Alarm Over India’s Dengue Fever Epidemic

Enrico Fabian for The New York Times

A man at the Yamuna River, an ideal breeding ground for mosquitoes. Filthy standing water abounds in New Delhi. More Photos »

NEW DELHI — An epidemic of dengue fever in India is fostering a growing sense of alarm even as government officials here have publicly refused to acknowledge the scope of a problem that experts say is threatening hundreds of millions of people, not just in India but around the world.

India has become the focal point for a mosquito-borne plague that is sweeping the globe. Reported in just a handful of countries in the 1950s, dengue (pronounced DEN-gay) is now endemic in half the world’s nations.

“The global dengue problem is far worse than most people know, and it keeps getting worse,” said Dr. Raman Velayudhan, the World Health Organization’s lead dengue coordinator.

The tropical disease, though life-threatening for a tiny fraction of those infected, can be extremely painful. Growing numbers of Western tourists are returning from warm-weather vacations with the disease, which has reached the shores of the United States and Europe. Last month, health officials in Miami announced a case of locally acquired dengue infection.

Here in India’s capital, where areas of standing water contribute to the epidemic’s growth, hospitals are overrun and feverish patients are sharing beds and languishing in hallways. At Kalawati Saran Hospital, a pediatric facility, a large crowd of relatives lay on mats and blankets under the shade of a huge banyan tree outside the hospital entrance recently.

Among them was Neelam, who said her two grandchildren were deathly ill inside. Eight-year-old Sneha got the disease first, followed by Tanya, 7, she said. The girls’ parents treated them at home but then Sneha’s temperature rose to 104 degrees, a rash spread across her legs and shoulders, and her pain grew unbearable.

“Sneha has been given five liters of blood,” said Neelam, who has one name. “It is terrible.”

Officials say that 30,002 people in India had been sickened with dengue fever through October, a 59 percent jump from the 18,860 recorded for all of 2011. But the real number of Indians who get dengue fever annually is in the millions, several experts said.

“I’d conservatively estimate that there are 37 million dengue infections occurring every year in India, and maybe 227,500 hospitalizations,” said Dr. Scott Halstead, a tropical disease expert focused on dengue research.

A senior Indian government health official, who agreed to speak about the matter only on the condition of anonymity, acknowledged that official figures represent a mere sliver of dengue’s actual toll. The government only counts cases of dengue that come from public hospitals and that have been confirmed by laboratories, the official said. Such a census, “which was deliberated at the highest levels,” is a small subset that is nonetheless informative and comparable from one year to the next, he said.

“There is no denying that the actual number of cases would be much, much higher,” the official said. “Our interest has not been to arrive at an exact figure.”

The problem with that policy, said Dr. Manish Kakkar, a specialist at the Public Health Foundation of India, is that India’s “massive underreporting of cases” has contributed to the disease’s spread. Experts from around the world said that India’s failure to construct an adequate dengue surveillance system has impeded awareness of the illness’s vast reach, discouraged efforts to clean up the sources of the disease and slowed the search for a vaccine.

“When you look at the number of reported cases India has, it’s a joke,” said Dr. Harold S. Margolis, chief of the dengue branch at the Centers for Disease Control and Prevention in Atlanta.

Neighboring Sri Lanka, for instance, reported nearly three times as many dengue cases as India through August, according to the World Health Organization, even though India’s population is 60 times larger.

Hari Kumar contributed reporting.

Read More..

Alarm Over India’s Dengue Fever Epidemic

Enrico Fabian for The New York Times

A man at the Yamuna River, an ideal breeding ground for mosquitoes. Filthy standing water abounds in New Delhi. More Photos »

NEW DELHI — An epidemic of dengue fever in India is fostering a growing sense of alarm even as government officials here have publicly refused to acknowledge the scope of a problem that experts say is threatening hundreds of millions of people, not just in India but around the world.

India has become the focal point for a mosquito-borne plague that is sweeping the globe. Reported in just a handful of countries in the 1950s, dengue (pronounced DEN-gay) is now endemic in half the world’s nations.

“The global dengue problem is far worse than most people know, and it keeps getting worse,” said Dr. Raman Velayudhan, the World Health Organization’s lead dengue coordinator.

The tropical disease, though life-threatening for a tiny fraction of those infected, can be extremely painful. Growing numbers of Western tourists are returning from warm-weather vacations with the disease, which has reached the shores of the United States and Europe. Last month, health officials in Miami announced a case of locally acquired dengue infection.

Here in India’s capital, where areas of standing water contribute to the epidemic’s growth, hospitals are overrun and feverish patients are sharing beds and languishing in hallways. At Kalawati Saran Hospital, a pediatric facility, a large crowd of relatives lay on mats and blankets under the shade of a huge banyan tree outside the hospital entrance recently.

Among them was Neelam, who said her two grandchildren were deathly ill inside. Eight-year-old Sneha got the disease first, followed by Tanya, 7, she said. The girls’ parents treated them at home but then Sneha’s temperature rose to 104 degrees, a rash spread across her legs and shoulders, and her pain grew unbearable.

“Sneha has been given five liters of blood,” said Neelam, who has one name. “It is terrible.”

Officials say that 30,002 people in India had been sickened with dengue fever through October, a 59 percent jump from the 18,860 recorded for all of 2011. But the real number of Indians who get dengue fever annually is in the millions, several experts said.

“I’d conservatively estimate that there are 37 million dengue infections occurring every year in India, and maybe 227,500 hospitalizations,” said Dr. Scott Halstead, a tropical disease expert focused on dengue research.

A senior Indian government health official, who agreed to speak about the matter only on the condition of anonymity, acknowledged that official figures represent a mere sliver of dengue’s actual toll. The government only counts cases of dengue that come from public hospitals and that have been confirmed by laboratories, the official said. Such a census, “which was deliberated at the highest levels,” is a small subset that is nonetheless informative and comparable from one year to the next, he said.

“There is no denying that the actual number of cases would be much, much higher,” the official said. “Our interest has not been to arrive at an exact figure.”

The problem with that policy, said Dr. Manish Kakkar, a specialist at the Public Health Foundation of India, is that India’s “massive underreporting of cases” has contributed to the disease’s spread. Experts from around the world said that India’s failure to construct an adequate dengue surveillance system has impeded awareness of the illness’s vast reach, discouraged efforts to clean up the sources of the disease and slowed the search for a vaccine.

“When you look at the number of reported cases India has, it’s a joke,” said Dr. Harold S. Margolis, chief of the dengue branch at the Centers for Disease Control and Prevention in Atlanta.

Neighboring Sri Lanka, for instance, reported nearly three times as many dengue cases as India through August, according to the World Health Organization, even though India’s population is 60 times larger.

Hari Kumar contributed reporting.

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Video Games: Unfinished Swan, Assassin’s Creed and Need for Speed

These edited and condensed reviews are from the writers and editors of the gaming Web site Kotaku.com. Full reviews are at kotaku.com/nytselects.

THE UNFINISHED SWAN

Released on Oct. 23

Developer: Giant Sparrow

Publisher: Sony Computer Entertainment of America

For PlayStation 3

Rated E10+ for fantasy violence

In the first chapter of The Unfinished Swan you will paint a wall. In the second you will water plants. The third lets you walk beside a river, then build a staircase. In the fourth you will feel tall.

This is among those video games that feel more like poetry than prose. It operates in the abstract; it lets you figure out what it means. The game is played in the first person. You are a boy, lost in the dream kingdom of a sad king, your mother long gone. And there’s a swan with an empty space where part of its neck should be. There’s something going on here about fathers disappointed in their lives and of creators frustrated with a life of uncompleted rough drafts.

The main action involves shooting paint or water into the world. In the opening scene the world is empty and white, its contours invisible until you start shooting black paint. The paint splatters define a wall, then a tree, then a bridge upon which you can safely walk. It’s just one of many of the game’s moments of gentle, interactive beauty.

This has been a stirring year for so-called art games. With Journey, Papo & Yo, Dyad and now The Unfinished Swan, the PlayStation 3 exhibits some of the best.

ASSASSIN’S CREED III

Liberation

Released on Oct. 30

Developer: Ubisoft Sofia

Publisher: Ubisoft

For PlayStation Vita

Rated M (Mature) for suggestive themes and violence

Assassin’s Creed III: Liberation features a progressive bit of creativity: the first female protagonist for this Ubisoft period-piece action series. More impressive, Liberation finds clever, affecting ways to implement the heroine Aveline de Grandpré’s biracial heritage and gender into gameplay mechanics.

The game’s key feature makes players change among three personas — a high-society Lady, a Slave who can go undercover and a secretive Assassin. Aveline uses her white French father’s dockside warehouse as a base of operations to find out what has been happening to disappearing slaves in 18th-century New Orleans.

Each persona wields special abilities related to its social status, so the Slave can foment riots and the Lady can seduce and bribe officials. The lead character’s quest to discover the fate of her long-lost mother — herself a freed slave — adds emotional heft to the experience.

By the time you’re finished, you’ll have seen the highest and lowest levels of life as it may have been lived in this area in 1768, from a point of view not often found in video games.

NEED FOR SPEED

Most Wanted

Released on Oct. 30

Developer: Criterion Games

Publisher: Electronic Arts

For Xbox 360, PlayStation 3, PlayStation Vita and PC

Rated T (Teen) for an alcohol reference and violence

Need For Speed: Most Wanted is a video game shot out of a cannon. Two minutes after pressing the start button, you’ll be behind the wheel of a car, careering through a sprawling city with a single objective: win as many races as possible.

As you explore downtown streets and mountain highways, you’ll quickly come upon and unlock dozens of slick, race-ready automobiles. From Land Rovers to Lamborghinis, each handles a bit differently and each has its own set of assigned races. By competing in those races, you’ll earn points and climb a global leader board, ever aware of your friends’ best times. You can also take the whole game online and compete in real-time multiplayer events.

Most Wanted is a stripped-down affair. The cars are simple to control, and the city may be wide open, but it offers few nonrace events and challenges. That single-mindedness works in the game’s favor, largely because Most Wanted effortlessly imparts a gut-twisting, exhilarating rush. Need For Speed: Most Wanted is in essence a fantasy game; the fantasy of racing expensive cars ludicrously fast without fear of injury or legal repercussion. In that, it is a success, a thrilling ride that wastes no time achieving maximum velocity.

SKYLANDERS GIANTS

Released on Oct. 21

Developer: Toys for Bob

Publisher: Activision

For Xbox 360, Wii, PlayStation 3 and Wii U (Nov. 18)

Rated E10+ for cartoon violence

The marriage of physical toys and electronic entertainment that began in last year’s wildly successful Skylanders: Spyro’s Adventure grows even stronger with the release of Skylanders Giants. Placing specially designed action figures on a circular portal connected to a game console brings them to life in this child-friendly action-adventure. The toys keep track of power gained during the game, which involves protecting the fanciful Skylands from the grip of an evil would-be overlord.

Giants’ gameplay mainly involves running about, smashing scenery and colorful cartoon enemies, which makes it simple to pick up and play for children and parents. It’s good, harmless fun. What isn’t harmless is the price of those plastic toys. With eight new giant-sized characters, the figures from the original game, reposed versions of the original characters and the glowing LightCore Skylanders, parents (or adult collectors) could easily spend upward of $1,000 putting together all of the pieces of this diabolically enticing electronic playset.

LETTERPRESS

Released on Oct. 24

Developer: atebits

For iPhone and iPad

Rated 4+ on iTunes for no objectionable content

Word games may all essentially be about showing off how clever you are. Letterpress might be the only one that feels like a boxing match, too. Each move in this game from the atebits studio can have the head-rattling effect of a right cross.

The game lays out a five-by-five grid on which two players compete to claim the most lettered squares. Tapping out a word from the letters before you lets you claim that word. But somewhere in that mix of jumbled letters is the combination that your opponent will rout you with.

The tension that accompanies every turn revolves around a simple question: What is your opponent seeing that you are not? An acquisitive pressure accompanies Letterpress, as well, since you can capture letters by surrounding them with other squares of your color, ensuring that only you can earn points off those tiles. Letterpress may look like a cute, minimalist Boggle cousin, but the key to its hypnotic allure is in its doubling as a cutthroat battle for territory.

These edited and condensed reviews are from the writers and editors of the gaming Web site Kotaku.com. Full reviews are at kotaku.com/nytselects.

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Obama Wins New Term as Electoral Advantage Holds

Doug Mills/The New York Times

President Obama greeted a volunteer during a visit to a local campaign office in Chicago. More Photos »

Barack Hussein Obama was re-elected president of the United States on Tuesday, overcoming powerful economic headwinds, a lock-step resistance to his agenda by Republicans in Congress and an unprecedented torrent of advertising as the nation voted to give him a second chance to change Washington.

In defeating Mitt Romney, the president carried Wisconsin, Iowa, New Hampshire, Colorado and Virginia and was holding on to a narrow advantage in Ohio and Florida. The path to victory for Mr. Romney narrowed as the night wore along, with Mr. Obama steadily climbing toward the 270 electoral votes needed to win a second term.

A cheer of jubilation sounded at the Obama campaign headquarters in Chicago when the television networks began projecting him as the winner at 11:20 p.m., even as the ballots were still being counted in many states where voters had waited in line well into the night. The victory was far narrower than his historic election four years ago, but it was no less dramatic.

As a succession of states fell away from Mr. Romney, a hush fell over his Boston headquarters on Tuesday night. Two advisers said in interviews that the contest seemed over, but Mr. Romney was not conceding, with the electoral votes from Ohio and Florida still outstanding.

The evening was not without the drama that has come to mark so many recent elections: Even after Fox News Channel projected that Mr. Obama would win Ohio — effectively sealing Mr. Obama’s re-election — its on-air analyst, the Republican strategist Karl Rove, was arguing that it had done so too quickly and that Mr. Romney still had a chance.

Hispanics made up an important part of Mr. Obama’s winning coalition, preliminary exit poll data showed. And before the night was through, there were already recriminations from Republican moderates who said Mr. Romney had gone too far during the primaries in his statements against those here illegally, including his promise that his get-tough policies would cause some to “self-deport.”

Mr. Obama, 51, faces governing in a deeply divided country and a partisan-rich capital, where Republicans retained their majority in the House and Democrats kept their control of the Senate. His re-election offers him a second chance that will quickly be tested, given the rapidly escalating fiscal showdown.

For Mr. Obama, the result brings a ratification of his sweeping health care act, which Mr. Romney had vowed to repeal. The law will now continue on course toward nearly full implementation in 2014, promising to change significantly the way medical services are administrated nationwide.

Confident that the economy is finally on a true path toward stability, Mr. Obama and his aides have hinted that he would seek to tackle some of the grand but unrealized promises of his first campaign, including the sort of immigration overhaul that has eluded presidents of both parties for decades.

But he will be venturing back into a Congressional environment similar to that of his first term, with the Senate under the control of Democrats and the House under the control of Republicans, whose leaders have hinted that they will be no less likely to challenge him than they were during the last four years.

The state-by-state pursuit of 270 electoral votes was being closely tracked by both campaigns, with Mr. Romney winning North Carolina and Indiana, which Mr. Obama carried four years ago. But Mr. Obama won Michigan, the state where Mr. Romney was born, and Minnesota, a pair of states that Republican groups had spent millions trying to make competitive.

Americans delivered a final judgment on a long and bitter campaign that drew so many people to the polls that several key states extended voting for hours. In Virginia and Florida, long lines stretched from polling places, with the Obama campaign sending text messages to supporters in those areas, saying: “You can still vote.”

Michael Cooper contributed reporting.

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DealBook Column: The Election Won't Solve All Puzzles

Here comes more uncertainty.

It may sound counterintuitive, but whatever the outcome of the election — whether President Obama or Mitt Romney wins — the economy and markets are likely to face more uncertainty, not less, over the coming year.

“Uncertainty” has become the watchword over the last several years for many chief executives, politicians and economists as an explanation — or perhaps an excuse — for the economy’s slow growth, for the lack of hiring by business and for the volatility in the stock market.

“The claim is that businesses and households are uncertain about future taxes, spending levels, regulations, health care reform and interest rates. In turn, this uncertainty leads them to postpone spending on investment and consumption goods and to slow hiring, impeding the recovery,” a group of professors from Stanford University and the University of Chicago wrote in a study that found “current levels of economic policy uncertainty are at extremely elevated levels compared to recent history.” (The professors have created a Web site, policyuncertainty.com, where you can track the “uncertainty” levels.)

Come Wednesday morning, we should know who our president will be. But the uncertainty hardly ends there.

Almost immediately after the elections, the next big talking point on Wall Street and in Washington is going to be the now infamous “fiscal cliff,” a series of automatic tax increases and spending cuts that was the result of a Congressional compromise reached last summer and is to take effect on Jan. 1, unless Congress finds an alternative. Some economists say the tax increases and spending cuts in the existing agreement could shave as much as 4 percent off G.D.P. if they are not renegotiated. Already, executives say that the uncertainty over the outcome of the fiscal cliff is causing them to hold back from making new investments.

But the greatest likelihood is that the fiscal cliff isn’t going to be resolved soon at all —the betting line of the political cognoscenti is that no matter who wins, Congress will find a way to kick the issue down the road, perhaps as far as the fall of 2013, providing a new cloud of uncertainty over the economy.

For investors, the fiscal cliff includes a tax increase on dividends (making them the equivalent of ordinary income, on which rates could rise to as high as 39.6 percent) and capital gains (up to 20 percent from 15 percent). In a note to clients sent out on Sunday night, Goldman Sachs said that it expected the rate for both dividends and capital gains to be negotiated to 20 percent in either a second Obama term or a Romney presidency. But more important, Goldman noted that when similar tax increases were on the table in 1970 and 1986, “the S.& P. 500 posted negative returns in the December prior to implementation as investors locked in the lower rate.” December, the report said, “has the second-highest average monthly return” since 1928.

Many investors have already begun selling stocks and companies in anticipation of tax increases. Speculation was rampant last week that one of the reasons for the timing of the sale of George Lucas’s company, Lucasfilm, to Disney for $4.1 billion in cash and stock, was the impending changes in tax policy. (Mr. Lucas has said that he plans to donate a majority of his wealth to charity.)

Once we get past the fiscal cliff, if we do at all, there is Europe. Remember Europe? The issues in Greece and Spain have managed to stay off the front pages during the election run-up, but they have not gone away. Some economists have argued that things have gotten worse. Angela Merkel, the chancellor of Germany, who will face election in 2013, said on Monday that the fiscal crisis in Europe was likely to last at least five years. “Whoever thinks this can be fixed in one or two years is wrong,” she said.

And don’t forget the Middle East. That “uncertainty” for the world — and the global economy — isn’t going away anytime soon either. Questions about a possible attack on Iran will persist under either candidate.

And finally, there is Ben Bernanke, chairman of the Federal Reserve, one of the biggest uncertainties of them all. As I reported in this column two weeks ago, the greatest likelihood is that Mr. Bernanke will step down at the end of his term in early 2014 no matter who wins the election.

It’s possible — though unlikely — that his departure could happen even sooner if Mr. Romney wins. Over the next year and a half, Mr. Bernanke’s future as the Fed chairman will feed a sense of uncertainty among investors who have become accustomed to his easy money policies. If President Obama wins, he is likely to appoint a successor to Mr. Bernanke who is dovish on monetary policy, and more likely to keep printing money as Mr. Bernanke has, a strategy that comes with its own risks. If Mr. Romney wins, he may appoint a more hawkish chairman, a move that could create a different sense of uncertainty about how the Federal Reserve will unwind itself from Mr. Bernanke’s policies.

None of these issues are new. President Obama took office facing a fiscal policy dispute that was not and probably could not be settled given the gridlock in Congress. No solution is in sight for Europe’s problems. Tension in the Middle East is escalating as fast as nuclear technology. And the Federal Reserve’s monetary policy is at its most opaque since the Reagan administration.

All of which shows that the comedian Jon Stewart is more on target than ever with the cheeky title of his election coverage on “The Daily Show” on Comedy Central. Carrying on a tradition, it is known as “Indecision 2012.”

Update that to 2013, and it’s good for another year.

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Global Update: Polio Eradication Efforts in Pakistan Focus on Pashtuns

Michael Kamber for The New York Times

Polio will never be eradicated in Pakistan until a way is found to persuade poor Pashtuns to embrace the vaccine, according to a study released by the World Health Organization.

A survey of 1,017 parents of young children found that 41 percent had never heard of polio and 11 percent refused to vaccinate their children against it. The survey was done in Karachi, Pakistan’s largest city and the only big city in the world where polio persists; it was published in the agency’s November bulletin.

Parents from poor families “cited lack of permission from family elders,” said Dr. Anita Zaidi, who teaches pediatrics at the Aga Khan University in Karachi. Some rich parents also disdained the vaccine, saying it was “harmful or unnecessary,” she added.

Pashtuns account for 75 percent of Pakistan’s polio cases even though they are only 15 percent of the population. Wealthy children are safer because the virus travels in sewage, and their neighborhoods may have covered sewers and be less flood-prone.

Pashtuns are the largest ethnic group in next-door Afghanistan, where polio has also never been wiped out. Most Taliban fighters are Pashtun, and some Taliban threatened to kill vaccinators earlier this year. Two W.H.O. vaccinators were shot in Karachi in July.

Rumors persist that the vaccine is a plot to sterilize Muslims. But the eradication drive is recruiting Pashtuns as vaccinators and asking prominent religious leaders from various sects to make videos endorsing the vaccine.

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Global Update: Polio Eradication Efforts in Pakistan Focus on Pashtuns

Michael Kamber for The New York Times

Polio will never be eradicated in Pakistan until a way is found to persuade poor Pashtuns to embrace the vaccine, according to a study released by the World Health Organization.

A survey of 1,017 parents of young children found that 41 percent had never heard of polio and 11 percent refused to vaccinate their children against it. The survey was done in Karachi, Pakistan’s largest city and the only big city in the world where polio persists; it was published in the agency’s November bulletin.

Parents from poor families “cited lack of permission from family elders,” said Dr. Anita Zaidi, who teaches pediatrics at the Aga Khan University in Karachi. Some rich parents also disdained the vaccine, saying it was “harmful or unnecessary,” she added.

Pashtuns account for 75 percent of Pakistan’s polio cases even though they are only 15 percent of the population. Wealthy children are safer because the virus travels in sewage, and their neighborhoods may have covered sewers and be less flood-prone.

Pashtuns are the largest ethnic group in next-door Afghanistan, where polio has also never been wiped out. Most Taliban fighters are Pashtun, and some Taliban threatened to kill vaccinators earlier this year. Two W.H.O. vaccinators were shot in Karachi in July.

Rumors persist that the vaccine is a plot to sterilize Muslims. But the eradication drive is recruiting Pashtuns as vaccinators and asking prominent religious leaders from various sects to make videos endorsing the vaccine.

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Silicon Valley Objects to Online Privacy Rule Proposals for Children

Washington is pushing Silicon Valley on children’s privacy, and Silicon Valley is pushing back.

Daniel Rosenbaum for The New York Times

Phyllis H. Marcus, a lawyer for the F.T.C., is leading a team that is updating a privacy rule to require more parental consent.

Apple, Facebook, Google, Microsoft and Twitter have all objected to portions of a federal effort to strengthen online privacy protections for children. In addition, media giants like Viacom and Disney, cable operators, marketing associations, technology groups and a trade group representing toy makers are arguing that the Federal Trade Commission’s proposed rule changes seem so onerous that, rather than enhance online protections for children, they threaten to deter companies from offering children’s Web sites and services altogether.

“If adopted, the effect of these new rules would be to slow the deployment of applications that provide tremendous benefits to children, and to slow the economic growth and job creation generated by the app economy,” Catherine A. Novelli, vice president of worldwide government affairs at Apple, wrote in comments to the agency.

But the underlying concern, for both the industry and regulators, is not so much about online products for children themselves. It is about the data collection and data mining mechanisms that facilitate digital marketing on apps and Web sites for children — and a debate over whether these practices could put children at greater risk.

In 1998, Congress passed the Children’s Online Privacy Protection Act in an effort to give parents control over the collection and dissemination of private information about their children online. The regulation, known as Coppa, requires Web site operators to obtain a parent’s consent before collecting personal details, like home addresses or e-mail addresses, from children under 13.

Now, federal regulators are preparing to update that rule, arguing that it has not kept pace with advances like online behavioral advertising, a practice that uses data mining to tailor ads to people’s online behavior. The F.T.C. wants to expand the types of data whose collection requires prior parental permission to include persistent ID systems, like unique device codes or customer code numbers stored in cookies, if those codes are used to track children online for advertising purposes.

The idea is to preclude companies from compiling dossiers on the online activities — and by extension the health, socioeconomic status, race or romantic concerns — of individual children across the Web over time.

“What children post online or search as part of their homework should not haunt them as they apply to colleges or for jobs,” Representative Edward J. Markey, Democrat of Massachusetts and co-chairman of the Bipartisan Congressional Privacy Caucus, said in a recent phone interview. “YouTube should not be turned into YouTracked.”

The agency’s proposals have provoked an intense reaction from some major online operators, television networks, social networks, app platforms and advertising trade groups. Some argue that the F.T.C. has overstepped its mandate in proposing to greatly expand the rule’s scope.

Others say that using ID systems like customer code numbers to track children “anonymously” online is benign — and that collecting information about children’s online activities is necessary to deliver the ads that finance free content and services for children.

“What is the harm we are trying to prevent here?” said Alan L. Friel, chairman of the media and technology practice at the law firm Edwards Wildman Palmer. “We risk losing a lot of the really good educational and entertaining content if we make things too difficult for people to operate the sites or generate revenue from the sites.”

The economic issue at stake is much bigger than just the narrow children’s audience. If the F.T.C. were to include customer code numbers among the information that requires a parent’s consent, industry analysts say, it might someday require companies to get similar consent for a practice that represents the backbone of digital marketing and advertising — using such code numbers to track the online activities of adults.

“Once you’ve said it’s personal information for children that requires consent, you’ve set the framework for a requirement of consent to be applied to another population,” Mr. Friel said. “If it is personal information for someone that’s 12, it doesn’t cease being personal information when they are 13.”

Indeed, many of the F.T.C.’s proposed rule revisions have vocal detractors.

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Egyptian Vigilantes Crack Down on Abuse of Women

Tara Todras-Whitehill for The New York Times

A self-appointed citizens patrol that tries to protect women on Cairo’s streets spray-painted a youth for identification last month.

CAIRO — The young activists lingered on the streets around Tahrir Square, scrutinizing the crowds of holiday revelers. Suddenly, they charged, pushing people aside and chasing down a young man. As the captive thrashed to get away, the activists pounded his shoulders, flipped him around and spray-painted a message on his back: “I’m a harasser.”

Egypt’s streets have long been a perilous place for women, who are frequently heckled, grabbed, threatened and violated while the police look the other way. Now, during the country’s tumultuous transition from authoritarian rule, more and more groups are emerging to make protecting women — and shaming the do-nothing police — a cause.

“They’re now doing the undoable?” a police officer joked as he watched the vigilantes chase downthe young man. The officer quickly went back to sipping his tea.

The attacks on women did not subside after the uprising. If anything, they became more visible as even the military was implicated in the assaults, stripping female protesters, threatening others with violence and subjecting activists to so-called virginity tests. During holidays, when Cairenes take to the streets to stroll and socialize, the attacks multiply.

But during the recent Id al-Adha holiday, some of the men were surprised to find they could no longer harass with impunity, a change brought about not just out of concern for women’s rights, but out of a frustration that the post-revolutionary government still, like the one before, was doing too little to protect its citizens.

At least three citizens groups patrolled busy sections of central Cairo during the holiday. The groups’ members, both men and women, shared the conviction that the authorities would not act against harassment unless the problem was forced into the public debate. They differed in their tactics: some activists criticized others for being too quick to resort to violence against suspects and encouraging vigilantism.  One group leader compared the activists to the Guardian Angels in the United States.

“The harasser doesn’t see anyone who will hold him accountable,” said Omar Talaat, 16, who joined one of the patrols.

The years of President Hosni Mubarak’s rule were marked by official apathy, collusion in the assaults on women, or empty responses to the attacks, including police roundups of teenagers at Internet cafes for looking at pornography.

“The police did not take harassment seriously,” said Madiha el-Safty, a sociology professor at the American University in Cairo. “People didn’t file complaints. It was always underreported.”

Mr. Mubarak’s wife, Suzanne, who portrayed herself as a champion of women’s rights, pretended the problem hardly existed. As reports of harassment grew in 2008, she said, “Egyptian men always respect Egyptian women.”

Egypt’s new president, Mohamed Morsi, has presided over two holidays, and many activists say there is no sign that the government is paying closer attention to the problem. But the work by the citizens groups may be having an effect: Last week, after the Id al-Adha holiday, Mr. Morsi’s spokesman announced that the government had received more than 1,000 reports of harassment, and said that the president had directed the Interior Ministry to investigate them.

“Egypt’s revolution cannot tolerate these abuses,” the spokesman quoted Mr. Morsi as saying.

Azza Soliman, the director of the Center for Egyptian Women’s Legal Assistance, dismissed the president’s words as “weak.” During the holiday, she said, one of her sons was beaten on the subway after he tried to stop a man who was groping two foreign women. The police tried to stop him from filing a complaint. “The whole world is talking about harassment in our country,” Ms. Soliman said. “The Interior Ministry takes no action.”

For years, anti-harassment activists have worked to highlight the problems in Egypt, but the uprising seemed to give the effort more energy and urgency.

Asmaa Al Zohairy contributed reporting.

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Fight Growing Over Online Royalties

The debate playing out in Washington has echoes of a presidential race. One side says businesses will suffer unless the government steps in to lower costs. The other accuses jet-set industrialists of a ploy that will cheat the middle class.

These attacks, however, are not between candidates for the White House. They are being made in a battle over the obscure but increasingly vital issue of royalty rates for streaming music online. The issue pits the survival of Pandora Media and other Internet radio services against the diminished paychecks of musicians in the digital age.

This fight has raged on and off for more than a decade, and it was renewed recently with a bill in Congress that would change the way digital royalty rates are set. But with streaming music starting to account for a significant chunk of the music industry’s revenue, and Pandora now a scrutinized public company, the issue has touched a nerve as never before.

“This is not just about our present; it is about our future, our ability to make it in the digital age,” said Cary Sherman, chief executive of the Recording Industry Association of America. “Artists and labels and the entire music community need to earn a fair return on the creative works that are the reason companies like Pandora exist.”

Tim Westergren, the founder and public face of Pandora, has denounced the current system’s “discrimination” and urged the service’s 175 million users to contact their representatives in Washington. Music industry groups and labor unions have also gone public, casting it as a fair-pay issue.

Rates are set by three judges on the federal Copyright Royalty Board, but they apply a different standard to Internet radio services like Pandora than they do to satellite and cable radio outlets like Sirius XM and Music Choice.

Sirius, for example, pays 8 percent of its revenue to record companies and artists. Pandora pays a fraction of a cent each time a song is streamed, which last year amounted to about 54 percent of its revenue, or $149 million.

“The rate being too high dramatically depresses how much music gets played,” Mr. Westergren said in a recent interview. “It has really suffocated the industry.”

The Internet Radio Fairness Act, introduced in September, would move Internet radio companies from their “willing buyer, willing seller” standard — which critics like Pandora say results in an unrealistically high rate — to the one used for satellite and cable radio. To determine a fair rate, that standard directs the judges to consider factors including whether the prices will have a “disruptive impact” on the industry.

Music industry groups also want one standard, but one that keeps rates high. For years they have also been pushing for laws that would require terrestrial stations to pay royalties to labels and artists. (In the United States — and almost nowhere else in the world — radio stations pay royalties only to music publishers.)

Representative Jason Chaffetz, a Republican of Utah who co-sponsored the bill, said in a phone interview that the bill was meant to encourage growth in the streaming business. But when Mr. Chaffetz, whose campaign committee has received $2,000 from Pandora, was asked to respond to complaints that the changes would hurt musicians, he could not resist taunting a bit.

“The old-school dinosaurs are trying to help, but they’re stuck in the tar,” he said. “They can go talk to the pterodactyls.”

Pandora has been down this road before, and in 2009 reached an agreement for a temporary discount of about 40 percent off the royalty board’s rates; that deal expires in 2015.

This time Pandora is a different beast: a company with a $1.4 billion market capitalization. Each month, 58 million people use it to stream more than 1.1 billion hours of music.

Streaming is now on every horizon in the music industry. SoundExchange, which collects royalties from Internet and satellite radio, recently announced that it had crossed the $1 billion benchmark in payments to labels and artists.

The royalties issue, Mr. Westergren said, has become a question about the wider health of the streaming business, which he believes has been stunted by royalties.

“This is not an argument about going out of business,” he said. “A fix here would be for the whole industry.”

But there is wide anger in the music industry that the bill would enrich technology companies at the expense of musicians. MusicFirst Coalition, which includes the recording industry association, SoundExchange and others, says it believes that if Pandora gets everything it wants, it could cut its royalty bill by up to 85 percent.

For Pandora, the critical question is whether streaming businesses can be successful at all in the current system. Digital music services have proliferated over the years, but just as many have died, and popular arrivals like Spotify have yet to turn a profit.

Clear Channel Communications, the radio giant, has recently moved more aggressively into streaming with its iHeartRadio app. Robert W. Pittman, its chief executive — who has been outspoken on the royalty issue — said in an interview that a change could generate more money for the music industry by allowing streaming businesses to thrive.

“It’s not so much about rates as about how much dollars you spend,” Mr. Pittman said. “The amount of dollars to artists is rate times volume. If the rate suppresses the volume, there’s less money. If it encourages volume, there’s more money.”

Mr. Westergren is revered as a self-made success with real musical bona fides; he is fond of telling stories about his years of scraping by as a touring musician. But the controversy over the Internet Radio Fairness Act threatens to tarnish that image.

The music industry says that if Pandora needs to improve its bottom line, it should sell more ads. When asked to respond, Mr. Westergren makes a gesture of banging his head on a table.

“It’s an easy thing to say,” he said. “But no one has yet explained to us why Internet radio is under a different standard. No one responds to that fundamental premise.”

Advertising sales, which make up almost 90 percent of Pandora’s revenue, doubled in the company’s last fiscal year.

For Mr. Westergren, though, the most difficult aspect of this battle has been the accusation that Pandora wants to take advantage of musicians.

“This adversarial reaction toward Internet radio is counterproductive,” he said. “It’s causing other businesses to sit on the sidelines, and that is hurting musicians. Ultimately, you want to have many boats in the harbor.”

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