County public health officials are taking a broader approach in tackling the typhus epidemic after multiple cases were discovered last week in Pasadena, Long Beach and Los Angeles.

The county Board of Supervisors asked Department of Public Health executive director Barbara Ferrer to work with the municipal health agencies in Long Beach and Pasadena to widen the scope of identifying and treating the disease. The supervisors also laid the groundwork for a pilot program of prevention and response for homeless populations on Oct. 16.

Approximately 65 cases of typhus have been reported in the county thus far. Public health officials now are looking at homeless encampments as necessary locations for an expansion of typhus prevention outreach, as the homeless population often finds it challenging to access hygiene facilities. Last year there were 47 confirmed cases of typhus.

Murine typhus is spread to people through contact with infected fleas, according to the Centers for Disease Control. People become ill with murine typhus when infected flea feces come into contact with abrasions or cuts in the skin. Rats, feral cats and opossums are the prime carriers of typhus.

The supervisors also requested county Animal Control to work with public health representatives in Long Beach and Pasadena to help homeless people who have pets get flea collars and possibly vaccines.

“Although typhus normally occurs throughout L.A. County, we are observing several cases in the downtown Los Angeles area,” Los Angeles County health officer Dr. Muntu Davis said in a statement. “We encourage pet owners to practice safe flea control and encourage all cities in the county to ensure maintenance of their trash clean-up and rodent control activities.”

Ferrer gave the supervisors a primer in how typhus is spread at their Oct. 16 meeting, calling the disease a “countywide endemic.”

“Typhus is a disease that occurs each year in Los Angeles County. What was unusual this year was the discovery of a clustering of 11 cases in downtown Los Angeles,” Ferrer told the board. “It cannot be transmitted person to person. In general, typhus cases primarily show up in the summer and the fall.”

Not all typhus cases have been found among the homeless. Pasadena Health Department Environmental Health Division manager specialist Rachel Janbek said 20 Pasadena residents have been diagnosed this year.

“All of these cases have been among housed people,” Janbek said.

As they did during a local outbreak of hepatitis A last year, the supervisors are calling for more mobile hand-washing stations and mobile restrooms near encampments as part of the pilot program.

“When I drive through some cities in my district, it looks like a Third World country,” said Supervisor Kathryn Barger, whose Fifth District includes parts of the San Gabriel and San Fernando valleys; she is a sponsor of the pilot program motion. “We’re trying to find a compassionate but effective way to approach this issue.

“It is simply inhumane to stand by while people are living in dangerous conditions,” Barger continued. “While efforts to address the typhus outbreak are underway, there is a need for a strategic public health solution to this component of the homelessness crisis.

“Disease does not know any boundaries.”

“If people need another reason to get inspired to get our homeless off the street, here’s another one,” added Fourth District Supervisor Janice Hahn, the motion’s co-sponsor.

A representative from the Long Beach Bureau of Environmental Health said confirmed cases in Long Beach this year had doubled the previous year’s numbers. “The 13 cases are the highest year-to-date number that we’ve had since 2013, and they’re mostly in residential neighborhoods,” he said.

Typhus is a treatable disease, according to the CDC, but left untreated, severe illness can cause damage to one or more organs including the liver, kidneys, heart, lungs and brain.

LA Weekly