The Los Angeles County Board of Supervisors asked public health officials Tuesday to develop a communicable-disease prevention and intervention plan in response to an LAPD employee contracting the bacteria that causes typhoid fever.
Supervisor Kathryn Barger recommended a coordinated intervention by public health workers in coordination with city sanitation departments and other health agencies.
"In the interest of protecting the health and safety of our residents and law enforcement personnel, the county must examine the root causes of the spread of communicable diseases associated with trash and rodent infestations, and develop a comprehensive plan to minimize risk of additional cases," Barger said.
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She reminded her colleagues that the county had a 2017 outbreak of hepatitis A and a flea-borne typhus outbreak last fall related to rat infestations and filthy conditions on the streets where homeless people congregate in tents or makeshift shelters.
An estimated 2,000 people sleep in Skid Row, one area of focus. The Department of Public Health has not declared an outbreak of typhoid fever, but there have been five reported cases this year and 14 in 2018. The disease is typically caused by contaminated food or water and is different from typhus, which can spread to people from infected fleas and their feces.
An employee at City Hall East came down with typhus last year, which led to a exhaustive inspection of city buildings in the Civic Center area. Department of Public Health Director Barbara Ferrer said a multi-pronged approach to disease prevention was required.
"I don't think there's a simple answer," she said.
Ferrer stressed the need for continuing outreach and the offer of services and support to get people off the street and into better living conditions, along with a crackdown on illegal commercial dumping.
Supervisor Mark Ridley-Thomas said consequences should be severe for businesses who dump their trash in the streets. The LAPD confirmed last Wednesday night that an employee at the department's Central Station near Skid Row had contracted salmonella typhi.
Although the department confirmed the following day that two other employees had developed similar symptoms, there has been no confirmation that they had actually contracted the bacteria. The department's Central Station is located at 251 E. Sixth St. in downtown Los Angeles.
"We are collaborating with the city's General Services Department, Personnel Division, Facilities Management Division and Central Bureau facilities personnel to address the concerns of our employees and mitigate any possible exposure to diseases at all of our facilities," according to a statement the LAPD issued last week. "We are committed to creating and maintaining healthy communities in Los Angeles, including our own places of work."
LAPD officials said work has been done to disinfect any "work areas that may have been exposed" at the station. According to the Centers for Disease Control and Prevention, typhoid fever is not common in the United States, where about 350 people are diagnosed with the illness each year. Most of those cases involve people who have traveled outside the country.
Symptoms include sustained fever that can reach 104 degrees, weakness, stomach pain, headache, diarrhea or constipation, coughing and loss of appetite. The disease is treated with antibiotics. Homeless advocates warned the board against choosing sweeps of individuals and their belongings to solve the problem on the streets.
One recalled Joe Reyes, a homeless man who died of a heart attack after his heart medication was allegedly taken away in a cleanup operation. Barger said she didn't believe that sweeps were a necessity.
"Individuals have a right to maintain their property," Barger said.
In a separate motion, she called for pilot storage programs for people living on the street or in shelters where space may be at a premium.
"At any given time, an individual might be carrying identifying documents, money, clothing, food, water, shelter materials, cell phones and hygiene products on their person. The theft or loss of any of these above items could be disastrous for vulnerable individuals living without shelter," the motion stated.
Barger said shipping containers are the most efficient storage space and said the county should look to downtown Los Angeles and San Diego for examples of storage facilities that are staffed throughout the day so that people can come and go while looking for a job or visiting a doctor.