Centers for Disease Control and Prevention

A CDC scientist harvests H7N9 virus that has been grown for sharing with partner laboratories for research purposes.

More than 50 travelers just back in the United States from China who had flu-like symptoms have been tested for the H7N9 bird flu virus, federal health officials say. So far, none has tested positive.

But the fact that they’re being tested at all shows just how worried the U.S. government is about this new strain of bird flu, which threatens at the same time as a still-mysterious coronavirus from the Middle East. The test kits had to be specially made up and distributed under an emergency provision.

“While no cases of H7N9 have been detected at this time in the U.S., 54 people with flu-like symptoms after travel to China have been tested. All have 54 tested negative for H7N9; while six tested positive for seasonal influenza A, and three tested positive for seasonal influenza B,” the Centers for Disease Control and Prevention says in its latest update on the virus.

Emergency operations centers are running 24/7, keeping an eye on both situations. While it's not unusual for the centers to be operating around the clock, it is rare to have two pandemic threats at once to plan for, says Edward Gabriel, who heads preparedness and response issues at the health and Human Services Department. 

"We want the latest and best information that we can get," Gabriel told NBC News. "We also need to look and see where it is moving to. To try to isolate its motion is a pretty significant thing."

If either virus turns into a form that spreads easily from person to person, a pandemic could follow within weeks. Both seem especially deadly in their current form: H7N9 seems to have about a 20 percent fatality rate, while the new coronavirus appears to have killed more than half its victims.

“In the case of the two latest threats — the H7N9 influenza virus and the new coronavirus — the number of infected people is small, and the infections are occurring thousands of miles away from the United States. Yet we should be seriously concerned about both,” Mike Osterholm, an infectious disease expert at the University of Minnesota, wrote in the New York Times on Friday.

“Our public health tools to fight these viruses are limited. We have no vaccines or effective drugs readily available to stop or treat the new coronavirus in the Middle East,” Osterholm adds. 

CDC

Influenza A H7N9 as viewed through an electron microscope. Both filaments and spheres are observed in this photo.

The H7N9 flu can spread silently, as people transmit influenza before they’re sick themselves. If the flu did mutate into a pandemic form, it would probably take at least six months to make enough vaccines to protect large numbers of people.

“It may take longer than it takes the virus to spread,” says Dr. John Treanor, a flu vaccine expert at the University of Rochester Medical Center. “The technology that we have today is such that the bulk of the pandemic disease may have already taken place before a vaccine is in place and can be used,” he added.

“The virus can spread very, very quickly. You are in a race against time.”

That happened in 2009, when the new strain of H1N1 swine flu broke out to cause the first pandemic of a new flu in 40 years. Companies raced to make vaccine but it was months before it was ready.

There are drugs to fight flu – a pill called Tamiflu and an inhaled powder called Relenza. Neither is a cure, however, and both need to be given very quickly to do much good at all.

Right now, H7N9 seems mostly confined to China and the spread has slowed. The World Health Organization reports 32 people have died out of 131 lab-confirmed cases.

“The drop-off in newly reported H7N9 cases in China may be the result of containment measures reportedly taken by Chinese authorities, including closing live bird markets, a venue where the risk of exposure to bird flu viruses can be high," the CDC says. “However it may also be a result of changing seasons, or a combination of both.”

Researchers in Hong Kong did a computer analysis of the outbreak and estimate that at least 200-500 more people have likely been infected with H7N9. The virus seems to cause serious illness mostly in people over 65 – doctors are not sure why yet.

“We estimated that risk of serious illness after infection is 5.1 times higher in persons 65 years and older versus younger ages,” Ben Cowling and colleagues at Hong Kong University wrote in the journal Eurosurveillance.

The evidence suggests that most of the patients got infected directly by birds, probably in poultry markets. So Cowling’s team took all the data and estimated how many younger people were likely to have been infected without knowing they had H7N9. "Our results suggest that many unidentified mild influenza A(H7N9) infections may have occurred, with a lower bound of 210–550 infections to date," they wrote. This would mean the virus isn’t that widespread, but which also confirms its high fatality rate. 

The coronavirus, which some are dubbing Middle East Respiratory Syndrome Coronavirus, or MERS, is a little different story. WHO says 33 infections have been reported, with 18 deaths. Experts are watching cases in France, where one patient who traveled from Dubai was confirmed to have the virus. 

A man who shared a hospital room with the 65-year-old man also has the virus, French officials said Sunday -- something that shows the virus and and does spread in hospitals. 

Officials were relieved that three health care workers who cared for the 65-year-old patient and who got sick have tested negative for the virus.

Also Sunday, WHO Assistant Director-General Keiji Fukuda could probably be passed between people in close contact, but there was no evidence of sustained "generalized transmission in communities."

Some reports suggest an outbreak in Saudi Arabia also affected people in the same hospital.

This worries Dr. Eric Toner of the Center for Health Security at the University of Pittsburgh Medical Center. SARS – severe acute respiratory syndrome – also spread mostly in hospitals. SARS spread to 29 countries in 2003, killing 775 people and making 8,000 sick before it was stopped.

“These cases, whether confirmed or not, should be a wake-up call,” Toner writes in his blog.

The good news is that SARS was stopped using good hospital hygiene. Face masks, gloves and careful disinfection prevented its spread. And SARS only spread once people were noticeably ill, unlike flu, which people can spread before they feel sick and after they feel better.

The bad news is that hospitals may have forgotten this lesson. “SARS was stopped by healthcare workers being aware of the disease, having a high index of suspicion of anyone with fever and respiratory symptoms who had recently been in an affected region, and quickly implementing infection control measures with any suspect case,” Toner says.

“Until now, all cases of MERS originated in the Middle East, but as the confirmed French case demonstrates, the virus is only a plane ride away from other parts of the world. In the 10 years since the SARS outbreak, many hospitals have become lax in their attention to respiratory precautions.”

Gabriel says he’s working to make sure this isn’t the case with U.S. hospitals. “Hygiene practices are now better than they ever have been,” Gabriel said. “We send out reminders daily.”

Related:

• WHO: New SARS-like virus can probably spread person to person
• US races to make new vaccines against bird flu
• New virus has officials worried about skimpy resources

This story was originally published on Sun May 12, 2013 9:33 AM EDT

World Health Organization (WHO) officials said on Sunday it seemed likely a new coronavirus that has killed at least 18 people in the Middle East and Europe could be passed between humans, but only after prolonged contact.

A virus from the same family triggered the outbreak of Severe Acute Respiratory Syndrome (SARS) that swept the world after emerging in Asia and killed 775 people in 2003.

On Sunday French authorities announced that a second man had been diagnosed with the disease after sharing a hospital room with France's only other sufferer.

WHO Assistant Director-General Keiji Fukuda told reporters in Saudi Arabia, the site of the largest cluster of infections, there was no evidence so far the virus was able to sustain "generalized transmission in communities" - a scenario that would raise the specter of a pandemic.

But he added: "Of most concern ... is the fact that the different clusters seen in multiple countries ... increasingly support the hypothesis that when there is close contact, this novel coronavirus can transmit from person to person.

"There is a need for countries to ... increase levels of awareness," he said.

A public health expert who declined to be identified, said "close contact" meant being in the same small, enclosed space with an infected person for a prolonged period.

The virus first emerged in the Gulf last year, but deaths have also been recorded in Britain and France of people who had recently been in the Middle East. A total of 34 cases worldwide have been confirmed by blood tests so far.

Saudi Deputy Health Minister for Public Health Ziad Memish told reporters that, of 15 confirmed cases in the most recent outbreak, in al-Ahsa district of Eastern Province, nine had died, two more than previously reported.

Saudi Arabia's Health Ministry said in a statement the country had had 24 confirmed cases since last summer, of whom 15 had died. Fukuda said he was not sure if the two newly reported Saudi deaths were included in the numbers confirmed by the WHO.

Memish added that three suspected cases in Saudi Arabia were still under investigation, including previous negative results that were being re-examined.

The first French patient was confirmed as suffering from the disease on Wednesday after travelling in the Gulf. The second patient was transferred to intensive care on Sunday after the two men shared a room in a hospital in Lille.

Professor Benoit Guery, head of the Lille hospital's infectious diseases unit, said the first patient had not been immediately isolated because he presented "quite atypical" symptoms.

He added in comments broadcast by BFMTV channel the case suggested that airborne transmission of the virus was possible, though still unusual, and that the public "should not be concerned" as there had been only 34 cases globally in a year.

Fukuda, part of a WHO team visiting Saudi Arabia to investigate the spread of the disease, said although no specific vaccine or medication was yet available for novel coronavirus, patients were responding to treatment.

"The care that is taken in the hospitals, in terms of using respirators well, in terms of treating pneumonia, in terms of treating complications, in terms of providing support, these steps can get patients through this very severe illness," he said.

Fukuda said that as far as he knew all cases in the latest outbreak in al-Ahsa district were directly or indirectly linked to one hospital.

He added that Saudi Arabian authorities had taken novel coronavirus very seriously and had initiated necessary health measures such as increased surveillance systems.

Related:

US safe from two new viruses -- so far

This story was originally published on Sun May 12, 2013 9:13 AM EDT

Erik S. Lesser / EPA for NBC News

Dr. Hunter Johnson, a pathology resident at the Emory University School of Medicine, has helped at least four patients with C. difficile infections by giving them a dose of his stool. Fecal transplants have been shown to have a 90 percent success rate of curing the potentially deadly infection.

An Emory University medical resident has taken the notion of donation to a whole new level, agreeing to provide stool samples for multiple patients who need life-saving procedures called fecal transplants.

Dr. Hunter Johnson has aided at least four people in the past year by providing doses of his healthy feces -- yes, poop -- to help cure devastating bowel infections caused by a nasty germ known as C. difficile.

“As you can imagine, it’s not the most glamorous thing,” says Johnson, 30, of Atlanta, who was recruited by his boss, Dr. Colleen Kraft. “It’s hard enough to get people to donate blood, but it’s much harder to get people to donate feces.”

Kraft, an infectious disease specialist and clinical microbiologist at Emory, turned to Johnson and other medical residents last summer, when a gravely ill lung transplant patient came down with a C. diff infection as well.

“Basically, we had been doing it using a family member or friend to donate and this patient didn’t have anyone who could help,” she said. That's where Johnson came in. 

The process worked, allowing the woman to recover from the bowel infection with the help of a stranger’s stool.

Fecal transplants are rapidly becoming a treatment of choice for recurrent C. diff infections, which strike more than 336,000 people each year and are linked to 14,000 deaths, according to the Centers for Disease Control and Treatment. 

In the procedures, stool from a healthy patient is transplanted into the colon of a C. diff sufferer to restore the balance of bacteria. C. diff infections typically occur following heavy antibiotic use, when the drugs kill healthy bacteria in the gut, allowing toxic germs to flourish.

Though they sound distasteful, fecal transplants have been racking up success rates as high as 90 percent or more. Sufferers say they recover swiftly after the transplants, returning to full health within a few days.

“I’m telling you, I can’t say enough good things about this thing,” said Tom Wilson, 76, who received one of Johnson’s stool donations in March.

Wilson, who was treated for a serious bowel condition called diverticulitis in 2006, developed a life-threatening case of C. diff last December and was severely ill for months. He tried a fecal transplant using a sample from a family member, but it wasn’t completely successful.

When he fell ill again, doctors sent the real estate developer from Alpharetta, Ga., to Emory for help. He said the notion of accepting stool from a stranger didn’t faze him at all.

“When you’re as sick as I have been, you’ll do anything to feel better,” said Wilson, who figures he’s nearly fully recovered.

Johnson said he gets a sense of satisfaction from helping -- and from knowing he’s advancing knowledge about a new kind of therapy.

He figures he’s a good donor because he’s young, fairly healthy, and is at low risk for infections. People with kids, for instance, wouldn’t be good choices because children bring home so many germs.

“They don’t want you to be eating anything too crazy, not a lot of travel, no history of gastrointestinal illness,” he said. “We can’t have taken any drugs in the recent past.

“Essentially, the best donor is someone who leads a pretty boring life," he added.

In addition, a good donor has to have predictable bowel habits and be able to perform, as it were, on demand. Johnson typically donates on the morning of a patient’s transplant. “They want it to be relatively fresh,” he said.

He provides the sample and then takes it to the lab, where it’s processed to be given to the patient. At Emory, they use a colonoscope to deliver the donation, though others use enemas or tubes that run through the nose and to the stomach.

Kraft has conducted the transplants on a case-by-case basis with hospital approval. She plans to apply for a investigational new drug application that would essentially define Johnson's stool as a useful medication. Meanwhile, she and others who perform fecal transplants are waiting for the federal Food and Drug Administration to weigh in on regulation of the promising new therapy.

Both Kraft and Johnson say they’re excited by the promise of fecal transplants to cure the misery of C. diff infections. “I became a physician to help people,” Johnson said. “To these patients, it’s a big deal.”

Still, he acknowledges that not everyone finds his altruism so intriguing.

“My wife is kind of tentatively grossed out by it,” he said. “It’s a little weird for her. But she realizes it’s a good thing.”

Related stories: 

• Fecal transplant from mom cures ailing toddler
• Sounds gross, works great: Fecal transplants cure nasty C. diff infections

At least 67 people have died in 20 outbreaks caused by contaminated drugs since 2001, experts told a Senate hearing Thursday. The Food and Drug Administration says there have likely been more cases than that, but they have no way of telling now.

Iowa Senator Tom Harkin says he believes the Senate is close to getting legislation that would give the FDA specific control over large pharmacies like the one behind the outbreak of fungal meningitis that’s killed 55 people so far. The hope is to prevent any more of these outbreaks.

“We must have changes or this is going to happen again,” Dr. Janet Woodcock, director of FDA’s Center for Drug Evaluation and Research, told a hearing of the Senates Health, Education, Labor and Pensions Committee Thursday. Harkin, a Democrat, chairs the committee.

“This tragedy was only the worst in a series of incidents involving compounded products,” Woodcock added. “In retrospect, FDA should have been more aggressive… We are being more aggressive now.”

More than 740 people have been sickened in the outbreak of disease linked to contaminated products distributed by the New England Compounding Center in Massachusetts last year. At latest count, the Centers for Disease Control and Prevention says, 55 have died from a rare form of meningitis caused by mold-contaminated steroid injections.

The Pew Charitable Trusts ran down some recent incidents and came up with 19 other compounding pharmacy errors that led to 22 deaths since 2001. And at least 38 patients were blinded or suffered vision loss because of contaminated eye injections.

The cases include three people killed and 11 sickened in California in 2001 from contaminated injections of a steroid called betamethasone. Five had bacterial meningitis. They also include overdoses from saline solutions that had too much sodium and bloodstream infections from various contaminated infusion products.

"I think it's unconscionable that we have failed to regulate this industry for so long and I am committed to moving forward," Sen. Elizabeth Warren, a Massachusetts Democrat, said at the hearing. But previous efforts to give the FDA more power have fallen apart, most recently in 2007. Tennessee Sen. Lamar Alexander, a Republican, said lobbying by the compounding pharmacy pressured lawmakers into dropping the legislation.

Inspections of NECC showed many of its products were contaminated with fungus and bacteria. The operation has been closed down and the FDA and several states have stepped up inspections of large-scale pharmacies.

The FDA says the problem has arisen because so many compounding pharmacies have become major manufacturers of products from saline solution to chemotherapy drugs. They were originally licensed to whip up treatments on a prescription-by-prescription basis, but many now make products far in advance of their being prescribed, and ship them all over the country.

What has not been clear is who regulates them, and the FDA says many of these operations use the lack of clear regulation as an excuse to fend off efforts to inspect them and see their records. States are supposed to regulate traditional pharmacies, including compounding pharmacies. FDA regulates large drug manufacturers.

The Senate legislation, proposed by the FDA, would create a third category – large-scale compounders – that it would regulate.

State pharmacy boards said they’d support the new legislation. “We agree with the FDA that the situation can and will happen again,” Carmen Catizone, executive director of the National Association of Boards of Pharmacy, told the hearing. He did question one part of the proposed law – allowing FDA to get into the records of pharmacies regulated by states, saying it could cause confusion.

The consumer group Public Citizen opposes the new legislation, saying the FDA has all the authority it ever needed to stop rogue compounding pharmacies, but has failed to act. Woodcock says this isn’t true and says pharmacies regularly defy the agency when it tries to inspect facilities and their records.

“We need to get into pharmacies to make sure they are not posing as traditional pharmacies,” she told the hearing. “Sometimes, if there is an outbreak, we get reports and they say, ‘no you can’t come into our pharmacy’. “ Without seeing records, Woodcock says, FDA can’t tell where a contaminated drug may have been shipped.

This, in turn, makes it hard to track outbreaks. A person with a complication caused by a contaminated drug may not even know which product caused it.

Pew supports prioritized oversight of sterile products, notes there are a number of areas it would miss. These include non-sterile compounded drugs, such as compounded “bioidentical” hormone replacement pills. ”Compounded oral dosage forms have the potential to cause harm by both impurities and sub- or super-potency,” Pew’s Allan Coukell told the hearing.

It would also leave large pharmacies that don’t ship their products out of state free to operate under the FDA’s radar, Coukell noted.

Related:

• FDA inspection prompts recall by Florida pharmacy
• Months after outbreak, patients still being newly diagnosed
• Agencies do battle with pharmacies after outbreak
• We didn't have power to stop fungal meningitis, FDA says

By Andrew M. Seaman
Reuters
Children born after being exposed to the flu during pregnancy may have a nearly four-fold higher risk of later developing bipolar disorder, according to a small new study. 

The senior researcher said the results can't prove that a mother's bout of flu while pregnant causes her child to develop the mental disorder, but the association does suggest that some cases might be prevented.

"The idea is that if influenza is playing a causal role - and we can't say that from one study - there is a vaccine," Dr. Alan Brown, a professor of psychiatry and epidemiology at Columbia University in New York, told Reuters Health.

"It's affordable and also I would argue that there are other things that pregnant women could do. For example, hand washing and staying away from people with the flu," Brown said.

Previous studies had already established a link between a mother's flu infection while pregnant and her child's increased risk of developing schizophrenia, a severe mental disorder that often comes with hallucinations, delusions and paranoia.

Bipolar disorder shares some traits of schizophrenia, but also differs because it includes alternate cycles of mania and depression - although one type of bipolar diagnosis involves mania alone.

Past research into the link between people's risk of bipolar disorder and their mother's flu has produced mixed results, Brown and his colleagues write in JAMA Psychiatry.

For the new study, Brown's group looked for a connection between flu exposure and children's bipolar diagnoses in data from a study that involved soon-to-be mothers living in Alameda County, California, between 1959 and 1966.

Using the mothers' medical records and follow up information about their children, the researchers had information on 92 kids who were exposed to the flu while in the womb, and on 722 who were not.

Of the children exposed to the flu, about 9 percent were later diagnosed with bipolar disorder. That compared to about 3 percent of the kids who were not exposed.

"What we found is that (schizophrenia and bipolar disorder) share at least this in common. Maternal influenza is related to bipolar disorder," Brown said.

He added, however, that they did not see an association between bipolar disorder and a mother's common cold or other upper respiratory infections.

And until more studies are done, Brown said he and his colleagues can only guess at what is behind the link between flu and bipolar disorder.

"We think there is an inflammation going on in the fetus due to this infection and it can alter key aspects of brain development and function," Brown said.

By Michelle Rindels
AP

A new report shows 200 people reported food poisoning symptoms after dining at one of Las Vegas' most popular restaurants about a block off the Strip. 

Southern Nevada Health District data released Friday show the salmonella outbreak at the Firefly restaurant in late April was more extensive than previously thought. An earlier report showed nearly 90 people sick.

Officials say patrons reporting illness hailed from 20 different states and two foreign countries.

Investigators say they haven't pinpointed a menu item or ingredient that's the likely culprit. Inspectors who visited the restaurant on April 26 documented food stored at improper temperatures and employees handling food without gloves.

The restaurant was one of Vegas' most highly rated eateries on the review site Yelp.com. Health District spokeswoman Stephanie Bethel says it was shuttered April 26 and remains closed. 

Stringer / EPA

Rescuers pull out a female survivor, Reshma, alive on the 17th day after the Rana Plaza building collapsed, in Savar, Dhaka, Bangladesh, 10 May 2013. Television footage showed troops removing the survivor, identified as Reshma Begum, from the rubble and taking her to an ambulance.

Water would have been key to the survival of a woman pulled from the rubble of a collapsed factory in Bangladesh after 16 days, experts say. 

The woman named as Reshma Begum, mother of a young son, was taken to a hospital with dehydration, officials said. But she’s likely to pull through if she has no major injuries, says Randall Packer, an expert on the body’s water balance at George Washington University.

“She had to have some sort of water source. She could survive that long without food intake but not without water intake,” Packer told NBC News. She later told rescuers she had both. "The last two days I had nothing but water. I used to drink only a limited quantity of water to save it. I had some bottles of water around me," Reshma told the private Somoy TV station from her hospital bed.

People have lived much longer without food, or with very little food. Mohandas Gandhi went on several hunger strikes in the 1930s and 1940s, and his thin body survived for as long as 21 days on only sips of water. Irish Republican prisoner Bobby Sands died after 66 days of a hunger strike in 1981 in Britain’s notorious Maze prison.

Six weeks without food is about the limit for an average weight person, Dr. Claude Piantadosi of Duke University in North Carolina says. "If somebody's really huge, really fat, they could live longer than six weeks."

Even a dribble of water would have helped, Piantadosi says. "If she could move around a little bit, she may have been able to lap some and stay alive," he said.

After Haiti’s 2010 quake, a man survived for 14 days in the rubble thanks in part to a two-gallon jug of water he had nearby.

Doctors know precisely how long people can live without water, says Packer. “Sometimes at the end of life, hydration and food is stopped,” he said. “Now, these people are already in a weakened state but they are in ideal conditions of temperature, and so on. Sometimes they go on for a week.”

But that’s about the maximum people can last with no water at all – and if it’s hot, or dry, or if people are moving around, they can die of dehydration much more quickly.

“I have sort of a 100-hour rule," says Piantadosi. "Depending on the temperature you are exposed to, you can go 100 hours without drinking at an average temperature outdoors. If it’s cooler, you can go a little longer. If you are exposed to direct sunlight, it’s less," he added.

“The more energy you expend the more likely you are to lose water,” Packer says. “You lose a little bit of water every time you exhale. You lose water when you sweat. You do make a little water when you metabolize food … but the balance is such that you always need some sort of water intake.”

Dehydration kills by bringing blood pressure down to fatal levels, Packer says.

“Under extreme conditions an adult can lose 1 to 1.5 liters of sweat per hour. If that loss is not replaced by drinking, the total volume of body fluid can fall quickly and, most dangerously, blood volume drops,” Packer says.

Water is the best fluid for survival, but it’s not the only one, he noted. “A person can stay hydrated by drinking many different kinds of fluids in addition to water, with one exception. Drinking alcoholic beverages actually causes dehydration,” Packer says.

“Ethanol depresses the level of anti-diuretic hormone, increasing urine volume to the extent where more fluid is lost in urine than is gained in the drink.”

He believes the woman in Bangladesh may have a shot at survival. “Physically, at least, unless she was really thin person she should come out of this in pretty good shape,” he said.

“It just had to be horrifically frightening.”

Related:

How long can you survive under quake debris

Hunger strikers through history

French health officials said Friday they are investigating three suspected cases of a deadly new respiratory virus related to SARS, in people who had close contact in the hospital with France's only confirmed case.

Beatrice Degrugillers, a spokeswoman for the regional health agency in France's Nord-Pas-de-Calais region, said a nurse at the hospital where the man was hospitalized in late April has herself been under watch at the hospital in Douai since Thursday night.

A doctor and a former hospital roommate who had each been in contact with the first patient also remain hospitalized. Test results are expected later Friday.

If confirmed, the additional cases would heighten concerns about the virus' ability to spread easily between people. Health authorities have previously said the new coronavirus has spread in limited circumstances between people in very close contact, such as relatives taking care of family members.

In 2003, the spread of SARS in hospitals in Asia ultimately sparked a global outbreak. Officials consider any spread of a new virus in hospitals to be the first sign it is gaining the ability to infect humans easily.

On Wednesday authorities announced the 65-year-old Frenchman was France's first confirmed case of the novel coronavirus, which has killed 18 people since being identified last year in the Middle East.

The patient fell ill after returning from a nine-day vacation in Dubai in the United Arab Emirates as part of a package tour, the Health Ministry said.

The man, whose identity was not released, returned from Dubai on April 17. He was hospitalized with respiratory problems in the northern French city of Valenciennes on April 23, and transferred to a more advanced facility in Douai on April 29.

Paris' Pasteur Institute analyzed the man's virus and confirmed that it is a novel coronavirus.

Since September 2012, the World Health Organization has been informed of 30 confirmed cases of the virus, and 18 of the patients have died. Cases have emerged in Saudi Arabia, Jordan, the UAE, Qatar, Britain and Germany, and health officials say the virus has likely already spread from person to person in some circumstances.

Since the virus emerged last year, European authorities have put in place monitoring measures. In France, 20 people have already been examined for suspected cases of the virus, but the other 19 turned up negative, Health Minister Marisol Touraine said.

The patient who traveled to Dubai is the only positive case. His family members have been tested and are not infected.

LILLE, France -- Two people who had contact with a Frenchman who is seriously ill with the new SARS-like coronavirus have fallen sick and been admitted to hospital, health officials in northern France said on Thursday. 

One is a patient who shared a ward with the 65-year-old man infected with the virus when he was in a hospital in the town of Valenciennes, northern France, at the end of April, and the other is a doctor who treated him there.

The 65-year-old man, who became ill on his return from a trip to Dubai, has since been transferred to an isolated intensive care wing in a hospital in Douai, near the northern city of Lille, where he is in a critical condition.

The ARS local health authority said the two other men were in individual rooms in separate hospitals, one in Lille and the other in the nearby town of Tourcoing, and that tests had been carried out on both of them.

"They show symptoms which require a special infectious diseases consultation," the ARS said in a statement. "The results of the tests carried out on these two people will be known soon and will be made public."

As France reported the 65-year-old as its first case of the coronoavirus on Wednesday, the World Health Organization said it would send experts to visit a Saudi hospital from which the virus has spread, killing seven people so far.

The French case brought the total number of known infections worldwide to 31, of which 18 resulted in death.

Coronavirus is from the same viral family that triggered the outbreak of Severe Acute Respiratory Syndrome (SARS) that swept the world from Asia in late 2003, killing 775 people.

Despite there being no evidence so far of sustained human-to-human transmission, health experts' concerns are growing over clusters of new cases. 

One in eight Americans over the age of 60 reports worsening memory loss, raising concerns of an Alzheimer’s Disease crisis as the baby-boom generation gets older, a large government study finds. And it's bugging the youngest members of that age group the most.

Nearly 13 percent people 60 or older reported confusion or memory loss occuring more often or getting worse over the past 12 months, the Centers for Disease Control and Prevention found.

Of these people, one-third reported that confusion or memory loss interfered with their work, social activities, or ability to do household chores, the CDC found in analyzing a survey of 59,000 people in 21 states.

Because it’s the first self-reported survey of memory loss, it’s difficult to draw conclusions, said Angela Deokar, a public health adviser at the CDC.

“This is the first time we have such data,” she said, adding that future surveys would look at why people in the 60-64 age group seemed to suffer more when they did have memory loss. The survey found that 12 percent of 60 to 64-year-olds complained of confusion or memory loss, and of them,  nearly 45 percent said it interfered with daily life or work. That's worse than in the 85-and-older group -- only 38 percent of them felt the memory loss or confusion interfered with their lives.

“These findings suggest a need for future studies to examine the relationship of age and functional difficulties caused by increased confusion or memory loss,” Deokar said.

But only 35 percent of those who reported memory loss said they had discussed their symptoms with a health care provider. It's not clear whether the symptoms are just very mild, or that baby boomers are in denial.

“Some say ‘Oh, it’s just a normal part of aging.’ It’s not,” said Matthew Baumgart, senior director of public policy for the Alzheimer’s Association, which is analyzing the CDC results.

“When one in eight Americans 60-plus says they are having memory problems, then we continue to have a problem and things are not going to get better for the foreseeable future,” he said.

Even though 12.7 percent reported worsening memory loss in the previous year, that did not necessarily mean they were developing Alzheimer’s, Baumgart said, although forgetfulness is a key sign of the disease. Alzheimer’s disease, the sixth leading cause of death in the United States, is also the fastest growing threat because of the aging population.

“There is definitely a stigma surrounding this disease and 80 percent not talking to their doctor is an indication of that,” he said.

The study, which was conducted in 2011, only included the first five years of the Baby Boom generation to turn 60. “We’ve got another 15 years to come,” Baumgart said.

That will put more pressure on the system, since Alzheimer’s and dementia are probably the costliest illnesses because many patients eventually need nursing home care, he said. Most patients live four to eight year after diagnosis, but many can live for 20 more years, Baumgart said, adding that about one-third of Alzheimer’s patients live alone and are unaware of their symptoms.

“No treatments will slow the advance of the disease, but a diagnosis can allow a patient to plan for future care,” he said, stressing the importance of early detection.

Lynda Anderson, who is director of the CDC’s Healthy Aging Program, said respondents were clearly told the study was about memory loss deteriorating in the previous 12 months. “We prefaced the questions by telling them it was not about losing your keys or forgetting a face, like we all do sometimes," she said.

Spending on prescription medicines in the U.S. fell for the first time in decades last year, slipping as cash-strapped consumers continued to cut back on use of health care services.

Patients also benefited from a surge of new, inexpensive generic versions of widely used drugs for chronic conditions like high cholesterol, according to a new report.

Total spending on medications dropped to $325.8 billion last year from $329.2 billion in 2011. Likewise, average spending per person on medicines fell by $33, to $898 last year, according to the report from the IMS Institute for Healthcare Informatics.

"That's the first time IMS has ever measured the decline in the 58 years we've been monitoring drugs," Michael Kleinrock, director of research development at the institute, told The Associated Press.

Factors behind last year's drop in drug spending include positive trends such as more use of cheap generic pills and flukes such as a fairly mild cold and flu season in early 2012. But there also was a big negative: people rationing their own health care.

IMS found affordability of health care remains a big problem for many Americans, with growing out-of-pocket costs forcing people to go without needed doctor visits, medicines and other treatments.

For some, that was because they lost jobs or homes during the worst recession in decades. But higher costs also are hitting many employed people who have health insurance.

Employers have been raising health costs for their workers well above the inflation rate, through higher copayments, premiums and deductibles. Many commercial insurance plans now have annual deductibles — the amount a patient must pay before insurance kicks in — that exceed $1,000, Kleinrock said.

The number of insured people with consumer-directed plans, where patients face very high deductibles and sometimes pay 20 percent of costs after that, has jumped from about 8 percent in 2008 to 19 percent last year. Now many folks insured through their jobs have such plans, not just young, healthy people buying insurance on their own.

"Even patients with insurance are feeling the pinch and have been reducing their use of health care," Kleinrock said.

The report notes that out-of-pocket costs, which exclude monthly health plan premiums, are now three times higher than they were five years ago, on average. They're seven times higher for those with consumer-driven plans.

That's one reason the number of doctor visits, planned hospital admissions and outpatient treatments each dipped by a half-percent to 1 percent last year, compared with 2011.

At the same time, the number of patients admitted to hospitals after coming to the emergency department spiked for the second straight year, climbing nearly 6 percent in 2012. That's a sign some people are waiting until they are very sick to seek medical help.

Meanwhile, the number of prescriptions used per person last year edged down just 0.1 percent. At the same time, the percentage of all prescriptions filled with a generic medicine rose from 80 percent in 2011 to 84 percent last year. Nearly three-quarters of prescriptions filled in 2012 cost patients $10 or less in copayments.

A big reason was new generic versions of some of the pharmaceutical industry's biggest-selling drugs of all time: Lipitor for high cholesterol, Plavix for preventing blood clots and strokes, Singulair for allergies and asthma, Diovan for high blood pressure and several others.

Those brand-name drugs all lost patent protection during 2012 or late 2011, enabling generic drug companies to flood the market with copycat pills costing up to 90 percent less.

Those new generics reduced spending on medicines by $28.9 billion last year. That savings was partly offset by the introduction of a big number of breakthrough drugs that are very expensive, drugmakers raising prices on existing medicines and population growth.

IMS, based in Parsippany, N.J., compiles and analyzes data from pharmacies, hospitals, nursing homes, drug wholesalers and other groups to produce its annual report on health care spending trends.

Back in 1957, the first year IMS studied, total U.S. drug spending was only $1.9 billion. That's risen each year since, generally climbing more in years when the economy is strong.

For now, IMS is forecasting that overall spending on health care will continue to grow faster than spending on medicines at least through 2017. That's due to factors including the increasing number of elderly patients and those with very expensive chronic conditions such as diabetes, psychiatric disorders, severe heart disease and various cancers.

"The sickest people drive most of our health care spending," Kleinrock said, noting that just over half the total spending by private health insurance plans last year was for just 5 percent of their members.