuters that, after their release, the 48 Iranians were escorted to Damascus by Iranian and Syrian officials.

The aid group has set up an operation center in Damascus to unite 2,130 prisoners, including 73 women, at one base while another aid team remained in Douma, near the Syrian capital, to oversee the return of the 48 Iranians.

The Syrian opposition has claimed that the Iranians are members of Iran’s Islamic Revolutionary Guards Corps, but Tehran has denied the assertion, saying the captives are Shiite civilian pilgrims. The Iranians were seized in August while traveling on a bus from Damascus International Airport to a Shiite shrine on the outskirts of the capital, Iran’s Press TV said.

Opposition fighters had threatened to kill the Iranians unless Mr. Assad’s forces halted military operations. But since then the fighting around Damascus has intensified.

Iran is Mr. Assad’s main ally in a region where many Arab states and neighboring Turkey have turned against him, seeking his ouster. The Iranian captives offered the rebels holding them a source of pressure on the Syrian leader to push for the release of prisoners.

“We expect the swap to be completed in the next hour,” Huseyin Oruc, a member of the aid group’s executive board said in a telephone interview around midday.

“Among the 2,130 there are Syrians, four Turks, and a Palestinian, names of whom we will announce later in the day.”

Diplomatic efforts to release more prisoners would continue, he added.

“It is the first time that the ‘humanitarian diplomacy’ we initiated succeeded in releasing such a large group of people at once,” Mr. Oruc said. “There are many more held captive and our efforts to free them will continue without delay.”

The aid group gained international attention in 2010 for organizing a flotilla of boats heading to Gaza, ostensibly with relief supplies, that prompted a deadly Israeli commando raid in which nine Turks died. At the time of the raid, the group was reported to have extensive connections with Turkey’s political elite. The episode began an unraveling of Turkey’s once close ties with Israel.

In recent months, the aid group has also been part of negotiations to free smaller numbers of prisoners, including two Turkish journalists held in Syria, Reuters reported. The organization has been active since the early 1990s in charitably works in Middle East and Africa, focusing most recently on Gaza.

Since the start of the uprising against Mr. Assad, the organization has also cast itself as a leading private charitable organization in Syria, delivering food and other basic supplies and pursuing what it calls “humanitarian diplomacy” to help free captive civilians.

While the numbers involved in Wednesday’s exchange seemed dramatic, some rebel commanders said more modest prisoner exchanges have become a feature of the conflict.

The leader of a rebel fighting group in the central city of Hama, reached via Skype, said pro-government militia had captured his uncle and two other relatives in a village in the northern Idlib province more than a month ago.

 “The  only  way  to  release them  is capturing  hostages,” the commander said, adding that negotiations were under way to win the release of his relatives in return for 12 captives held by the rebels. Two months ago, the commander said, nine members of the pro-government shabeeha militia were  exchanged for five captured rebels. Syria’s uprising began in March 2011 with peaceful demonstrations, but a brutal crackdown broadened into civil war with an estimated 60,000 people killed, according to United Nations estimates.

Sebnem Arsu reported from Istanbul and Alan Cowell from London. Hwaida Saad contributed reporting from Beirut, Lebanon.

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