Business is better than ever for disease detective Yolanda Vargas.
The number of reported syphilis cases in Ventura County is double what it was last year at this time--the result, health officials say, of an increased incidence of syphilis among out-of-town prostitutes visiting Latino farm workers.
Vargas often visits not long afterward.
As a communicable disease representative for the state Department of Health in Ventura County, her job is to interview those who test positive for syphilis and gonorrhea, get names of their sex partners and track them down to come in for treatment.
So far this year, the county has logged 56 cases of syphilis, up from about 28 at this time last year, said Dr. Larry Dodds, the county's Director of Public Health.
Vargas--the only person who tracked those cases from January until this month, when the state filled a second position--has had her hands full.
"You run into some very awkward situations," she says. "The worst is when you're dealing with an unfaithful husband."
Tracking Down Cases
Vargas's job takes her to gay bars, seedy cantinas, middle-class homes and offices. She leaves handwritten notes in mailboxes and cruises streets where her quarry might hang out. Her job requires tact and tenacity, an ability to dole out facial tissues as well as to remain cucumber-cool when doors are slammed in her face and phones in her ear. And for those who need further persuasion that treatment is necessary, there's a nasty set of color photos to illustrate the ravages of secondary and tertiary syphilis.
"I don't like to use them unless I have to," Vargas says drily. "I say, would you like to see some pictures. . . ."
The rise in Ventura County's syphilis incidence mirrors a national trend. In Los Angeles County, syphilis has reached levels unprecedented since the advent of penicillin 45 years ago. Los Angeles County reported 4,198 cases of infectious syphilis in 1987, up from 1,558 in 1984.
Because its initial symptoms are painless and appear fleetingly weeks after infection, the disease can go undetected or ignored for years.
Unless treated with antibiotics, however, the bacteria that cause syphilis can infect the bloodstream and eventually damage the nervous system or cause heart disease. Infected mothers may give birth to deformed or blind babies. Some are born dead. Additionally, syphilis may heighten a person's risk of infection with the AIDS virus, which can be transmitted through open sores in the genital area.
In Los Angeles, authorities attribute the rise of syphilis in part to the practice of exchanging sex for drugs, which has increased with the spread of addictive crack cocaine. The Los Angeles County Board of Supervisors voted last month to spend $2.7 million to curb the disease, and has suspended the $20 fee charged for diagnosis and treatment at county-run health clinics.
The state administers Ventura County's communicable disease program and, despite the doubled syphilis caseload, at present there are no plans by this county's board of supervisors to augment that program. Patients are adequately diagnosed and screened at county clinics for $8, Vargas said.
In Ventura County, health officials trace the syphilis increase to prostitutes from Los Angeles, Fresno and San Diego who do a thriving weekend business at local migrant labor sites, plying their trade in cars or from cheap hotels in Fillmore, Santa Paula, Oxnard or Ventura.
Farm Workers Affected
Vargas says that most of the prostitutes are intravenous drug users and that most of the cases she runs across are in the the county's agricultural areas. Very few cases surface in Thousand Oaks and Simi Valley, she says.
Health officials also attribute the dramatic increase to the discovery of previously undiagnosed cases among Latinos who recently have applied for amnesty.
In her daily work, Vargas is well acquainted with the thrill of victory and the agony of defeat, and she tabulates both carefully. One coup she recalls with relish was locating a farm worker who tested positive for a stubborn, penicillin-resistant strain of gonorrhea.
The lab results put her on red alert, so within an hour she hopped into her county-issued car and headed north for a Santa Maria ranch where the infected man worked picking vegetables.
Vargas, who was then working for the Santa Barbara County health department, told the ranch foreman that she was from a doctor's office and that the man needed a new medicine urgently.
Impressed by her authoritative manner, the foreman bundled Vargas into his jeep and roared past rows of broccoli and cauliflower until he found the worker.
The man agreed to get treatment and named a prostitute as his sexual contact. Vargas was unable to track down the woman; she apparently had passed through the county on her way north.
Wife Was Infected
Then there are the disappointments.