The Scourge of Skid Row

A staph infection threatens the lives of cops, firefighters and homeless people. But don’t expect any help from county health officials

Comments (0) By Christine Pelisek Wednesday, Oct 18 2006

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Bancroft says the county just doesn’t have the money to monitor the cases, because they are so widespread in L.A. County. “The most important thing is for them to get housing,” she says. “Right now, there are no plans to do surveillance studies in Skid Row . . . If we do a study on Skid Row, we have to give something else up that we are currently doing, and the health department leaders have decided, at this time, that there are other, more pressing priorities.”

Dena Carreyn is a deputy city attorney assigned to downtown L.A., including Skid Row, as part of a neighborhood prosecution program. In November 2004, the 32-year-old Carreyn hugged a homeless woman who had just found permanent housing. The woman had open sores on her arms, and within four days Carreyn noticed what she thought was an ingrown hair or spider bite on the back of her neck. Her doctor told her it was a spider bite and put her on antibiotics. The infection didn’t go away. She went back to the doctor, who prescribed another medication. By February, abscesses had formed under her arm, groin and toe. Her neck wound grew to the size of a tennis ball. A culture sample revealed Skid Row staph. She was immediately admitted to the hospital, where she had vancomycin, the highly potent antibiotic, directly pumped into her chest. It took her five months to get workers’-compensation benefits, which were initially denied, because the city didn’t consider her infection a work-related injury.

A medium-sized abdominal abscess with cellulitis in a 40-year-old IV drug user.

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“Nobody from the CDC or the health department told us in law enforcement that there was an outbreak,” she says. “It made me rethink my job and the dangers that I am in down here. You don’t think you would be exposed to infectious bacteria that could kill you. It never crossed my mind.”

In May 2005, Carreyn participated in a roundtable discussion on Skid Row staph, convened at Parker Center, with law enforcement, health-care advocates and the county health department.

“The county officers infuriated me about their attitude that you can get it anywhere,” says Carreyn. “They basically told me I was a liar. They were totally downplaying what happened to me, and that it is an easily treatable infection and just wash your hands and you will be fine. There were people who knew it was a nasty infection, and the health department was making it out not to be a big deal.”

Carreyn believes the health department should do more than expect homeless people, some of whom suffer from mental illness, to seek help at walk-in clinics. Even worse is forcing jail officials to deal with the cases that begin on Skid Row. “To rely on the jail as their only resource of medical attention is irresponsible,” she says.

Four months later, 20 firefighters contracted Skid Row staph in one month. Instead of sending them home to heal, the city told the firefighters to report to duty. The firefighters union went to the City Council and argued that the city was putting the community at risk by keeping them on duty. Firefighters were also having their workers’-compensation claims rejected.

In October, the city’s personnel department recommended that Skid Row–staph training be part of the fire department’s protocol, but downplayed the threat. The department insisted that it was hard to tell where firefighters and officers contracted the infections, blaming them on “random outbreaks from unknown sources.” The report concluded: “We are confident that [Skid Row staph] does not currently represent a significant occupational risk factor for city employees.”

This theory, which was also echoed by county health officials, angered firefighters who believe the city was reluctant to admit that the infection is work related because they didn’t want to be saddled with costly workers’-compensation claims.

“We are like, ‘Are you kidding me?’ says Dave Pimentle, director of United Firefighters of Los Angeles. “Don’t tell us we are getting it from library books. You don’t need a rocket scientist to put two and two together. The public needs to understand and recognize it. These things can get pretty big quickly.”

Two recent cases show how workers who contract the infection have run into a dead end when they try to put responsibility on their employer.

. Herman Tibbs, a county repairman, claimed that he contracted Skid Row staph after he dropped a metal stair on his foot while fixing an escalator at Men’s Central Jail in June 2002. A few days later, Tibbs’ foot began to hurt and swell. He went to the hospital the following week and was treated for an infection. When the infection failed to respond to the antibiotic regimen, a culture test found it to be Skid Row staph. He was off work for several months. The lawsuit claimed that the county had an outbreak at the jail at the time and was negligent in failing to warn him. The county argued that it was immune from liability. The jury returned a verdict in 2005 that the jail facility was not in a dangerous condition at the time of the incident.