Bolster AIDS Programs, Health Staff, County Told

An aggressive education program and a bigger staff for the county Department of Public Health are needed to help stem the spread of acquired immune deficiency syndrome in San Diego County, county officials and private physicians said Tuesday.

AIDS cases have doubled each year and have crippled the department’s ability to respond to other infectious diseases, Dr. Donald Ramras, the county’s health officer, told the county Board of Supervisors.

Should the county be hit by an outbreak of measles, for instance, Ramras said he would have to choose between fighting that disease and continuing the battle against AIDS.

“We may be lucky and not have (that) problem,” Ramras said. “But I don’t like to rely on luck.”

Ramras proposed hiring an epidemiologist, two investigators of communicable diseases, and one public health microbiologist to help combat the spread of AIDS, which has infected 154 county residents. Ramras also proposed adding two mental health consultants to counsel people with AIDS and AIDS-related complex, a condition that often leads to the disease.

But Ramras and others said a more effective education program is needed to prevent AIDS from spreading among people who are most at risk: homosexual men, intravenous drug users and recipients of infected blood products.

Dr. Brad Truax, who has treated many AIDS victims, said those who are likely to contract the disease need to recognize their risk, while those who are safe need to be reassured. Truax said most people are aware of AIDS but few understand it.

“Awareness without knowledge leads to a fear, and the fear leads to a lot of inappropriate public and private action,” Truax said. “Our emphasis must be on practical education that can be received and have a chance of getting through.”

County supervisors will consider specific actions on AIDS at a meeting next week.

Among the proposals the board will consider:

- Formation of a county task force on AIDS, possibly to replace a similar group sponsored by the City of San Diego.

- Establishment of an AIDS medical committee to include doctors who treat AIDS patients and physicians conducting research on the disease.

- Investigation of ways to quarantine people who have AIDS, or carry the AIDS virus, but refuse to heed precautions to prevent spread of the disease. Any quarantine would be difficult to enforce, Ramras said.

- Support changes in state law that would enable heath officials to order tests for persons suspected of spreading the AIDS virus to others. Ramras said such a power would be used in cases where nurses accidentally stick themselves with a needle that has been used on a suspected AIDS victim, or when police or rescue workers come in close contact with someone thought to have carried the virus.