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Los Angeles

TB outbreak in downtown L.A.'s skid row called 'largest in a decade'

by City News Service

LOS ANGELES - Public health officials have launched an effort to contain a persistent outbreak of tuberculosis on downtown Los Angeles' skid row and are searching for more than 4,500 people who may have been exposed to the disease, it was reported today.

The Centers for Disease Control and Prevention has dispatched scientists to Los Angeles to help local health officials determine why the disease is spreading and how to stop it, the Los Angeles Times reported. Officials say 11 have died since 2007. Sixty of the 78 cases were among homeless people who live on and around skid row.

Scientists recently linked the outbreak to a tuberculosis strain unique to Los Angeles, with a few isolated cases outside the area, according to The Times.

"This is the largest outbreak in a decade," Dr. Jonathan Fielding, director of the Los Angeles County Department of Public Health, told The Times. "We are really putting all of our resources into this."

Health workers have identified about 4,650 people who were probably exposed and are trying to track them down for testing and treatment, the newspaper reported.

Local and federal officials are particularly concerned because the cases are linked to one relatively small geographic area and one vulnerable population, but officials also fear the outbreak could spread beyond skid row if action isn't taken, according to The Times.

Homeless people are especially at risk of getting TB and of being undiagnosed because of poor hygiene and nutrition, limited access to healthcare and ongoing contact with infected people. Many homeless people also have substance abuse or mental health issues that can impede treatment.

http://www.dailynews.com/news/ci_22646041/tb-outbreak-downtown-l-s-skid-row-called

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Los Angeles

TB outbreak not spreading beyond downtown L.A.

by Mariecar Mendoza

Los Angeles homeless advocates reassured residents Friday that while the downtown area is dealing with what health officials are calling the largest tuberculosis outbreak in the last decade, the disease's reach is far from epidemic proportions.

An investigation has been launched into what scientists believe is a new strain of TB unique to downtown Los Angeles' Skid Row after 11 deaths have been linked to the disease since 2007, according to the Los Angeles County Department of Public Health.

County health officials have been monitoring the issue and identified 4,650 people they believe may have been exposed to the airborne disease, prompting officials with both the state and Los Angeles County TB control programs to reach out to the federal Centers for Disease Control and Prevention.

CDC plans to dispatch staff in the next two weeks to assist in the outbreak investigation, said CDC spokeswoman Salina Cranor.

But local health officials and homeless service providers said residents shouldn't rush to their local hospital in a panic just yet.

"I wouldn't want people in the outlying areas to get hysterical and fearful. Yes, the homeless move about, but they're likely not going to move to the Valley or elsewhere because there aren't a lot of services," said R. Gerald Smith, senior health educator for Homeless Health Care Los Angeles, a nonprofit organization that focuses on health and education to improve conditions for the homeless. "There's a possibility that it can spread, that is true, but right now it's centralized in downtown and will likely stay there."

TB is caused by an airborne bacteria that typically targets the lungs, but it can also affect other parts of the body such as the brain, kidneys or spine.

Symptoms include fatigue, weight loss, fever and night sweats with the most severe being chest pains and coughing up of blood, according to the CDC.

While a regimen of multiple medications over a course of six to nine months may cure a TB infected-person, if left untreated TB can be fatal.

In 2011, the most recent data available, 10,528 cases of TB disease were reported in the United States, which the CDC declared an all-time low for the country. The disease, however, remains one of the most fatal infectious diseases in the world with 1.4 million TB-related deaths around the globe.

While many medical advances have helped stifle TB epidemics over the years, numbers are spiking at a worrisome rate among the homeless who experts say are most susceptible to the disease because of poor hygiene, limited access to health care and spending extended time in close quarters with those who are infected.

"They're more vulnerable because they're at these crowded shelters or missions downtown and spend night after night on cots where the exposure to other homeless people who may have the TB germ can be concentrated," Smith said.

But both Smith and HHCLA executive director Mark Casanova emphasized that TB is a "very light bacteria" and its spread can be prevented with simple modifications.

"For instance, they can have people sleep head to foot; keep an eye on those who have been coughing for a long period and showing signs of TB," Casanova said. "And the main thing is to ensure proper airflow, from keeping windows open to turning on fans."

That's why Smith emphasizes for those who ride the bus or the Metro: "Don't worry."

"You'd have to be inside, they'd have to be coughing in your face," he said, "and you need to be around them for more than one day to catch the disease."

http://www.dailynews.com/news/ci_22650834/tb-outbreak-not-spreading-beyond-downtown-l

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New Jersey

Princeton police ask residents what they expect of new consolidated police force

by Jon Offredo

PRINCETON — Town police plan to mix old-fashioned shoe leather and community policing tactics with social media outreach to reboot how they communicate and interact with the citizens of Princeton.

Officers in the newly consolidated department have been used to thinking of themselves as borough or township officers, but that all changed as of Jan. 1.

“As a new department, it's a new start. We have a long history separately, but we don't have a history collectively,” Captain Nick Sutter said. “We need to see how we operate collectively, rather than go out blind and take a shot at it.”

The most immediate effort is the start of a weeks-long survey that gauges the public's perception and expectations of the newly-consolidated police department.

In the next 10 days, a team of three officers from the department's Safe Neighborhood Unit will go door-to-door in various parts of the community to survey residents about what they expect of the new police department, any specific services that they want, and how the department is doing on traffic management and patrols.

Officers will conduct the survey on Saturdays and during the week between 5 p.m. and 7:30 p.m. An electronic version of the survey will be available online as well, on surveymonkey.com, and on the department's web site, www.princetonnj.gov/police.

Chief David Dudeck also said the department plans on being much more active on electronic media, by providing Facebook and Twitter updates, for example.

“Nixle, pixel, we have all different kinds of things,” Dudeck said.

The officers will knock on about 75 doors in the community. Council members supported the effort, saying the survey and the department's planned increase use of social media was a step to being proactive, rather than reactive.

“I think this may be the first time that I can remember anything of this sort being done in Princeton, where police officers actually come to your door for information,” council and public safety committee member Lance Liverman said.

Currently, the department has about 50 active officers, Sutter said. But that number could change, depending on needs, officials said.

Councilwoman and police commissioner Heather Howard said they are hoping to have a data-driven analysis of what the community's needs are to help with the staffing judgment.

http://www.nj.com/mercer/index.ssf/2013/02/princeton_police_ask_residents.html