The head of Los Angeles County's public health department apologized Friday for not publicly disclosing that three local men had died of bacterial meningitis in an announcement Wednesday about the possible disease cluster.
Dr. Jonathan Fielding said his department left that news out of a press release urging gay men to get vaccinated against meningitis because he did not consider it critical information.
On Wednesday, the department reported eight cases of the bacterial infection, including four among men who have sex with men, three of whom were HIV-positive. It cited a possible disease cluster, since three of those four men lived or socialized in North Hollywood and West Hollywood, and were 27 or 28 years old.
But the news release failed to mention that three of the eight people had died of the disease. The news reached the general public after L.A. County Supervisor Zev Yaroslavsky's website reported the deaths, and journalists confirmed the news with the health department.
That angered some advocates in the gay community, who demanded better communication about critical health issues.
"In retrospect, I didn’t realize it was going to be that important," Fielding said in a phone interview. "I said it was this very serious disease with a high fatality rate. I thought that would be enough, rather than talking about just whether these four cases had succumbed to meningococcal disease.
"But apparently, for some, it’s an extremely important detail, and for that we’re sorry that it wasn’t included," he said.
Fielding said the health department did disclose the deaths in a separate letter to medical providers. Still, he defended the news release, emphasizing that the crucial public health message was that all men who have sex with men should get vaccinated.
"To the degree that hearing about these deaths increases the likelihood that someone in the target group will get immunized, I think it’s important information," Fielding acknowledged. But "it wasn’t the deaths that determined whether we made the recommendation," he added. "It was in fact the cluster – the possible cluster – that was the basis of the recommendation."
West Hollywood City Councilman John Duran criticized Fielding's handling of the situation. "Piece-mealing information out," and only when asked about it, is "such an ineffective way to deal with a contagious disease that is fatal," said Duran, who is running for county supervisor.
The health department confirmed Friday that the three men who died all had sex with men, and two were HIV-positive. One man died in February, and two died at the end of March, it said. None of the deaths was linked in any way, according to the department.
The health department is offering free vaccinations at various locations.
There are typically between 12 and 30 cases of bacterial meningitis in L.A. County each year, according to Fielding. The risk for the disease is very low in the general population. It’s spread through close contact with an infected person: kissing, sharing cigarettes or drugs and being in group settings — dorms, jails or shelters — for long periods of time.
Symptoms usually occur within five days. They include high fever, stiff neck, skin rash, severe headache, low blood pressure, aversion to bright lights and generalized muscle pains. The infection can cause brain damage, hearing loss and death. It progresses quickly, so immediate diagnosis and treatment is imperative, health experts say.