Public Health

Some restaurant ABCs are MIA

As neighborhood cafes go, Julienne would seem to have it all—a charming setting in upscale San Marino with hordes of loyal patrons who throng the sidewalk waiting for a table at breakfast or lunch.

Julienne also has one of L.A. County’s most important food preparation status symbols: an “A” from the public health department. But you wouldn’t know it by looking in the café’s window.

Letter grades—displayed in restaurants and markets throughout Los Angeles County and soon to be posted on food trucks—are nowhere to be seen in San Marino. The same goes for Avalon, La Habra Heights, Sierra Madre and Signal Hill.

For Terrance Powell, those cities are the ones that got away.

Since the restaurant ordinance went into effect in 1998, Powell has been the public health department’s man on the front lines of getting municipalities within the county to adopt the law. Over the years, virtually every city with food-serving businesses has gotten onboard (with the exception of Pasadena, Long Beach and Vernon, which have their own health departments to inspect restaurants and don’t issue letter grades.)

That leaves the five holdouts, with about 160 eateries among them, including the lone food-serving establishment in La Habra Heights—the Hacienda Golf Club. Together, the five cities’ restaurants and markets represent a tiny fraction of the 40,097 establishments across the county that currently post letter grades.

Powell, a top official in the public health department’s environmental health division, said his persuasion initiative “simply stopped when we got to 99%.”

Restaurants in cities that haven’t adopted the ordinance still are required to be inspected by the county, and their grades are posted online. But no letter grades are displayed at the establishments—even if individual restaurateurs would like to do so—unless their city councils have adopted the county ordinance.

Explaining why San Marino hasn’t joined the crowd, Mayor Dennis Kneier said he’s not sure the measure is right for his city.

“Things are working fine the way they are,” Kneier said. He’s been on the council just 3 1/2 years, so he’s not sure why the county’s restaurant ordinance wasn’t adopted by his city in the early years.

But his personal opinion is that the letter signs would be “another ugly distracting thing sitting in a window. To me, it’s no class.”

While he said he doesn’t have any strong opinions on the issue one way or the other, he said he was “not going to be a champion” of bringing the matter before the San Marino City Council.

“If it came before me,” he said, “I would give it due consideration.”

Some local officials seemed surprised to learn that their city’s eateries and markets are not among those posting grades.

“Oh gosh,” said Gary Jones, Signal Hill’s community development director. “In my mind’s eye, I’ve seen letters posted in Signal Hill. But have I really seen letters posted in Signal Hill? Maybe not.”

He said the current city council would likely be amenable to adopting the ordinance—along with the new one requiring letter grade posting for food trucks.

“I can’t imagine why they wouldn’t want to adopt it,” he said. “Everyone wants to know what they’re eating.”

Powell, a county veteran of 23 years, has done his share of presentations before local city councils—and expects to do more in the weeks and months ahead as outreach on the food truck posting ordinance begins.

He figures it’ll be an easier sell than when the restaurant ordinance first was introduced 12 years ago. He said there are several reasons for that: the program has proven to be extremely popular with the public, studies have found fewer reported hospitalizations for food-related illnesses since it took effect and surveys indicate that the posted grades are good for business (at least for the eateries that rank an “A.”)

But that wasn’t always the case. Beverly Hills lagged behind other cities in adopting the ordinance, as did Duarte. And South Pasadena initially adopted the ordinance but then decided to opt out; the city since has opted in again.

As for the remaining holdouts? They’re welcome to join in any time, Powell said. “It’s an open invitation. The evidence is now overwhelming.”

And if they don’t, he believes the eating public deserves an explanation.

“If the public doesn’t see a grade,” he said, “they should ask their city if they’ve adopted it, and if not, why not?”

Posted 10/13/10

New on the mobile menu: letter grades [updated]

As Los Angeles County prepares for a new public health initiative to bring restaurant-style letter grades to the region’s growing food truck fleet,  it’s also setting its sights on the ubiquitous—and frequently renegade—pushcarts that peddle everything from fresh fruit to bacon-wrapped hotdogs.

A proposed ordinance scheduled for a vote by the Board of Supervisors next week initially would bring the letter grading process—including more frequent inspections and a requirement that the itinerant vendors provide the county with information on their routes—to an estimated 6,000 mobile food trucks. If the ordinance amending the county code is approved by supervisors, the grading system would be extended to some 3,500 food carts by July 1, 2011.

The move comes as Los Angeles’ mobile food scene continues to boom, with trucks now peddling everything from the traditional tacos and breakfast burritos to Korean BBQ, grilled cheese sandwiches and red velvet mocha whoopee pies.

Mobile food purveyors “are becoming more common, and also people are asking us: ‘What about these food carts?’ ” said Dr. Jonathan E. Fielding, the county’s director of Public Health. He said letter grades for food trucks and carts are an extension of the county’s12-year-old restaurant grading system, which he called “the signature program of this department.”

But as public health officials move to step up regulation of the legitimate mobile vendors, they’re also engaged in constant skirmishes with the outlaws, many operating from makeshift carts with jury-rigged cooking surfaces.

Terrance A. Powell, director of the public health department’s Bureau of Specialized Surveillance & Enforcement Environmental Health Division, said the county’s off-the-grid food scene is “extremely pervasive.”

He estimates there may be as many as 6,000 illegal vendors slinging hash (or, more likely, hotdogs or fruit) from carts or other mobile venues in the county.

They’re active enough to keep four or five flatbed trucks busy in regular raids that yield enough confiscated carts and the occasional rogue catering truck to fill a department warehouse. (A second warehouse in northern Los Angeles County would be helpful in keeping up with the illicit equipment overload, Powell said.)

He said the outlaw operators range from people “selling tamales out of trucks” to those who set up a “full-fledged restaurant after dark in the parking lot.”

The public health department’s raids, undertaken in conjunction with local law enforcement officials, take place at least weekly, usually after dark, in response to public complaints of illegal vending. When confronted, the operators often disappear into the night.

“A lot of times they’ll simply walk off and abandon everything,” Powell said. “Many times the operators intentionally don’t have any identification.”

The proposed letter-grading ordinance has the support of most law-abiding food truck vendors, Powell said. Many of them have gone to great lengths to follow the county’s rules, which include obtaining public health department certification and operating out of officially-approved commissaries where they can dispose of wastewater and properly clean their vehicles

“I think, in general, everybody bought into it,” Powell said. “Having the grade on the vehicles is an easy identifier for the public to discern which are legal and which are illegal,” he said.

Vendor fees paid to the county—which range from $695 a year for a full-fledged catering truck to $301 for a simple pushcart selling prepackaged items—would not initially change under the new county ordinance, but could be raised later if cost analysis studies show an increase is warranted to cover the cost of the program. Health officials said they may be carrying out more inspections under the new system because they’ll be able to more easily locate the roving food-sellers, who would now be required to report their routes to the county. Like the restaurant-grading system, the new measure also would need approval by individual cities within the county.

Molly Taylor, whose Sweets Truck offers an array of upscale goodies to customers around town, said she supports the proposed grading system.

“I think a letter grade is great. My truck is cleaned every day from top to bottom,” Taylor said. She admits to some trepidation about new layers of bureaucracy coming not just from the county but from the city of Los Angeles, where new regulations also are being considered. But “hopefully, it will be for the greater good,” she said.

So popular is the food truck boom that some brick-and-mortar eateries are getting in on the act as well. And there, too, operators see the upside of doing business by the letters.

Bonnie Bloomgarden, who runs the Canter’s Truck, a mobile offshoot of the famed Fairfax Avenue deli, said the grades could be a helpful development in public education about the food-on-the-go industry.

“I think a lot of people still don’t understand that trucks have the same standards as a restaurant,” Bloomgarden said. “We pay rent, we pay taxes, we get inspected all the time. This is a way for people to know that our standards are high.”

Posted 9/14/10

Updated 10/12/10: The dining public is about to find out which local food trucks make the grade—literally.

The Los Angeles County Board of Supervisors today voted to extend the county’s successful and highly popular restaurant-grading system to mobile food vendors. The new ordinance amending the county code will apply first to 6,000 or so food trucks, and eventually will cover some 3,500 food carts, too.

For the new food truck ordinance to take hold countywide, local cities will need to sign on as well. Widespread participation is expected from the cities, which have overwhelmingly passed ordinances adopting the restaurant-grading system.

Terrance A. Powell, director of the public health department’s Bureau of Specialized Surveillance & Enforcement, Environmental Health Division, said the new regulations mark a major cultural shift in the food world.

“I think there is a realization now that mobile vending is a viable part of food service,” he said in an interview after the supervisors’ vote. “You don’t hear people refer to them as ‘roach coaches’ anymore.”

If adopted by supervisors on a second reading next week, the food truck ordinance will take effect in 30 days.

Updated 10/7/10: Supervisors on Tuesday, October 12, are expected to vote on this revised ordinance to post letter grades on food trucks.

Got West Nile fears? Go fish

Dead birds, slimy abandoned swimming pools and bloody-thirsty mosquitoes might sound like plot elements from a B horror movie. But they’re all possible harbingers of a real-life hazard in our midst—the West Nile virus.

Fortunately, there’s a real-life weapon against the pesky insects, which can spread West Nile to humans after feeding on birds infected with the virus. That’s the mosquitofish, a.k.a. Gambusia affinis, which makes a meal out of mosquito larvae before they can grow up to make a meal out of us. Mosquitoes are more than just a backyard annoyance; in addition to West Nile, they can spread various strains of encephalitis and other diseases to humans.

And, because of the surge in home foreclosures in recent years, mosquitoes have found a new Southern California breeding ground—abandoned swimming pools. While the impact of these pools on the mosquito population can’t be quantified, “home foreclosures are definitely a factor,” said Crystal Brown, public information officer for the Greater Los Angeles County Vector Control District.

The fish are an effective, non-chemical way to keep mosquitoes from proliferating in garden ponds, animal drinking troughs and other standing water sources. Brown said that since 2005, more than 1,200 requests for the free fish have poured in to her district—one of five in the county. The fish should never be placed in natural habitats such as creeks and streams, or in drainage culverts that lead to waterways, however, because of harm they could cause to wildlife there. (Read up on the proper use of mosquitofish here.)

Overall, West Nile activity so far this year has been slower than last year, perhaps partly because of a cooler-than-usual summer.

But public health officials say this season’s first human case recently was confirmed in a Los Angeles County teenager, pointing up the need to be aware of the symptoms and vigilant about potential mosquito breeding grounds. The teenager, from the eastern part of the county, has recovered.

Most mosquitoes don’t carry the virus, and fewer than 1 in 150 people who are bitten by an infected mosquito go on to become seriously ill. But for those who do, “it isn’t a pleasant disease,” said Dr. David E. Dassey, deputy chief of Acute Communicable Disease Control for the public health department. “The problem comes in older individuals who have other chronic medical conditions.”

The vast majority of others experience only mild symptoms—which can include fever, headache, nausea, body aches and skin rashes—or none at all. They also come away with lifelong immunity to the virus.

To be on the safe side, Dr. Jonathan E. Fielding, the county’s director of Public Health, recommends using an insect repellant containing DEET when outside in mosquito-prone areas, particularly at dawn or dusk.

In addition, the county Public Health Department’s Environmental Health Bureau encourages anyone who spots a “green pool” to report it by calling (626) 430-5200. And because mosquitoes pick up the disease from infected birds, health officials are asking the public to promptly call the state’s “Dead Bird Hotline” if they spot a bird carcass. The number is (877) 968-2473. Reports also can be filed online.

The West Vector and Vector-Borne Disease Control District, covering the Third Supervisorial District, has a helpful website with questions and answers about West Nile,  along with useful links and phone numbers, including one for requesting those free mosquitofish. Call (310) 915-7370 for information on when and where to pick them up.

And keep in mind that this is strictly a BYOB operation—meaning bring your own bucket.

Posted 9/9/10

Double whammy of a food recall [updated]

Bad eggs and contaminated frozen fruit pulp have hit Los Angeles County—which means that a large serving of caution should now be added to your food-preparation menu.

County public health officials this week put out the word that consumers should avoid some batches of eggs from Wright County Egg in Iowa as well as Goya Brand frozen mamey pulp. (Also called sapote, the tropical fruit pulp is often used in smoothie-style beverages known as licuados )

Both are contaminated with strains of salmonella bacteria, which can cause an array of unpleasant and potentially fatal symptoms.

So far, 55 people have gotten sick from the eggs in the county, with more than 266 affected statewide. Two Los Angeles County residents, along with three others statewide, have been sickened by the fruit pulp. There have been no deaths associated with either of the recalls, which are unrelated.

Health officials said the eggs were sold under these brand names: Lucerne, Albertson, Mountain Dairy, Ralph’s, Boomsma’s, Sunshine, Hillandale, Trafficanda, Farm Fresh, Shoreland, Lund, Dutch Farms and Kemps.

“Eggs are packed in varying sizes of cartons (6-egg cartons, dozen egg cartons, 18-egg cartons) with Julian dates ranging from 136 to 225 and plant numbers 1026, 1413 and 1946,” according to the public health department’s news release. “Dates and codes can be found stamped on the end of the egg carton. The plant number begins with the letter P and then the number. The Julian date follows the plant number, for example: P-1946 223. Consumers are advised by Wright County Egg to return the eggs in the original carton to the store where they were purchased for a full refund.”

As for the recalled frozen mamey pulp, all lots numbered 041331090803 should be discarded. Customers should then contact Goya’s consumer affairs department, (800) 275-4692.

Posted 8/18/10

Updated 8/19/20: Public health officials announced an expansion of the egg recall, and said up to 60 people in the county have now been sickened.

Eggs from the expanded recall were packaged under the following brand names: Albertsons, Farm Fresh, James Farms, Glenview, Mountain Dairy, Ralphs, Boomsma, Lund, Kemps and Pacific Coast. “Eggs are packed in varying sizes of cartons (6-egg cartons, dozen egg cartons, 18-egg cartons, and loose eggs for institutional use and repackaging) with Julian dates ranging from 136 to 229 and plant numbers 1720 and 1942,” the public health department said. Officials urged consumers to check packages of eggs in their refrigerators to make sure they are not part of the recall.

For up-to-the-minute updates on the recall, which is national in scope, consult the U.S. Food and Drug Administration’s recall webpage.

The beat goes on—but with new rules

The Los Angeles Coliseum Commission on Friday sent a strong signal that it would like to remain in the rave business but only if promoters of the massive electronic dance events can control them more tightly to avert tragedies like last month’s apparent drug death of a 15-year-old girl.

The commission, which oversees the Los Angeles Memorial Coliseum and Sports Arena, approved 11 recommendations aimed at better protecting the health and safety of concertgoers during three upcoming festivals, or raves, scheduled for the Sports Arena between August and New Year’s Eve. On the advice of its lawyers, the commission is allowing those events to move forward because of contractual obligations.

The commissioners also voted to continue a moratorium on signing any new contracts with festival promoters until it can be determined whether the more restrictive rules—including an enforced age limit of 18—substantially reduce the kind of problems that marred last month’s Electric Daisy Carnival at the Coliseum.

The two-day event drew 185,000 people and ended with dozens of attendees being transported to area hospitals, many for overdoses related to the drug Ecstasy, apparently including teen Sasha Rodriguez, who later died.

Among the many speakers who appeared before commission on Friday was a representative of Rodriguez’s parents. In a statement, the couple urged the commission to “put our children’s health and safety ahead of profits.”

Los Angeles County Supervisor Zev Yaroslavsky, a commission member who first called for the moratorium after Rodriguez’s death, said he was unhappy that the panel was legally locked into the upcoming concerts. He also said he’s “very pessimistic that they can be done more safely.”

“But the next best thing is that we have a new set of rules and regulations that we can enforce,” said Yaroslavsky. He then bluntly warned promoters of the upcoming festivals that they’re “on probation”—in control not only of their business futures but of the lives of the young people who attend their events.

The new health and safety rules—endorsed by Electric Daisy Carnival’s promoter, Insomniac, Inc.—were contained in a preliminary report prepared by an outside law firm, Miller Barondess, headed by attorney Skip Miller. On Friday, after an hour-long closed session, he provided highlights of the 14-page report during the commission’s public meeting.

Among other things, Miller’s report provided a historical perspective of the underground roots of raves and their lucrative explosion into the mainstream, now packing major venues across the nation, including the Coliseum and Sports Arena. Since 1998, according to the report, those two venues have hosted 37 electronic music festivals, drawing an audience of more than 1 million people.

With that kind of draw, the festivals have become crucial to the economics of the Coliseum. Miller’s report disclosed, for example, that the historic stadium grosses approximately 28% of its revenue from such events as Electric Daisy Carnival, Monster Massive, Together As One and Love Festival.

What’s more, according to the report, the Coliseum hired more than 4,400 people to provide services in connection with the Electric Daisy Festival. Miller also noted that local businesses have profited as well from the event, which his report contends was exceptionally well planned—an observation supported by Los Angeles police and fire officials during testimony Friday.

LAPD Commander Andrew Smith, who was responsible for the department’s personnel within the Coliseum, said planning for the event was “every bit as thorough as for a Lakers’ parade.”

With so much money on the line, the Coliseum Commission has been placed in a difficult spot, caught between these financial realities and the need to assure the public that safety issues trump all else.

The sensitivity of that task was brought into stark relief during the hearing’s most dramatic moment, when Debbie Macaluso and her 19-year-old daughter, Aisha Marmer, took the microphone for their allotted 60 seconds of testimony.

Macaulso recounted how her daughter had overdosed on Ecstasy during last year’s Electric Daisy Carnival. She ended up on life support for two months and suffered four strokes, the mother said, her voice cracking. “It’s all about money, not the kids,” she said of the raves.

Aisha, who has been forced to undergo extensive speech therapy, said simply of the raves: “I just think it’s not a safe thing.”

Los Angeles City Councilman Bernard Parks, also a member of the Coliseum Commission, said the public should not be mislead into thinking that the new rules, which call for better health precautions and more drug education, are a cure-all for the problems plaguing raves.

“There are no perfect events,” said the former LAPD chief. “I don’t want to overplay what we can do.”

Posted 7/16/10

Get smart about whooping cough

If you’re the parent of an infant, the news coming out of Los Angeles County’s Department of Public Health these days might be frightening. Since the beginning of the year, three babies have died from pertussis, or whooping cough, with the most recent death disclosed on Tuesday.

In Los Angeles County this year, there already have been 289 possible cases of whooping cough, according to health officials, soaring past last year’s total of 156. Since 2004, more than 80% of whooping cough deaths have been in infants younger than three months.

But the good news is that there’s something you can do to protect yourself and your loved ones. Get vaccinated.

“It’s important for all kids to be up to date and particularly for adults who take care of infants,” said Michelle Parra, director of the Immunization Program for the public health department.  Because infants under the age of six months cannot be vaccinated, she said, they’re particularly vulnerable to whooping cough.

“If one message is to be heard, it’s that young babies who can’t be immunized are in need of protection and that’s why people around them need to be immunized,” Parra said. “We call it the cocooning effect. If you vaccinate everyone around the infant…then essentially you are protecting the infant.”

While the thought of getting a shot is never pleasant, catching whooping cough is much worse. “Your system is so distressed you cough to the point where you are convulsing and vomit,” Parra said.

“If you are an adult or an older person with a cough, you should not be around young babies,” she said. “You should go immediately to get a diagnosis because it might just seem like a regular cough. But if it’s whooping cough it’s a virus that can be very deadly for babies.”

According to Parra, pertussis is a cyclical illness. “It kind of comes in waves. The last peak was in 2005.”

The current outbreak, she said, has a connection of sorts to the rising number of mumps cases in recent months.

“We’re in a period where there’s an increase in parents who are choosing not to vaccinate their children, which leads to higher rates of disease regardless of what disease it is,” Parra said. “There are a lot of parents who have never seen the diseases. They have this perception that the disease doesn’t exist anymore and vaccines are no longer necessary.”

(For information from the county’s Department of Public Health on how to minimize pertussis risks and obtain vaccinations, click here.)

Posted 7/21/10

Task force on raves and Ecstasy created

The Los Angeles County Board of Supervisors on Tuesday ordered the creation of a multi-agency task force to attack what experts warn is a growing threat to the public health—the potentially deadly relationship between drugs and raves.

The board, voting on a motion by Supervisors Zev Yaroslavsky and Don Knabe, directed the departments of Health Services and Public Health to assemble a team that would recommend ways to make these huge all-night dance events safer and to educate young people and their parents about the dangers of Ecstasy, the so-called “party” drug that is widely known to fuel the raves.

“They need to know what the risks are and what the stakes are,” said Yaroslavsky, who last week called for a moratorium on raves at the Los Angeles Memorial Coliseum Commission, where a recent two-day event led to more than 120 people being rushed to emergency rooms, most for drug-related causes, including a 15-year-old girl who died from an apparent overdose. A special meeting of the Coliseum Commission, of which Yaroslavsky is a member, is scheduled for July 16.

Outside the meeting, Yaroslavsky emphasized that the mission of the new task force would not be limited to a single event but rather to addressing larger public health implications. “It’s about the whole issue,” he said, “about the epidemic of Ecstasy that we have in our society.”

The new task force would bring together representatives from hospitals, law enforcement agencies, local cities, community health providers and the concert promotion industry—a request made by a representative of Insomniac, Inc., which organized the Electric Daisy Carnival at the Coliseum and has remained largely silent about the chaos at the event.

“We hope that the task force, with input from a broad range of the community and stakeholders, including representatives from the musical events industry, will recreate responsible and reasonable recommendations which can be implemented for all musical events in the County,” Insomniac spokesman Simon Rust Lamb. Questioned after his testimony, Lamb and Insomniac’s public relations representative refused further comment.

Also appearing before the supervisors was the county’s public health director, Dr. Jonathan E. Fielding, who said he welcomed the opportunity to lead an effort aimed at tackling Ecstasy abuse at raves, which he called “a significant public health problem.”

Fielding said it is crucial that the public become educated about the unique and growing dangers Ecstasy and its use at raves, whether the events are held in public facilities like the Coliseum or in privately owned warehouses.

He said Ecstasy—methamphetamine combined with psychoactive drugs—can create severe strains on the body, including high blood pressure, elevated body temperature, a rapid heart rate and dehydration. He said that some users become so thirsty that they drink too much water, dangerously lowering their sodium levels, sometimes to fatal levels. He said that warning signs of excessive intoxication include vomiting, headaches, confusion and agitation.

In the early part of the decade, Fielding said, Ecstasy use declined but has started to climb again in recent years. Of drugs that are abused, he said, Ecstasy is “relatively small but increasingly consequential.”

Fielding said the task force might consider suggesting a number of safety measures to decrease Ecstasy health risks at raves, including having more breaks in the music to reduce the activity level and providing sports drinks that will not perilously lower sodium levels. Fielding also suggested that attendees never go alone so they have someone to help them should they fall ill.

As for the parents of younger teens, he offered this advice outside the hearing room: “I would tell them that they should not let their children go to raves. It’s not a place for kids.”

Posted 7/6/10

Before pot vote, consider health impact

With California voters set to decide in November whether to legalize marijuana, Los Angeles County’s top health officer has come up with an analysis of the drug’s effects.

Dr. Jonathan E. Fielding’s June 8 report to the Los Angeles County Board of Supervisors draws on an array of studies from authorities, including the American Medical Assn. to examine what marijuana does to the health of those who use it medically or recreationally.

“We really tried to be very objective,” said Fielding, the county’s director of public health. He said he was moved to create the report because of a shortage of comprehensive data on the subject.

“There’s a lot of mythology on all sides here,” he said in an interview. “Trying to understand what the science says is often a good first step.”

Fielding’s analysis does not come down on either side of the initiative, but includes statistics about how often marijuana use is a factor in some treatment and hospital settings.

One-third of those admitted to Los Angeles County substance abuse treatment facilities say that marijuana is their primary or secondary drug of choice, the report said. Nationwide, it contributed to 375,000 emergency room visits in 2008.

“Marijuana is a significant public health problem,” Fielding said.

Used medically, though, it may be effective in treating a few conditions, the report found. In addition to treating nerve pain, it also can help combat severe weight loss, alleviate some multiple sclerosis symptoms, fight chemotherapy-related nausea and vomiting and relieve eye pressure from glaucoma.

As for recreational use, Fielding’s report states that marijuana is consistently associated with difficulties in learning and remembering new information, along with lower test scores and decreased levels of academic achievement. Studies also have found that marijuana use correlates to increased consumption of other drugs. But it has not been “consistently associated with other measures of mental and psychological harm,” the report said.

The report, citing national surveys, says that more than 30% of people 18 and older who’ve used marijuana in the past year are classified as dependent on the drug. But that number is greatly reduced when actual “diagnostic criteria” for substance dependence are considered. Under that measure, between 4% and 9% of marijuana users are addicted. Overall, Fielding reported, marijuana users are “considerably less likely to [become dependent] than users of alcohol and nicotine, and withdrawal symptoms are less severe.” Still, younger users face higher risks, with 17% of those who’ve used the drug at age 13 becoming addicted.

Other findings:

• One recent clinical trial involving marijuana smokers had to be halted early when some participants started having suicidal thoughts.

• Marijuana’s association with psychosis is “somewhat controversial.” Although some recent studies suggest an increased psychosis risk associated with marijuana use, “marijuana accounts for only a small proportion of psychoses.”

• Smoking marijuana, like smoking tobacco, has been linked to lung damage and chronic bronchitis. Additional long-term studies are needed to determine whether marijuana smoking leads to an increased risk of lung cancer or other cancers of the oral cavity and airway.

The initiative to legalize, regulate and tax marijuana will appear on California’s November 2 ballot. It would allow people over 21 to grow and possess the drug and would permit local government to regulate and tax its sale. It would prohibit using marijuana in public or when minors are present, and would not allow its possession on school grounds,

Posted 6/22/10

On alert for mumps

Getting the mumps was once a childhood rite of passage. But it’s rare in modern-day Los Angeles County, where the vast majority of young children are vaccinated against it, along with measles and rubella.

So with nine cases so far this year—six confirmed and four of those in the past two months—the Public Health department isn’t taking any chances. Mindful of an outbreak that started last year in Orthodox and Hasidic Jewish communities in New York and New Jersey, the department is putting out the word that mumps is communicable, potentially dangerous—and preventable.

The county had just seven confirmed cases in all of 2009, the same number in 2008 and only five in 2007, according to Dr. Jonathan E. Fielding, the county’s director of public health. In a public health advisory issued Tuesday, May 11, Fielding said symptoms include “swelling of salivary glands, fever and inflammation of the testes in teenage and adult males.”

He urged those with symptoms to stay out of group settings and see a doctor. And he noted that the best protection against the virus is the measles-mumps-rubella vaccine.

While the vaccine is most commonly given to children, medical officials say adults who have not been vaccinated should also do so.

“A few of the cases seem to have some relationship with the outbreak in the Hasidic community in New York,” Fielding said Thursday. But piecing it all together is a complicated matter of medical investigation. “Somebody came through South Africa,” Fielding said.

Dr. Nelson El Amin, medical director of the county’s immunization program, said there was evidence that some of the L.A. cases “may be related to travel related to Passover.”

“Not all are among the Hasidic population. Some are,” El Amin said.

He declined to be more specific, other than to say the L.A. patients ranged in age from infancy to adulthood and were from the northern and “Metro West” areas of the county.
“I can tell you that the majority of those who got it have not been immunized. I don’t believe any of them have been immunized as kids.”

The Centers for Disease Control and Prevention have been tracking the New York area cases as well as an outbreak at a small college in Iowa and among “a bunch of guys in Omaha” who went to a reunion basketball game and came down with the mumps, among other cases, spokesman Jeff Dimond said. The agency has posted on its website a mumps Q & A and “fast facts” on symptoms.

While the Los Angeles numbers may be small, the level of concern is not.

“We’ve been on heightened alert,” El Amin said. “Our job is to jump on things when there might be a trend.”

Posted 4-13-10

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