County and Aids Foundation Spar Over Meningitis Vaccination

The adversarial relationship between the AIDS Health Foundation and county officials was on display today as both groups worked to limit the spread of invasive meningococcal disease.

The latest case of the bacterial disease -- which usually causes meningitis and is fatal in about one in 10 cases -- was confirmed Feb. 4 by the Los Angeles County Department of Public Health. The patient is a Hollywood resident who self-identified as gay, according to county records.

The county issued new guidelines last April, recommending vaccination for all men having sex with men (MSM) who regularly have intimate contact with multiple partners, seek partners through digital applications, share cigarettes or use illegal drugs. Vaccinations were also recommended for all HIV-positive MSM, including men who might not identify as gay or bisexual.

However, recent county efforts to reach out to healthcare providers working with at-risk MSM to make sure they are aware of those guidelines seem to have backfired.

Calling the response “two years late,” the AIDS Health Foundation today accused county officials of “quibbling” in 2013 over whether to label a group of 2013 deaths from the disease a “cluster” or an “outbreak” even as AHF mounted an aggressive vaccination campaign.

“While L.A. County health officials were debating the semantics of what to actually call the group of meningitis infections that was killing some gay men and MSM in Los Angeles in 2013, AHF was providing over 3,300 free meningitis vaccinations to potentially at-risk individuals in the community,” AHF President Michael Weinstein said.

County health officials did not immediately respond to a request for comment.

Three people in Los Angeles County died of the disease in 2014, out of a total of 11 confirmed cases.

Cases have increased among gay men, even as they have decreased in the community at large. Six of those 11 patients in 2014 were gay, according to DPH records.

Weinstein asked for more intensive study.

“We are now glad to see that Los Angeles County has come around, however, county health officials need to step up and focus even greater attention on meningitis in these populations,” Weinstein said.

The comments highlight a longstanding antagonism between the two groups. AHF fought to establish an independent health department for the city of Los Angeles, ultimately forcing the Los Angeles City Council to establish a health commission to avoid a ballot measure on the issue.

In 2012, AHF successfully backed a ballot measure requiring the use of condoms in adult films, over county officials’ objections that it was a state enforcement issue.

The foundation has accused county auditors of acting in retaliation for its political positions, while county officials say AHF has overbilled for services in the past.

Earlier today, county attorneys reporting to the Board of Supervisors attributed a spike in legal costs to fighting four lawsuits filed by AHF.

“Why would their legal fees suddenly skyrocket?” Supervisor Don Knabe asked about a more than 40 percent year-over-year increase in DPH litigation costs.

Steven Estabrook, the county’s litigation cost manager, said he couldn’t provide a total off the top of his head, but that “quite a bit of money” was being spent on battles with AHF, as well as on a lawsuit related to lead- based paint.

However, the adversaries both want to help reach those at risk of contracting meningitis.

The county offers low-cost vaccination at community clinics and free vaccination to anyone without health insurance. AHF offers free meningitis vaccines through its wellness centers.

The vaccine provides five years of protection. The latest patient was not vaccinated, but his illness was caused by meningitis serogroup B, which is not covered by the vaccine, according to AHF.

• City News Service