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Emergency Declared as Tuberculosis, Measles Surge


LONG BEACH — The City Council has declared a public health emergency following an outbreak of measles and tuberculosis that health officials say is imperiling children and stretching already scarce resources to the limit.

While only 13 cases of measles were reported in Long Beach between 1986 and 1988, the total soared to 100 in 1989 and killed three children, the Department of Health and Human Services reported.

At the same time, tuberculosis cases more than doubled from 59 in 1988 to 128 last year, records show.

Both diseases, as in years past, appear to be concentrated in the refugee and immigrant communities where people have limited access to public health care or are unaware that low-cost services are available, said Dr. Marion Johnson, the city's health officer.

"Measles is so preventable, that's what is so sad about all these cases," Johnson said after the council's unanimous declaration Tuesday.

The emergency status clears the way for Long Beach to apply next week for a portion of $1.2 million in state funds to fight the measles outbreak with education and immunization clinics. State regulations prohibit using the money for the vaccine itself and local health officials complain that there is a shortage.

No state funds are yet available for tuberculosis, but Johnson asked for the emergency status to emphasize to the state and the city that more doctors and nurses are needed to hold off an epidemic. Health Department Director Diana Bonta has said resources would have to be quadrupled to adequately handle the caseload that officials say is the 19th-highest tuberculosis rate in the nation.

While both diseases are potentially fatal if left untreated, measles is the greatest concern because, unlike tuberculosis, it is preventable, Johnson said.

More than half of those infected with measles last year were preschoolers or children entering kindergarten. Nearly one in five was an infant, health officials said.

The three children who died--a 14-month-old girl, a 19-month-old girl and a 3-year-old boy--were all Samoan. That population was hardest hit by the outbreak, accounting for one-third of the total number of cases reported.

An intense education and vaccination drive in the Samoan community stemmed the epidemic, but the disease appears to be moving to the Latino population, particularly preschoolers, health officials said.

More than one-third of 27 new measles cases reported this year involved Latinos; 79% of the total were preschoolers under age 5.

"There is no sign of the epidemic remitting," Johnson wrote in a report to the council. Doctors recommend that children be immunized at 12 months; the vaccine is considered ineffective earlier than that. Some physicians suggest a second shot when a child enters kindergarten or junior high school, but that policy has not been made official due to a shortage of funds for a vaccine, officials said.

Vaccinations are available at the Health Department's clinic at 265 Pine Avenue and the fee is based on ability to pay, Johnson said. City Council members called for more vaccination sites throughout the city but health officials said current resources make that difficult.

Long Beach, one of only three cities with a health department independent of that of Los Angeles County, is juggling precious resources while the tuberculosis rate climbs, infecting children and a growing number of people who carry the AIDS virus, epidemiologist Robert Salcido said.

A growing number of cases were reported in people infected with the AIDS tuberculosis, a chronic disease that attacks the lungs, is detectable by a skin test and can be successfully treated with oral medication and injections, experts say.

The body can carry the inactive germ without showing symptoms and the disease is not then contagious. Once active, however, it is highly contagious and marked by a cough, high fever and night sweats. It is most often passed within the household, Johnson said.

The Health Department makes it a policy to follow up all reported tuberculosis cases and preventive medication is available to family members who are at risk of infection, she said.

The department offers tests and treatment for $20 a visit, but the fee can be waived if needed.

"People should not consider cost a barrier to care," Johnson said.


Measles Tuberculosis Year Cases Cases 1985 1 59 1986 1 90 1987 0 68 1988 12 59 1989 100 128 1990 * 27 13

* First three months.

Source: Long Beach Department of Health and Human Services

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