LONG BEACH — Teresa Gorospe pounded on an apartment door where she heard a baby crying over salsa music and yelled, " Hola , Maria" until a woman cracked open the door. Gorospe handed the mother a flyer and urged her to get measles shots for the children.
"There's an epidemic," Gorospe said in Spanish. "Please do it. It's free."
The mother listened warily, as Gorospe explained how 46% of those who contracted measles last year are Latino preschoolers and how it is life-threatening for the little ones. The mother asked for another bilingual green flyer to give to a neighbor.
"I never heard about this, I'll go," the mother promised.
Gorospe, a former community worker for the Long Beach Unified School District, works part-time for the city Department of Health and Human Services in an outreach program to slow the spread of measles. She is the only staff member assigned to go door-to-door to inform parents about the free immunizations, which cover measles, rubella (German measles) and mumps.
That job takes Gorospe into some of Long Beach's most crime-ridden neighborhoods. A recent trip just before Christmas took her to the Washington Middle School area, past housing complexes where gang shootings have occurred recently.
"I'm safe, I'm careful, but it's so important to tell people in these neighborhoods," said Gorospe, who dresses brightly in a red shawl and blue-knit beret. Her casual style puts parents at ease, and sometimes their talks end with a hug. "It's hard for people to believe I'm with the health department," she added.
Long Beach is experiencing a measles epidemic. In 1989, three children died and 100 cases were reported, compared to 13 cases between 1986 and 1988. The number of measles cases climbed to at least 191 last year. All of the cases were rubeola, the most serious strain. No deaths were recorded locally in 1990.
To handle the emergency, Long Beach received $29,891 for six months of free immunizations as part of a $1.2-million state Health Department grant to six of the hardest-hit California communities. The grant pays for one nurse and one community worker to staff the temporary clinics at schools in predominantly minority communities, where the rate of measles is highest. Children's Clinic of Long Beach also provides one nurse and social worker to help with the clinics.
"People will come if they're told about it in person, and we have an ambitious outreach worker who is really good at getting the word out," said Nancy Lewis, the health department's nursing services officer.
"In the past we have advertised and done everything right, and only five or six people show up. It's the outreach that is different and making people come."
The measles clinics so far have attracted 45 to 60 children each day for vaccines, and most of those were invited directly by Gorospe, although other social agencies and teachers refer parents to the program.
Los Angeles County had at least 17 measles-related deaths in 1990, said Charles Alexander, director of immunizations for the Los Angeles County Health Department, which works closely with the Long Beach staff.
Most deaths from measles in the county have occurred in poor Latino neighborhoods where the highly contagious disease spreads quickly via colds and coughs because families live in close quarters. Language barriers prevent some families from learning about free health services.
"When parents have to worry about how to pay rent and provide food, having their children immunized is not top on their list of priorities," Alexander said. "That's why it is so important to have the community outreach that is being done in the county and in Long Beach."
Long Beach Health and Human Services Director Diana Bonta said the talks by Gorospe and the public health nurses have been extremely successful in educating parents about vaccines.
In 1989, the three children who died in Long Beach were from Samoan families, and some parents said they were opposed to immunizations because it was against their belief to inject foreign substances into their children. Such cultural opposition is rare, and programs aimed at Samoans in 1990 have been somewhat successful by emphasizing safety for the children, Bonta said.
"All of us value our children, and we must emphasize that immunization is important for their future, no matter what cultural background they are from," Bonta said.
People in immigrant communities often are unaware of the low-cost health services available, and measles is preventable, Gorospe said. Many parents in those communities are unaware that vaccines are required for children before they go into school.
Causing fever and flu symptoms, measles is characterized by a red, blotchy rash. The general malaise lasts 10 days and could include pneumonia and encephalitis.