Flu season 'bad one for the elderly,' CDC says

The number of older people hospitalized with the flu has risen sharply, prompting federal officials to take unusual steps to make more flu medicines available and to urge wider use of them as soon as symptoms appear.

The U.S. is about halfway through this flu season, and "it's shaping up to be a worse-than-average season" and a bad one for the elderly, said Dr. Thomas Frieden, director of the Centers for Disease Control and Prevention.

It's not too late to get a flu shot, and "if you have symptoms, please stay home from work, keep your children home from school" and don't spread the virus, he said.

New figures from the CDC show widespread flu activity in all states but Tennessee and Hawaii. Some parts of the country are seeing an increase in flu activity "while overall activity is beginning to go down," Frieden said. Flu activity is high in 30 states and New York City, up from 24 the previous week.

Nine more children or teens have died of the flu, bringing the nation's total this flu season to 29. That's close to the 34 pediatric deaths reported during all of the last flu season, although that one was unusually light. In a typical season, about 100 children die of the flu and officials said there is no way to know whether deaths this season will be higher or lower than usual.

The government doesn't keep a running tally of adult deaths from the flu, but estimates that it kills about 24,000 people most years.

So far, half of confirmed flu cases are in people 65 and older. Lab-confirmed flu hospitalizations totaled 19 for every 100,000 in the population, but 82 per 100,000 among those 65 and older, "which is really quite a high rate," Frieden said.

"We expect to see both the number and the rates of both hospitalizations and deaths rise further in the next week or so as the flu epidemic progresses,'" so prompt treatment is key to preventing deaths, he said.

About 90 percent of flu deaths are in the elderly; the very young and people with other health problems such as diabetes are also at higher risk.

If you're worried about how sick you are and are in one of these risk groups, see a doctor, Frieden urged. One third to one half of people are not getting prompt treatment with antiviral medicines, he said.

Two drugs — Tamiflu and Relenza — can cut the severity and risk of death from the flu but must be started within 48 hours of first symptoms to do much good. Tamiflu is available in a liquid form for use in children under 1, and pharmacists can reformulate capsules into a liquid if supplies are short in an area, said Dr. Margaret Hamburg, head of the Food and Drug Administration.

To help avoid a shortage, the FDA is letting Tamiflu's maker, Genentech, distribute 2 million additional doses of capsules that have an older version of package insert.

"It is fully approved, it is not outdated," just lacks information for pharmacists on how to mix it into a liquid if needed for young children, she said.

This year's flu season started about a month earlier than normal and the dominant flu strain is one that tends to make people sicker. Vaccinations are recommended for anyone 6 months or older. There's still plenty of vaccine — an update shows that 145 million doses have been produced, "twice the supply that was available only several years ago," Hamburg said.

About 129 million doses have been distributed already, and a million doses are given each day, Frieden said. The vaccine is not perfect but "it's by far the best tool we have to prevent influenza," he said.

Carlos Maisonet, 73, got a flu shot this week at New York's Brooklyn Hospital Center at the urging of his wife, who was vaccinated in August.

"This is his first time getting the flu shot," said his wife, Zulma Ramos.

Last week, the CDC said the flu again surpassed an "epidemic" threshold, based on monitoring of deaths from flu and a frequent complication, pneumonia. The flu epidemic happens every year and officials say this year's vaccine is a good match for strains that are going around.

___

Online:

Flu vaccine finder: http://www.flu.gov

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

___

AP Photographer Bebeto Matthews in New York contributed to this report.

___

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Man molested girls, gave them tattoos, police allege

Authorities were looking Thursday for more possible victims of a Mission Viejo tattoo artist arrested for allegedly molesting two teenage girls after giving them free tattoos and alcohol in his apartment, deputies said.

Edder Giovani Nieves-Vera, 29, met one of the 14-year-olds through Facebook and promised to give her a tattoo, alcohol and drugs, said Jim Amormino, a spokesman for the Orange County Sheriff’s Department.

In December, authorities believe the girl and a 14-year-old friend went to the man’s apartment, where he supplied them with alcohol and gave them tattoos.

He is suspected of making “sexual advances” toward the teenagers and engaging in “highly inappropriate conduct,” Amormino told the Times.

The girls told authorities, who then posed as one of the 14-year-olds by chatting with him on Facebook, said Gail Krause, a spokeswoman with the Sheriff’s Department.

Nieves-Vera allegedly said he wanted to meet the girl Tuesday at Dana Point Harbor, then take her to his apartment to finish the tattoo and enjoy his Jacuzzi. Instead, Nieves-Vera was met by investigators and taken into custody.

Several years ago, he was deported after serving three years in state prison in connection with a 2004 arrest in a child annoyance case in Riverside County. Investigators do not know when Nieves-Vera re-entered the United States.

The Sheriff’s Department, along with several other agencies, including the Orange County district attorney’s office, the FBI and the U.S. Postal Inspection Service, investigated the case.

Anyone with information is asked to call the Sheriff’s Department at (714) 647-7000. Anonymous tippers may call OC Crime Stoppers at (855) TIP-OCCS.

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Reward offered for 'AK-47 Bandit' who shot Chino officer

Robert Citron, treasurer at center of O.C. bankruptcy, dies

Environmental group pushes for hearing on San Onofre restart

-- Robert J. Lopez and Nicole Santa Cruz

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The Lede Blog: An Irish Hostage Is 'Safe and Free' in Algeria, But Britons Are Told to Brace for Bad News

An Arabic-language video report from Al Jazeera showing the gas facility in Algeria where dozens of workers were taken hostage by Islamist militants.

Following a military raid on a gas facility in Algeria, where a heavily armed group of Islamist militants took dozens of workers hostage, the Irish government confirmed on Thursday that a man from Belfast who had been part of the group taken captive was freed. The fate of other hostages remained unclear.

Algeria’s communications minister, Mohand Saïd Oublaïd, said that many of the hostages had been freed, but some were killed in the rescue effort, along with “a large number of terrorists.” A news agency in neighboring Mauritania reported that a spokesman for the Islamists claimed that a number of hostages were killed in the Algerian government raid.

Ireland’s foreign minister, Eamon Gilmore, said at a news conference, “while naturally we are delighted that Stephen McFaul is free and safe, our thoughts are with his fellow workers and the other people who have not been so fortunate. Our thoughts are particularly with the citizens of other countries who have still not been accounted for.”

Video of Ireland’s foreign minister, Eamon Gilmore, speaking to reporters about an Irish citizen, Stephen McFaul, who was freed from the custody of kidnappers in Algeria on Thursday.

Mr. McFaul was physically unharmed and being held at a military base, the minister said. He declined to provide further details of Mr. McFaul’s ordeal, out of respect for the families of the other hostages.

Prime Minister David Cameron of Britain confirmed in an interview posted online by Britain’s Channel 4 News that at least one British hostage had been killed and said, “we should be prepared for the possibility of further bad news, very difficult news, in this extremely difficult situation.”

A spokesman for the Norwegian oil firm Statoil, which jointly operates the gas facility with BP, told reporters, “We have received information about two of our employees being physically hurt, not serious, but the situation is unclear and very difficult to follow.”

Agence France-Presse video of a statement by a Norwegian oil company official on the hostage crisis at a facility in Algeria.

In Belfast, Mr. McFaul’s family expressed joy and relief in interviews with Ulster Television and BBC News. “I feel over the moon. I’m just really excited. I just can’t wait for him to get home,” his young son told UTV, as he broke down in tears.

The Irish prime minister, Enda Kenny, said in a statement:

I am greatly relieved to hear that Stephen is safe and well. I believe he has already spoken to his family in Belfast and I wish him a safe return home to his loved ones. I would like to pay tribute to all those who have been involved in the effort to resolve this crisis and my thoughts are with the other oil field workers and their families who have found themselves at the center of this traumatic situation.

In the interview with UTV, Mr. McFaul’s family said he had called his wife after reaching safety. “I was delighted, I could not get better news,” said his mother, Marie. “I feel sorry for the other hostages and their families,” Mr. McFaul’s father, Christopher, said.

---

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Intel’s revenue forecast short of expectations

SAN FRANCISCO (Reuters) – Intel Corp forecast current-quarter revenue that was slightly below expectations as the personal computer industry grapples with falling sales and a shift toward tablets and smartphones.

PC makers are struggling to stop a decline in sales as consumers hold off on buying new laptops in favor of spending on more nimble mobile gadgets.

Microsoft Corp‘s long-awaited launch of Windows 8 in October brought touchscreen features to laptops but failed to spark a resurgence in sales that Intel and many PC manufacturers had hoped for.

Intel said its capital spending in 2013 would be $ 13 billion, plus or minus $ 500 million, exceeding what many analysts had expected.

In the fourth quarter, Intel’s revenue was $ 13.5 billion, compared with $ 13.9 billion a year earlier. Analysts had expected $ 13.53 billion in revenue for the fourth quarter, according to Thomson Reuters I/B/E/S.

Intel estimated first-quarter revenue of $ 12.7 billion, plus or minus $ 500 million. Analysts expected $ 12.91 billion for the current quarter.

Net earnings in the December quarter were $ 2.5 billion, or 48 cents a share, compared with $ 3.4 billion, or 64 cents a share, in the same quarter last year.

(Reporting by Noel Randewich; Editing by Richard Chang)

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Britney Spears & Jason Trawick Split: Will She Be Okay?

01/17/2013 at 04:45 PM EST

Britney Spears and Jason Trawick

Michael Kovac/Getty

The new year has already been full of change for Britney Spears.

"She's left her gig as judge on The X Factor, her new puppy Hannah is gravely ill, and on Jan. 11 she announced she and fiancé Jason Trawick, 41, have called it quits after more than three years together.

While Spears, 31, told PEOPLE in an exclusive statement, "I'll always adore him, and we will remain great friends," a family source says the signer is "definitely upset about the split."

What tore the couple apart? Spears, who has two sons with ex-husband Kevin Federline, had hoped to start a family soon with Trawick, but he wasn't ready. Says the close source: "There were so many issues he wanted worked out before that" – including her neediness. "It was difficult for Jason to have his own life."

Adds an insider: "Britney is very insecure and has had a lot of trouble with jealousy." These insecurities may be heightened now. "[She] is very worried about being alone," says the family source. "She is upset, but for a long time she has treated him like a friend, not a romantic partner." The family source adds that some close to the singer, who had a breakdown in 2008, "are concerned about her future."

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Will Obama's order lead to surge in gun research?

MILWAUKEE (AP) — Nearly as many Americans die from guns as from car crashes each year. We know plenty about the second problem and far less about the first. A scarcity of research on how to prevent gun violence has left policymakers shooting in the dark as they craft gun control measures without much evidence of what works.

That could change with President Barack Obama's order Wednesday to ease research restrictions pushed through long ago by the gun lobby. The White House declared that a 1996 law banning use of money to "advocate or promote gun control" should not keep the Centers for Disease Control and Prevention and other federal agencies from doing any work on the topic.

Obama can only do so much, though. Several experts say Congress will have to be on board before anything much changes, especially when it comes to spending money.

How severely have the restrictions affected the CDC?

Its website's A-to-Z list of health topics, which includes such obscure ones as Rift Valley fever, does not include guns or firearms. Searching the site for "guns" brings up dozens of reports on nail gun and BB gun injuries.

The restrictions have done damage "without a doubt" and the CDC has been "overly cautious" about interpreting them, said Daniel Webster, director of the Center for Gun Policy and Research at the Johns Hopkins Bloomberg School of Public Health.

"The law is so vague it puts a virtual freeze on gun violence research," said a statement from Michael Halpern of the Union of Concerned Scientists. "It's like censorship: When people don't know what's prohibited, they assume everything is prohibited."

Many have called for a public health approach to gun violence like the highway safety measures, product changes and driving laws that slashed deaths from car crashes decades ago even as the number of vehicles on the road rose.

"The answer wasn't taking away cars," said Dr. Georges Benjamin, executive director of the American Public Health Association.

However, while much is known about vehicles and victims in crashes, similar details are lacking about gun violence.

Some unknowns:

—How many people own firearms in various cities and what types.

—What states have the highest proportion of gun ownership.

—Whether gun ownership correlates with homicide rates in a city.

—How many guns used in homicides were bought legally.

—Where juveniles involved in gun fatalities got their weapons.

—What factors contribute to mass shootings like the Newtown, Conn., one that killed 26 people at a school.

"If an airplane crashed today with 20 children and 6 adults there would be a full-scale investigation of the causes and it would be linked to previous research," said Dr. Stephen Hargarten, director of the Injury Research Center at the Medical College of Wisconsin.

"There's no such system that's comparable to that" for gun violence, he said.

One reason is changes pushed by the National Rifle Association and its allies in 1996, a few years after a major study showed that people who lived in homes with firearms were more likely to be homicide or suicide victims. A rule tacked onto appropriations for the Department of Health and Human Services barred use of funds for "the advocacy or promotion of gun control."

Also, at the gun group's urging, U.S. Rep. Jay Dickey, a Republican from Arkansas, led an effort to remove $2.6 million from the CDC's injury prevention center, which had led most of the research on guns. The money was later restored but earmarked for brain injury research.

"What the NRA did was basically terrorize the research community and terrorize the CDC," said Dr. Mark Rosenberg, who headed the CDC's injury center at the time. "They went after the researchers, they went after institutions, they went after CDC in a very big way, and they went after me," he said. "They didn't want the data to be collected because they were threatened by what the data were showing."

Dickey, who is now retired, said Wednesday that his real concern was the researcher who led that gun ownership study, who Dickey described as being "in his own kingdom or fiefdom" and believing guns are bad.

He and Rosenberg said they have modified their views over time and now both agree that research is needed. They put out a joint statement Wednesday urging research that prevents firearm injuries while also protecting the rights "of legitimate gun owners."

"We ought to research the whole environment, both sides — what the benefits of having guns are and what are the benefits of not having guns," Dickey said. "We should study any part of this problem," including whether armed guards at schools would help, as the National Rifle Association has suggested.

Association officials did not respond to requests for comment. A statement Wednesday said the group "has led efforts to promote safety and responsible gun ownership" and that "attacking firearms" is not the answer. It said nothing about research.

The 1996 law "had a chilling effect. It basically brought the field of firearm-related research to a screeching halt," said Benjamin of the Public Health Association.

Webster said researchers like him had to "partition" themselves so whatever small money they received from the CDC was not used for anything that could be construed as gun policy. One example was a grant he received to evaluate a community-based program to reduce street gun violence in Baltimore, modeled after a successful program in Chicago called CeaseFire. He had to make sure the work included nothing that could be interpreted as gun control research, even though other privately funded research might.

Private funds from foundations have come nowhere near to filling the gap from lack of federal funding, Hargarten said. He and more than 100 other doctors and scientists recently sent Vice President Joe Biden a letter urging more research, saying the lack of it was compounding "the tragedy of gun violence."

Since 1973, the government has awarded 89 grants to study rabies, of which there were 65 cases; 212 grants for cholera, with 400 cases, yet only three grants for firearm injuries that topped 3 million, they wrote. The CDC spends just about $100,000 a year out of its multibillion-dollar budget on firearm-related research, New York Mayor Michael Bloomberg has said.

"It's so out of proportion to the burden, however you measure it," said Dr. Matthew Miller, associate professor of health policy at the Harvard School of Public Health. As a result, "we don't know really simple things," such as whether tighter gun rules in New York will curb gun trafficking "or is some other pipeline going to open up" in another state, he said.

What now?

CDC officials refused to discuss the topic on the record — a possible sign of how gun shy of the issue the agency has been even after the president's order.

Health and Human Services Secretary Kathleen Sebelius said in a statement that her agency is "committed to re-engaging gun violence research."

Others are more cautious. The Union of Concerned Scientists said the White House's view that the law does not ban gun research is helpful, but not enough to clarify the situation for scientists, and that congressional action is needed.

Dickey, the former congressman, agreed.

"Congress is supposed to do that. He's not supposed to do that," Dickey said of Obama's order. "The restrictions were placed there by Congress.

"What I was hoping for ... is 'let's do this together,'" Dickey said.

___

Online:

Violence prevention research: http://www.ucdmc.ucdavis.edu/vprp

CDC injury prevention: http://www.cdc.gov/violenceprevention/nvdrs/

___

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Woman repeatedly raped inside Nordstrom, police allege

Prosecutors said one of the five people charged in connection with the
take-over robbery at a Nordstrom Rack department store in Westchester raped one of the female hostages.

Prosecutors offered no details. But a district attorney's office spokeswoman said the victim was sexually assaulted "multiple times."

Raymond Sherman Jr., 34, who authorities said was the most violent in the group, was charged with two counts
of forcible rape, one count of
oral copulation, one count of kidnapping for rape, one count of assault
with a
deadly weapon and 14 counts of second-degree robbery.

DOCUMENT: Read the criminal complaint 

Troy Marsay Hammock, 29, and Everett Oneal Allen, 24, face 14 counts
each of second-degree robbery and one count each of assault with a
deadly weapon, identified as a knife, according to the Los Angeles
County district attorney's office.

Rochelle Monique Sherman, 33; and Paula Roneshia Bradley, 29, were charged with one count each of accessory after the fact.

The complaint also alleges Sherman, who is awaiting extradition from Phoenix, where he was
arrested Saturday, used a handgun in the commission of the crimes.

Police have not detailed the roles of the suspects in the
robbery and hostage situation. But those in law enforcement familiar with
the investigation said there is strong evidence linking the crimes to those charged, including physical evidence and security video.

The incident began about 11 p.m. Thursday at the Promenade at Howard
Hughes Center, near the 405 Freeway. Sherman, Hammock and Allen
allegedly confronted the employees as they were leaving the store, which
had just closed.

As the incident was unfolding, one of the employees called her
husband and told him to call 911. The LAPD called a tactical alert and
closed off the area around the shopping center. When the police
department's SWAT officers arrived, they surrounded the store.

At one point, one of the suspected burglars exited, saw the police and ran back inside. A
second suspected burglar walked out with an unidentified woman, saw police and
also headed back inside. The officers entered the store at 3:30 a.m. and
freed the captives.

At least three of the employees were injured, including at least one
woman who was sexually assaulted. Another woman was stabbed in the neck
and sustained non-life-threatening injuries, and a third employee was
pistol-whipped, police said. LAPD Chief Charlie Beck praised the
employees for their bravery and composure.

Beck would not discuss whether the robbers hid in the store or gained
entrance after it closed. Nor would he say how long they remained in the
store before fleeing in a white SUV, or discuss how much cash was taken
in the robbery.

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--Andrew Blankstein

Photo: Police officers stand outside Nordstrom Rack in Westchester following take-over style robbery. Credit: Irfan Khan / Los Angeles Times

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China Arrests 7 in New Effort to Stop Tibetan Self-Immolations

BEIJING — The authorities in northwest China have detained seven people they claim organized the fatal self-immolation of a Tibetan villager in October, photographed his burning body and then sent the images abroad.

The arrests, announced Tuesday by Xinhua, the official news agency, suggest that the Chinese government is increasing the use of its newest strategy against the politically motivated suicides in Tibetan areas of China: punishing friends and relatives of those who self-immolate.

The Xinhua report blamed a Tibetan advocacy group in India for convincing the villager, Sangye Gyatso, a 27-year-old father of two, that self-immolation was a “heroic deed” and that it would improve his family’s standing.

A spokesman for the group, the Tibetan Youth Congress, rejected the accusations, calling them “ridiculous.”

With the accumulated toll of self-immolations approaching 100, Beijing has been scrambling to find effective deterrents to such acts, which began in 2009 as a desperate attempt to publicize what many Tibetans consider heavy-handed Chinese policies. In the early months of the crisis, officials sought to demonize self-immolators as terrorists or mentally deranged people. The authorities also locked down the most restive towns and monasteries, preventing monks from leaving or foreign journalists from entering.

Such measures appear to have done little to quell the protests, prompting officials to try new tactics. In Tongren County, in Qinghai Province, the authorities recently issued new regulations that permanently revoke public benefits for the families of self-immolators and cancel government-financed projects in their hometowns. If a monk or nun visits the home of a self-immolator, their monastery is to be shut down as punishment, according to the rules.

In recent weeks, more than a dozen people across the region have been charged with inciting self-immolations or accused of spreading information about the incidents via text message or e-mail. Last month, eight people were detained on accusations of trying to publicize a self-immolation near a government office in Luchu County in Gansu Province. Among those arrested, exile groups say, was a relative of the deceased.

In October, four young Tibetans in Sichuan Province were given sentences ranging from 7 to 11 years; two were convicted of encouraging their friend to self-immolate, and the other two for leaking news of the incident to “outside contacts.”

In the most recent case in Gansu Province, Xinhua said one of the seven detained men, a Buddhist monk named Khyi Gyatso, had joined the Tibetan Youth Congress in Dharamsala, India, after escaping in 2000. But the monk, Xinhua said, stayed in touch with his boyhood friend, Sangye Gyatso, and persuaded him through phone calls and e-mails to “contribute to the cause of Tibetans” by setting himself on fire.

Xinhua said Sangye Gyatso — whom it described as a convicted thief, perennially unemployed and a chronic womanizer — fell under the monk’s sway. He later told three friends about the time and place of his self-immolation so they could take photographs and share them with overseas groups, including representatives of the Dalai Lama, the exiled spiritual leader regarded by China as a subversive. “Shortly thereafter,” Xinhua said, “the Dalai clique launched a high-profile ‘propaganda’ campaign on the well-orchestrated incident, claiming there was a ‘humanitarian crisis’ in China and calling for the international community to interfere.”

Tenzin Norsang, joint secretary of Tibetan of Youth Congress in Dharamsala, said the group had no connection to Sangye Gyatso’s death, adding that the intense government restrictions and monitoring limited communication between Tibetans in China and abroad.

“Those who are self-immolating have been living under Chinese rule for more than 50 years — they don’t need anyone to tell them what to do,” he said. “Instead of blaming outsiders, the Chinese government could end the self-immolations by re-examining and changing their own repressive policies.”

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RIM says users line up to try new BlackBerry 10 platform

TORONTO (Reuters) – BlackBerry maker Research in Motion is helping customers prepare to switch to its soon-to-be-launched BlackBerry 10 smartphones that it hopes will help it reclaim market share from rivals such as Apple Inc.

RIM is betting that the new range of touch-screen and keyboard devices, set for a January 30 launch, will revive its fortunes.

The company was “very enthused by the engagement and response of our customer base” to a program aimed at persuading them to adopt the BlackBerry 10 devices, Bryan Lee, senior enterprise accounts director, told Reuters on Wednesday.

Indeed, whether it will be successful in clawing back market share will depend on the response from RIM’s top clients, like companies and government agencies, who have long valued the strong security features that BlackBerry devices offer.

Lee said more than 1,600 customers in North America had registered for its recently launched BlackBerry 10 Ready Program and more than a thousand were actively using the program, which offers customers access to services, information and tools to ease their transition to the BlackBerry 10 and the BlackBerry Enterprise Server 10.

RIM also said its BlackBerry Enterprise Server 10, which runs the new devices on corporate networks, was in beta testing with more than 130 major government agencies and corporations in North America.

SHARES RISE

Waterloo, Ontario-based RIM, a one-time pioneer in the now ultra-competitive smartphone industry, has bled market share to Apple’s iPhone and devices powered by Google’s market-leading Android operating system, even among enterprise clients who once used BlackBerry devices exclusively.

Early adoption of the long-awaited BlackBerry 10 devices by government and corporate clients will help breathe new life into the struggling company, whose shares are down 90 percent from an all-time high of more than $ 148 in 2008.

Still, shares of RIM, which fell as low as $ 6.22 in September, have more than doubled in value over the last four months as the BlackBerry 10 launch approaches.

Lee said clients that were beta testing the new BlackBerry Enterprise Server 10 included more than 60 Fortune 500 companies and top North American government agencies.

RIM promises that its new line of devices will be faster and smoother than existing BlackBerry phones and will boast a large catalog of apps, crucial to the success of any new line of smartphones.

Shares of RIM were up 3.8 percent at $ 15.03 in afternoon trading on the Nasdaq on Wednesday, after Visa approved the smartphone company’s method of handling secure mobile payments; the technology will potentially allow users to tap their smartphones on credit card readers and pay for purchases.

RIM’s Toronto-listed shares were up 3.9 percent at C$ 14.83.

(Editing by Janet Guttsman and Bernadette Baum)

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ER visits tied to energy drinks double since 2007

SAN FRANCISCO (AP) — The young man stumbled into the emergency room late one night after a house party, saying his heart wouldn't stop pounding and he could barely breathe after downing liquor mixed with energy drinks.

Emergency physician Steve Sun soon found the patient was so dehydrated he was going into kidney failure — one of many troubling cases Sun says he has treated in recent years tied to energy drink consumption.

Sun's changing caseload appears in line with a new government survey that suggests the number of people seeking emergency treatment after consuming energy drinks has doubled nationwide during the past four years, the same period in which the supercharged drink industry has surged in popularity in convenience stores, bars and on college campuses.

"Five years ago, perhaps I would see one or two cases every three months or so. Now we're consistently seeing about two cases per month," said Sun, assistant medical director of the emergency department at St. Mary's Medical Center, on the edge of San Francisco's Golden Gate Park.

From 2007 to 2011, the government estimates the number of emergency room visits involving the neon-labeled beverages shot up from about 10,000 to more than 20,000. Most of the cases involved teens or young adults, according to the survey of the nation's hospitals released late last week by the Substance Abuse and Mental Health Services Administration.

More than half of the patients considered in the survey told doctors they had consumed only energy drinks. In 2011, about 42 percent of the cases involved energy drinks in combination with alcohol or drugs, such as the stimulants Adderall or Ritalin.

The beverage industry says energy drinks are safe and there is no proof linking the products to adverse reactions.

The report doesn't specify which symptoms brought people to the emergency room, but it calls energy drink consumption a "rising public health problem" that can cause insomnia, nervousness, headache, fast heartbeat and seizures that are severe enough to require emergency care.

Several emergency physicians said they had seen a clear uptick in the number of patients suffering from irregular heartbeats, anxiety and heart attacks who said they had recently downed an energy drink.

"A lot of people don't realize the strength of these things. I had someone come in recently who had drunk three energy drinks in an hour, which is the equivalent of 15 cups of coffee," said Howard Mell, an emergency physician in the suburbs of Cleveland, who serves as a spokesman for the American College of Emergency Physicians. "Essentially he gave himself a stress test and thankfully he passed. But if he had a weak heart or suffered from coronary disease and didn't know it, this could have precipitated very bad things."

The findings came as concerns over energy drinks have intensified following reports last fall of 18 deaths possibly tied to the drinks and so-called energy shots — including a 14-year-old Maryland girl whose family filed a lawsuit after she drank two large cans of Monster Energy drinks and died. Monster says its products were not responsible for the death.

Two senators are calling for the Food and Drug Administration to investigate safety concerns about energy drinks and their ingredients.

Late last year, the FDA asked the U.S. Health and Human Services to update the figures its substance abuse research arm compiles about emergency room visits tied to energy drinks.

The Substance Abuse and Mental Health Services Administration's survey was based on responses it receives from about 230 hospitals each year, a representative sample of about 5 percent of emergency departments nationwide. The agency then uses those responses to estimate the number of energy drink-related emergency department visits nationwide.

The more than 20,000 cases estimated for 2011 represent a small portion of the annual 136 million emergency room visits tracked by Centers for Disease Control and Prevention.

The FDA said it was considering the findings and pressing for more details as it undertakes a broad review of the safety of energy drinks and related ingredients this spring.

"We will examine this additional information ... as a part of our ongoing investigation into potential safety issues surrounding the use of energy-drink products," FDA spokeswoman Shelly Burgess said in a statement.

Beverage manufacturers fired back at the survey, saying the statistics were misleading and taken out of context.

"This report does not share information about the overall health of those who may have consumed energy drinks, or what symptoms brought them to the ER in the first place," the American Beverage Association said in a statement. "There is no basis by which to understand the overall caffeine intake of any of these individuals — from all sources."

Energy drinks remain a small part of the carbonated soft drinks market, representing only 3.3 percent of sales volume, according to the industry tracker Beverage Digest. Even as soda consumption has flagged in recent years, energy drinks sales are growing rapidly.

In 2011, sales volume for energy drinks rose by almost 17 percent, with the top three companies — Monster, Red Bull and Rockstar — each logging double-digit gains, Beverage Digest found. The drinks are often marketed at sporting events that are popular among younger people such as surfing and skateboarding.

From 2007 to 2011, the most recent year for which data was available, people from 18 to 25 were the most common age group seeking emergency treatment for energy drink-related reactions, the report found.

"We were really concerned to find that in four years the number of emergency department visits almost doubled, and these drinks are largely marketed to younger people," said Al Woodward, a senior statistical analyst with the Substance Abuse and Mental Health Services Administration who worked on the report.

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Follow Garance Burke on Twitter at http://twitter.com/garanceburke

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