Concerned with the rising numbers of measles cases among Latinos, county Department of Health Services officials say poverty, the fear of deportation and ignorance are responsible for the failure of many Latinos to seek vaccinations against the disease.
For the first four months of the year, 2,236 measles cases were reported in Los Angeles County--almost five times higher than the number reported during the same period last year. At least six people have died in the county this year as a result of the outbreak.
Latinos, who account for about 35% of the county's population, make up 65% of the measles cases so far this year.
Health department officials have mounted an information campaign and extended the hours at 23 health-care facilities in hopes of getting the word out to those at risk that the chance of acquiring the disease can be greatly lowered with proper vaccinations.
"Too many people are seeking help only after they get the disease," said Dr. Shirley L. Fannin, the county's associate director of disease control programs for public health. "We are using all our resources to put a feeling of urgency in everyone's mind. People need to come in (to get vaccinated). It can be a matter of life or death."
Sixty-two percent of reported cases in Los Angeles County have been children from 12 months to five years of age. Of those, 70% are Latinos. A recent study by the health department found that at least one-third of Latino children living in Los Angeles County have not received the measles vaccine.
The reason for this, Fannin said, is many parents, especially those who are poor, stop seeking health care for their children after the age of 6 months, and the children never get the measles vaccine, which is usually administered after age 1.
"Poor people have to worry about keeping a roof over their heads and putting food on their tables. The vaccination for a possible problem comes second," said Fannin.
The challenge facing the health department, Fannin conceded, is informing people that help is available. The department's efforts include the placement of bilingual billboards throughout the county and distribution of bilingual information flyers.
Also part of the effort are 12 newly hired community outreach workers, all fluent in English and Spanish.
"Very, very many people have died of something that is preventable," said Dr. Stephen Waterman, chief of the health department's communicable disease control unit. "We're trying to reach them and tell them there's a way to avoid the disease."
But simply telling Latinos about the need for vaccinations is not enough, said Dr. Aliza Lifshitz, who has been working closely with health department officials in trying to reach the Latino community. Latinos, many of them illegal immigrants, must be assured that they will not run the risk of deportation if they go in for the vaccine, she said.
"People positively, absolutely will not be deported," said Lifshitz, a private practitioner and health reporter for Spanish-language television. "The county health centers don't even need to see any ID or immigration papers. All they need is your immunization records, if you have them."
Also a problem for many Latinos is a lack of knowledge about the disease itself.
"Some Hispanics think that it's OK for everyone to get measles in childhood," Fannin said. "Others simply don't understand how serious the disease is. I cannot stress to them enough the importance of getting vaccinated."
Measles, also known as red measles, is very contagious. The viral disease usually starts with coughing and a high fever. The disease and the severe rash it produces usually disappear after five days.
Complications can include dehydration, diarrhea, pneumonia, vomiting and inflammation of the brain. If not diagnosed and treated, complications can lead to death.
To prevent the disease, a first dose of measles vaccine is recommended for children at 12 months and a second dose at four to six years. Adults born in 1957 or later who have not been vaccinated and not had measles should also be immunized.
Some of the health department clinics in Los Angeles County have extended their hours to provide free vaccinations. For example, the Edward R. Roybal Comprehensive Health Center in East Los Angeles offers free vaccinations until 8:30 p.m. on Thursdays. About 20 people are vaccinated there every day, said Jorginna Rios, a nurse supervisor.
The measles outbreak has occurred throughout Southern California. In Orange County, 141 cases of measles have been reported and there have been at least two deaths so far this year. Temporary vaccination clinics have been set up to help meet the demand and provide free vaccinations.
* Los Angeles and Orange County public health clinics are offering free vaccinations, called MMR. Each three-in-one injection is meant to protect against measles, mumps and rubella, which is also known as German measles. See your family physician. Or for information on the clinic nearest to your home, call (213) 250-8055 in Los Angeles County or (714) 834-8444 in Orange County.