Flu-related deaths total 43 in San Diego County, a near-record

Three more influenza-related deaths in San Diego County have pushed the seasonal total to 43, the second highest on record, county health officials reported Wednesday.

But "on a positive note," new lab-confirmed flu cases declined for the fourth consecutive week, said officials of the county Health and Human Services Agency. The highest mortality for a flu season was 2009-2010 when 58 persons in the county died.

"While we believe the worst of the flu season may have passed, influenza is still making people sick," said Dr. Wilma Wooten, San Diego County public health officer.

Of the 43, ages ranged from 42 to 99 and all but one had underlying medical conditions, officials said.

Flu vaccine is available throughout the county, at doctor's offices and retail pharmacies, Wooten said.  County public health centers have flu vaccine for children and adults without medical insurance.

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Photo: Flu vaccine inoculation. Credit: San Diego County News

Whittier High students tested for tuberculosis

Students at Whittier High School are being tested for tuberculosis after someone associated with the campus tested positive for the respiratory illness.

The school sent a letter to parents on Feb. 13, alerting them that the Los Angeles County Department of Public Health had notified them of the positive TB result. As a precaution, the school offered free testing to students who may have come in contact with the infected person.

And other children were tested by their doctor for the illness, spread through sneezing and coughing, and which can be highly contagious in close quarters like a classroom.

Concerns about TB at Whittier High follow an outbreak among L.A.'s homeless on skid row, where public health officials say thousands of people may have been exposed to a unique strain that has led to 11 deaths since 2007.

There was no update from the heath department about whether the case in Whittier was at all related to the strain on skid row.

Health officials have not yet said whether any students tested positive for tuberculosis, which is treatable and curable if detected early.

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Debi Austin, featured in anti-smoking 'Voicebox' ad, dies

Deborah "Debi" Austin, a Californian who became a symbol of the anti-smoking movement for her powerful role in advocacy and education, died last week. She was 62.

Austin, of Canoga Park, is perhaps best known for her role in a public-awareness television ad in the mid-1990s and later spots she filmed after being diagnosed with cancer of the larynx and receiving a laryngectomy.

"They say nicotine isn't addictive," Austin says in one ad, taking a drag of her smoke. "How can they say that?"

Her raspy voice, poised demeanor in the face of adversity, and dark hole in her throat are unforgettable.

In recent years, Austin continued filming advertisements for anti-smoking groups and died Friday after a two-decade bout with cancer, according to a statement from her family.

"True to Debi's spirit, she was a fighter to the end and leaves a big hole in our hearts and lives. Debi will be remembered fondly by who those who love her to be caring, courageous, very funny and always there to offer advice or lend a hand," according to the statement from the family provided by Allison+Partners.

"She was passionate and outspoken about what she believed in and deeply touched all who knew her or heard her story."

Downtown L.A. TB outbreak: LAPD urges officers to wear masks

Los Angeles police over the weekend warned officers who patrol the skid row area to wear protective masks and minimize face-to-face contact with suspects or the public if there is reason to believe that they are infected with tuberculosis.

The warning, contained in an internal communication to officers and employees in the department's Central Division, comes after The Times reported that public health officials have launched a new, coordinated effort to contain what they are calling the largest TB outbreak in a decade.

The Centers for Disease Control and Prevention have dispatched scientists to Los Angeles to help local health officials gain a better understanding why TB is spreading and strategies on how to stop it.

Public health officials are searching for more than 4,500 people who may have been exposed to the disease. In all, nearly 80 tuberculosis cases have been identified and 11 people have died since 2007, most of them homeless people who live in and around skid row.

Scientists have recently linked the outbreak to a tuberculosis strain that is unique to Los Angeles, with a few isolated cases outside the area.

Tuberculosis is easily passed along. It is contracted by inhaling droplets from infected patients when they sneeze, cough or laugh. When left untreated, the disease can be deadly. The skid row strain can be treated by all anti-TB medications. Treatment lasts six to nine months. 

LAPD officers who patrol the area have long been warned to be on the lookout for people on the street who exhibit symptoms of communicable diseases which include Hepatitis to HIV and staph infections to drug-resistant TB. Officers must also contend with individuals who have parasitic conditions like scabies and lice.

L.A. Now Live: Tuberculosis outbreak on L.A.'s skid row

Times staff writer Anna Gorman will join L.A. Now Live at 9 a.m. on Friday to discuss what public health officials are calling the largest tuberculosis outbreak in a decade in Los Angeles.

Officials say 11 have died since 2007. Sixty of the 78 cases were among homeless people who live on and around skid row.

Scientists have recently linked the outbreak to a tuberculosis strain that is unique to Los Angeles, with a few isolated cases outside the area.

"This is the largest outbreak in a decade," said Jonathan Fielding, director of the Los Angeles County Department of Public Health. "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. Local and federal officials are particularly concerned because the cases are linked to one relatively small geographic area and one vulnerable population. But officials are concerned that the outbreak could spread beyond skid row if action isn't taken.

Tuberculosis outbreak: Health workers ID 4,650 at risk in L.A.

Health workers have identified about 4,650 people who were probably exposed to a persistent outbreak of tuberculosis on downtown Los Angeles' skid row and are trying to track them down for testing and treatment.

The Centers for Disease Control has dispatched scientists to Los Angeles to help local health officials determine why the disease is spreading and how to stop it.

Officials say 11 have died since 2007. Sixty of the 78 cases were among homeless people who live on and around skid row.

Scientists have recently linked the outbreak to a tuberculosis strain that is unique to Los Angeles, with a few isolated cases outside the area.

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

Local and federal officials are particularly concerned because the cases are linked to one relatively small geographic area and one vulnerable population. But officials are concerned that the outbreak could spread beyond skid row if action isn't taken.

The public health department issued an alert several weeks ago to doctors at emergency rooms, clinics and urgent-care centers informing them about the investigation within the homeless community.

Most of the patients are men and about 20% are also HIV-positive, according to the alert, which was obtained by The Times. Six of the eight patients who also had HIV have died.

The health department also issued new guidelines for shelters earlier this year on how to effectively screen and identify patients at risk of tuberculosis. The guidelines urge shelters to appoint a TB liaison and to create a "cough alert" log for tracking patients with persistent coughs.

The county also recommended that shelters determine if incoming clients have been screened and refer those who haven't been to health providers.

The county suggests that all employees and volunteers also be screened for TB because they are also at risk.

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No disease-causing bacteria in water at hotel where body was found

No traces of disease-causing bacteria were found in the water supply of a downtown L.A. hotel where authorities discovered the body of a Canadian tourist inside a rooftop water tank this week, health officials said Thursday.

A do-not-drink order implemented Tuesday was expected to be in place through the weekend until the L.A. County Department of Public Health determines that the water is suitable for drinking purposes, said Angelo Bellomo, director of environmental health.

Authorities discovered the body of Elisa Lam, a 21-year-old tourist from Vancouver, Canada, inside a water tank on the hotel's roof Tuesday. A maintenance worker found the body after receiving complaints from Cecil residents about low water pressure.

An autopsy was completed Thursday, but Lam’s cause of death will be deferred pending toxicology tests, coroner's officials said. The results could take six to eight weeks.

Health officials tested for disease-causing coliforms at points inside the 15-story Cecil Hotel.

“The tests came back negative, meaning that if they were in the water they are no longer viable,” Bellomo said. “They could’ve been in there, but they’re no longer viable, meaning they’re dead.”

Bacteria, in particular from fecal matter, could have put resident’s health at risk, Bellomo said. But he suspects the chlorine inside the water probably killed the bacteria, which normally lives inside humans.

The Cecil Hotel is expected to drain and flush its tanks and water lines before sanitizing them, a process that could take two to three days. At that point, the Department of Public Health is to conduct another series of tests before deeming the water safe to drink.

About a dozen residents refused to leave the building and are being provided with bottled water, Bellomo said. About 50 residents were staying at the hotel when the body was found; most of them were moved to the Historic Mayfair Hotel in downtown L.A.

The only appropriate use of the Hotel Cecil's water supply was to flush the toilet, Bellomo said.

The remaining residents, many of whom have lived at the Cecil for years, are required to sign a waiver every time they enter the hotel. Cecil employees declined to provide a copy of the waiver to The Times. Repeated calls were not returned.

A steady stream of water gushed from a pipe on the street in front of the Cecil on Thursday afternoon. The entrance to the lobby was flooded, with a bucket and towels sitting on the floor to catch the water.

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Photo: Emergency personnel gather Tuesday on the roof of the Hotel Cecil on Main Street. Credit: Jay L. Clendenin / Los Angeles Times

Tuberculosis outbreak in downtown L.A. sparks federal effort

Public health officials have launched a new, coordinated effort to contain a persistent outbreak of tuberculosis in downtown L.A.’s skid row, including searching for more than 4,500 people who may have been exposed to the disease.

The Centers for Disease Control and Prevention have dispatched scientists to Los Angeles to help local health officials figure out why the disease is spreading and how to stop it.

Nearly 80 tuberculosis cases have been identified and 11 people have died since 2007, most of them homeless people who live in and around skid row.

Scientists have recently linked the outbreak to one tuberculosis strain that is unique to Los Angeles, with a few isolated cases outside the area.

“This is the largest outbreak in a decade,” said Jonathan Fielding, director of the Los Angeles County Department of Public Health. “We are really putting all of our resources into this.”

Health workers have identified about 4,650 people who probably were exposed and are trying to track them down for testing and treatment. Local and federal officials are particularly concerned because the cases are all linked to one relatively small geographic area and one vulnerable population. Officials are worried the outbreak could spread beyond skid row if action isn’t taken.

Homeless people are especially at risk of getting tuberculosis and of being undiagnosed because they tend to have poor hygiene and nutrition, limited access to healthcare and ongoing contact with infected people. Transmission of the airborne disease is also common because they tend to live in overcrowded areas and to continually move among hospitals, shelters and the streets. Many homeless people also have substance abuse or mental health issues that can impede treatment.

“They go from place to place and the likelihood of passing it along is much greater,” said Paul Gregerson, chief medical officer of the JWCH Institute, which runs a homeless healthcare program on skid row. “It makes everybody more susceptible.”

Tuberculosis is easily passed along. It is contracted by inhaling droplets from infected patients when they sneeze, cough or laugh. When left untreated, the disease can be deadly. The skid row strain can be treated by all anti-TB medications. Treatment lasts six to nine months.

Doctor gets 6 months in jail for fondling unconscious patients

An Orange County anesthesiologist convicted of sexually assaulting three unconscious female patients  has been sentenced to six months in jail and five years probation, despite the objections of prosecutors who wanted state prison time.

Yashwant Balgiri Giri, 60, pleaded guilty to a court offer to multiple felony counts related to the sexual battery of patients, including a 16-year-old, according to a statement from the Orange County district attorney's office.

Giri will have to register as a lifetime sex offender and will have his medical license revoked, in addition to the jail time and probation.

Prosecutors sought a state prison sentence, citing a violation of his "position of power and trust" with the women at a particularly vulnerable time.

Giri, who lives in Cypress, was working at Placentia-Linda Hospital at the time of the crimes, prosecutors said. He previously worked at several hospitals in Anaheim and Lakewood.

Through a spokeswoman, Placentia-Linda Hospital declined to comment.

Prosecutors said that in February 2009,  while a 16-year-old was unconscious from medication, Giri assaulted the girl when a scrub nurse preparing surgery tools had her back turned. The nurse witnessed the assault, prosecutors said, and reported it immediately to a hospital official.

Prosecutors allege that the hospital did not report the incident to police at the time.

In March 2011, prosecutors said, a hospital employee witnessed Giri fondling the breasts of a 36-year-old woman while she was under anesthesia for an outpatient surgery procedure.

An employee allegedly witnessed the incident  Prosecutors said the fondling continued for an extended period of time, as his actions were concealed from the surgeon and nurse.

County faces transit, healthcare issues, Yaroslavsky says

Los Angeles County Supervisor Zev Yaroslavsky, who is preparing to return to private life after nearly four decades in public office, offered some thoughts on the direction of the county and the city of Los Angeles at a lunch forum Wednesday.

Yaroslavsky cited expanding the county's public transportation system and adjusting its healthcare system to implement the Affordable Care Act as two priorities before he terms out in 2014.

With the impending implementation of healthcare reform, the county will be forced to court newly insured patients who previously relied on the county's four hospitals. Yaroslavsky said it is critical that the county gets it right.

"Our challenge is to convert our county culture from one where we didn't have to be nice to people, or we didn't have to compete with Kaiser or the next guy," he said.

He praised outgoing Los Angeles Mayor Antonio Villaraigosa's efforts to accelerate the expansion of the region's public transportation system, but had harsh words about the city's budget issues.