Pasadena Public Health Department Reports on Its Constant Vigil for Disease

Department’s top officer reports disturbing trend—rise in flea-borne typhus in Pasadena

Published : Tuesday, November 6, 2018 | 6:39 AM

Dr. Ying-Ying Goh, Pasadena's Health Officer

When there is an Ebola outbreak in the Congo, the Pasadena Public Health Department knows about it. The same for a measles outbreak at Disneyland, or the threat of a Zika virus case, or your basic flu season.

The department’s Health Officer, Dr. Ying-Ying Goh, reported to the Public Safety Committee Monday that those illnesses are only some of the “emerging organisms” that the Pasadena Health Department is currently dealing with.

Goh told the  Public Safety Committee in her presentation that, in her position, she is authorized to “take measures as may be necessary” to prevent and control the spread of disease within city limits.

And that would include everything from Malaria and Colorado Tick Fever, to Leprosy and Lyme disease, and from Measles to the Plague, and yes, Ebola.

Goh noted a troubling trend in Pasadena over the last five years—a 13% increase in flea-borne Typhus Fever since 2013.

According to Goh, all local health care providers must report all suspected and confirmed cases of diseases listed on the Pasadena Health Department’s “Reportable Diseases and Conditions List,” which lists more than a hundred chronic, and in some cases, communicable diseases.

The reporting timeline varies by disease, said Goh, but includes sexually transmitted infections, foodborne illnesses , such as  Salmonella, or E.coli; vector-borne diseases such as West Nile or rabies; and “outbreaks of any type.”

When any of the listed diseases or illnesses is encountered, the Department will interpret laboratory tests, utilize clinical history, contact cases by phone, mail, or in person; contact doctors, employers, and family members, as needed; contact other jurisdictions and health departments, as needed; and conduct investigations to “interrupt” the  disease transmission, according to Goh’s report.

Flea-borne Typhus is caused by a bacteria called Rickettsia typhi, said Goh, and  is spread to people through contact with Xenopsylla cheopis, or infected rat fleas  carried by cats, opossums, and rats. It is not spread person-to-person, she said.

The condition can cause symptoms within two weeks, including fever, headache, muscle pain, nausea/vomiting, cough, rash

Goh also explained to the committee that the disease can be treated effectively with antibiotics, and most people will recover without treatment, although “some cases may be severe.” Severe illness can cause damage to one or more organs including the liver, kidneys, heart, lungs, and brain.

In 2013, there were three incidences of flea-borne Typhus, with 108 in California. In 2018, however, there were 20 cases of the disease with 99 total in the state, an increase of 13.8 percent.

Goh told the Committee that Pasadena’s Health Department is not sure what specifically is causing the local outbreaks, but suggested that it was some type of exposure to pets or animals.

Goh recommended that residents should routinely use flea control products on pets. In addition, said Goh, where possible, residents should:

  • Keep pets indoors

  • Use EPA-labelled insect repellent for use against fleas

  • Avoid being near wild or stray animals

  • Not feed wildlife

  • Not leave pet food outdoors

  • Keep garbage containers tightly covered

  • Maintain yards free of debris and overgrown vegetation

  • Seal all openings and crawl spaces under the home

Meanwhile, said the report, the Pasadena Health Department is currently making routine surveillance of typhus cases and conducting case investigations by public health nurses.

The report also noted that “Additional steps [would be] taken if geographic clusters are identified.”

The Department, reported Goh,  is also providing public education and healthcare provider guidance and is involved in an ongoing collaboration with the San Gabriel Valley Mosquito & Vector Control District,  and other California jurisdictions statewide.

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