Efforts to Contain Infection Criticized

The county’s failure to halt the spread of a painful skin infection among jail inmates prompted the Los Angeles County Board of Supervisors on Tuesday to criticize the Sheriff’s Department and county health officials.

Although inmates with infections caused by drug-resistant Staphylococcus aureus, or staph, have been found in all eight of the county’s jails since last June, Sheriff’s Department and public health officials delivered an update Tuesday indicating a slight drop in new cases.

In April, there were 105 confirmed new staph infections, down from 133 in March, according to a report by the Department of Health Services. There have been 358 new cases reported in the jails so far this year.

Staph infections, which cause painful boils and skin abscesses, are spread by skin-to-skin contact or shared personal items. The bacterium that causes the infections has gained a foothold in the jail system’s crowded, and sometimes unsanitary, conditions, officials say.

Sheriff’s Cmdr. Richard Barrantes outlined the department’s latest efforts to stem the spread of infections, including better screening of new inmates, improved treatment and cleaning of wounds, and informational videos, posters and fliers available to jail inmates and staff.

Public Health Director Dr. Jonathan Fielding said he has asked county attorneys for an opinion on whether inmates who refuse to bathe could be forced to shower if a public health emergency were declared.

But two supervisors who last month pressed for more aggressive action against staph infections said they were disappointed in the report and with some tactics used to contain the outbreak.

“This poster about ‘Let’s take a shower every day and be healthy’ is to me not a very convincing approach to containment,” said Supervisor Gloria Molina. “With all due respect, the [people in jail] don’t know how to follow rules in the first place.”

After Barrantes said that most inmates have 24-hour access to phones and showers, Supervisor Yvonne Brathwaite Burke said he appeared to contradict a Sheriff’s Department official who last month told the supervisors that some inmates were using time allotted for showers to make phone calls.

“It’s very difficult for us to approach [the problem] when we get different information,” Burke said.

A county epidemiologist said poor inmate hygiene was only part of the problem, since in 2002 about 9% of the 928 inmates who tested positive for staph were probably infected before they were jailed.

“From an epidemiology point of view, even in dorm areas where they have 24-hour access to showers, we are still seeing a significant number” of cases, said Dr. Elizabeth Bancroft.