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Mobile clinic brings mammograms to women on Skid Row

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Mobile clinic brings mammograms to women on Skid Row

Sharon Horton stepped through the door of a sky-blue mobile clinic and onto a Skid Row sidewalk. She wore a yellow knit beanie, gold hoop earrings and the relieved grin of a woman who has finally checked a mammogram off her to-do list.

It had been years since her last breast cancer screening procedure. This one, which took place in City of Hope’s Cancer Prevention and Screening mobile clinic, was faster and easier. The staff was kind. The machine that X-rayed her breast was more comfortable than the cold hard contraption she remembered.

Relatively speaking, of course — it was still a mammogram.

“It’s like, OK, let me go already!” Horton, 68, said with a laugh.

The clinic was parked on South San Pedro Street in front of Union Rescue Mission, the nonprofit shelter where Horton resides. Within a week, City of Hope, a cancer research hospital, would share the results with Horton and Dr. Mary Marfisee, the mission’s family medical services director. If the mammogram detected anything of concern, they’d map out a treatment plan from there.

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Naureen Sayani, 47, a resident of Union Rescue Mission, left, discusses her medical history with Adriana Galindo, a medical assistant, before getting a mammogram on last week.

(Kayla Bartkowski / Los Angeles Times)

“It’s very important to take care of your health, and you need to get involved in everything that you can to make your life a better life,” said Horton, who is looking forward to a forthcoming move into Section 8 housing.

Horton was one of the first patients of a new women’s health initiative from UCLA’s Homeless Healthcare Collaborative at Union Rescue Mission. Staffed by third-year UCLA Medical School students and led by Marfisee, a UCLA assistant clinical professor of family medicine, the clinic treats mission residents as well as unhoused people living in the surrounding neighborhood.

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The new cancer screening project arrives at a time of dire financial pressures on county public health services.

Citing rising costs and a $50-million reduction in federal, state and local grant and contract income, the Los Angeles County Department of Public Health on Feb. 27 ended services at seven of 13 public clinics that provide vaccines, tests and treatment for sexually transmitted diseases and other services to housed and unhoused county residents.

Although Union Rescue Mission’s own funding comes mainly from private sources and is less imperiled by public cuts, the 135-year-old shelter expects the need for its services to rise, Chief Executive Mark Hood said.

Even as unsheltered homelessness declined for the last two years across Los Angeles County, the unsheltered population on Skid Row — long seen as the epicenter of the region’s homelessness crisis — grew 9% in 2024, the most recent year for which census data are available.

For many local women navigating daily concerns over housing, food and personal safety, “their own health is not a priority,” Marfisee said.

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Those whose problems have become too serious to ignore face daunting obstacles to care. Marfisee recalled one patient who came to her with a lump in her breast and no identification.

In order to get a mammogram, Marfisee explained, the woman first needed to obtain a birth certificate, and then a state-issued identification card. Then she needed to enroll in Medi-Cal. After that, clinic staff helped her find a primary care physician who could order the imaging test.

Given the barriers to preventative care, homeless women die from breast cancer at nearly twice the rate of securely housed women, a 2019 study found. Marfisee’s own survey of the mission’s female residents found that nearly 90% were not up to date on recommended cancer screenings like mammograms and pap smears, which detect early cervical cancer.

To address this gap, Marfisee — a dogged patient advocate — reached out to City of Hope. The Duarte-based research and treatment center unveiled in March 2024 its first mobile cancer screening clinic, a moving van-sized clinic on wheels that it deploys to food banks and health centers, as well as to companies offering free mammograms as an employee benefit.

“In true Dr. Mary fashion, she saw the vision,” said Jessica Thies, the mobile screening program’s regional nursing director. After working through some logistical hurdles, the mission and City of Hope secured a date for the van’s first visit.

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The next challenge was getting the word out to patients. Marfisee and her students walked through the surrounding neighborhood, went cot to cot in the women’s dorm and held two informational sessions in December and January to answer patients’ questions.

At the sessions, the team walked through the basics of who should get a mammogram (women age 40 or older, those with a family history of breast cancer) and the procedure itself. (“Like a tortilla maker?” one woman asked skeptically after hearing a description of the mammography unit.)

The medical students were able to dispel rumors some women had heard: The test doesn’t damage breast tissue, nor do the X-rays increase cancer risk. Others questioned a mammogram’s value: What good was it knowing they had cancer if they couldn’t get follow-up care?

On this latter point, Marfisee is determined not to let patients fall through the cracks.

Thirteen patients received mammograms at the van’s first visit on Wednesday. Within a week, City of Hope will contact patients with their results and send them to Marfisee and her team. She is already mentally mapping the next steps should any patient have a situation that requires a biopsy or further imaging: working with their case manager at the mission, calling in favors, wrangling with any insurance the patient might have.

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“It’ll be a good fight,” Marfisee said, as residents in the adjacent cafeteria carried trays of sloppy joes and burgers to their lunch tables. “But we’ll just keep asking for help and get it done.”

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The neuro disease rat lungworm has reached California

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The neuro disease rat lungworm has reached California

A disease that can cause neurological illness and meningitis in people, rat lungworm, has been found in wild opposums, rats and a zoo animal in San Diego County, indicating its establishment in California for the first time.

Researchers reported their findings in the journal Emerging Infectious Diseases, published by the U.S. Centers for Disease Control and Prevention. The authors, who include veterinarians, researchers and wildlife biologists, urged physicians and other healthcare workers in the region to consider lungworm infection when patients come in with nervous system disorders.

The discovery highlights “a notable expansion of the range of this parasite in North America,” they said.

The CDC website says the risk to the general public of getting this infection is low, but it can be deadly.

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If ingested, the worms can cause severe headaches, stiff neck, the sensation of tingling or painful skin, low-grade fever, nausea, vomiting, coma and sometimes death. People who eat freshwater crab, prawns, frogs, snails and slugs are at greatest risk. However, people can also get the disease by eating un-rinsed produce that’s been slimed by a snail or slug, or eating a slug or snail that was chopped up in produce. The worms need moisture, however; if the produce is dry, the worms will die.

Domestic animals, including dogs and cats, are also at risk.

Officials with the California Department of Public Health were not ready to call the disease endemic, or established, in the state.

“Additional surveillance and testing will be necessary to determine whether the detections of rat lungworm in the animals evaluated in San Diego County represent an isolated introduction of the parasite or ongoing local transmission,” spokeswoman Elizabeth Manzo wrote in a statement to The Times.

The department said it is not aware of rat lungworm outside San Diego County, and has seen no human cases.

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“However, the San Diego study affirms that the parasite can be introduced to California through movement of infected animals from endemic areas,” the statement said. “Because some species of snails and slugs present in California are capable of serving as hosts for rat lungworm, and the presence of the parasite in other parts of the state is unknown, it is advised to take certain food safety precautions. Persons should not consume any raw or undercooked wild snails or slugs, and should thoroughly wash all produce before consuming.”

The worms that cause the disease, Angiostrongylus cantonensis, are native to Southeast Asia. They’ve been found in the U.S. since the 1960s — including in isolated human and zoo animal cases in California — and are established in Hawaii as well as in much of the southeastern U.S.

It is believed they came overseas via rats on boats.

The worms favored environment is the moist, warm bed of a rat’s lung. When a rat is infected, the worms cause respiratory distress, priming the rodent to cough. Worm-filled sputum is then ejected into the rat’s mouth, and swallowed. The rat then poops the worms out, and animals such as slugs and snails eat the poop. When a rat eats an infected invertebrate, the cycle begins again.

Occasionally, another animal, such as a raccoon or dog, or a person, will accidentally eat an infected animal, or the slime of one, and contract the disease.

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The discovery of the worm in San Diego County rodents and opossums was made by staff at the San Diego Zoo and a local wildlife rehabilitation center, Project Wildlife, which is run by the San Diego Humane Society.

In December 2024, a 7-year-old male parma wallaby, born and raised at the zoo, began showing concerning neurological behaviors: incessant head shaking, blindness, a lack of muscle coordination and paralysis in his hind legs. He was euthanized after 11 days in the zoo infirmary.

When zoo staff examined the body, they found six rat lungworms in the marsupial’s brain, along with a lot of damage.

Because the diagnosis was so unusual, zoo staff examined the bodies of 64 free-ranging roof rats that had either been euthanized in the course of regular pest control or found dead on the property. Two, a little more than 3%, had lungworms. Their feces had them too: “numerous live … larvae with coiled posterior ends.” The larvae, roughly 300 in each poop sample, were each about the size of a grain of sand.

Officials at the San Diego Zoo did not respond to requests for comment.

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Curiously, at the same time the zoo investigation was underway, staff from Project Wildlife had been dealing with sick opossums brought to them from around the county. Tests of 10 dead animals showed seven carried the lungworms.

Many people and animals remain asymptomatic when they’re infected. Symptoms typically appear within hours or days after ingestion and can last up to eight weeks. The worms will eventually die.

Because the disease has so many varied symptoms, health officials say it can go undiagnosed and untreated. Health officials from Hawaii, where the disease is endemic, say if lungworms are suspected, it’s best to be treated as soon as possible — even before lab results come back.

The CDC too notes that treatment works best when the disease is caught early, and can consist of high doses of corticosteroids, lumbar punctures for symptomatic relief of headaches, and antiparasitic medications, such as albendazole.

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Owners of fire-destroyed Palisades mobile home park seek to displace residents for development deal

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Owners of fire-destroyed Palisades mobile home park seek to displace residents for development deal

For months, former residents of the Pacific Palisades Bowl Mobile Estates have feared the uncommunicative owners of the property would seek to displace them in favor of a more lucrative development deal after the Palisades fire destroyed the rent-controlled, roughly 170-unit mobile home park.

A confidential memorandum listing the Bowl for sale indicates the owners intend to do exactly that.

The memorandum, quietly posted on a website associated with the global commercial real estate company CBRE, says that the Palisades fire created a “blank canvas for redevelopment” at a site “ideally positioned for a transformative residential or mixed-use project.”

“I just thought, oh my god, this is so much propaganda and false advertising,” said Lisa Ross, a 33-year resident of the Bowl and a Realtor. “How can they even get away with printing this?”

Neither the current owners of the Bowl nor the real estate companies listed on the memorandum responded to requests for comment.

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The memorandum describes the current single-family residential zoning as “favorable” for developers; however, the city and mobile housing law experts have painted a different picture.

Fire debris at Pacific Palisades Bowl in January 2026.

(Myung J. Chun / Los Angeles Times)

“Multifamily and mixed-use development on this site is not allowed by existing zoning and land use regulations,” Mayor Karen Bass’s office said in a statement Wednesday, adding only low density single-family housing or reconstructing the mobile home park are currently allowed. “Mayor Bass will continue taking action and [work] with residents to restore the Palisades community.”

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City Councilmember Traci Park also reiterated her focus on getting the mobile home park rebuilt and allowing residents to return, with a spokesperson noting she is not entertaining the potential for any rezoning efforts from a developer.

Zoning changes typically require a city council vote and are subject to the mayor’s approval or veto.

Beyond the zoning laws, the site is also currently governed by a state law requiring cities to preserve affordable housing along the coast and a city ordinance protecting mobile home residents against sudden displacement.

Spencer Pratt, a resident of the Palisades and an outspoken supporter of the neighborhood’s mobile home community, criticized the mayor and the owners in a statement to The Times. “It’s unfortunate that Karen Bass has not advocated for mobile home residents impacted by the fire,” he said, “and that the current owner of the Bowl is ignoring good faith offers from residents to buy the property.”

The mayor’s office disputed this, noting Bass recently led a delegation of Palisadians, including mobile home owners, to Sacramento to advocate for recovery. “Mayor Bass’ priority is getting every Palisadian home — single-family homeowners, town home owners, renters, mobile home owners.”

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Los Angeles Mayor Karen Bass in Los Angeles on Jan. 7, 2026.

Los Angeles Mayor Karen Bass speaks during a private ceremony outside City Hall with faith leaders, LAPD officers and city officials to commemorate the one-year anniversary of the Eaton and Palisades fires on Jan. 7, 2026.

(Allen J. Schaben / Los Angeles Times)

Bass also advocated for the federal government to include the Bowl in its debris cleanup efforts; however, the Federal Emergency Management Agency ultimately refused to include it, unlike other mobile home parks impacted by the Palisades fire. Its reasoning: It could not trust the owners to rebuild the park as affordable housing.

Court rulings over the years found the owners routinely failed to maintain the infrastructure and worked to replace the park with an “upscale resort community.” Residents also accused the owners of attempting to circumvent rent control regulations.

After the fire, it ultimately took more than 13 months to begin cleaning up the debris.

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Ross said she approached the owners with independent mobile home park developers who were interested in buying the fire-destroyed lot and letting residents rebuild within months. She also approached the owners with a proposition that the former residents band together to buy the park. She heard nothing back.

“They don’t communicate,” Ross said. “It’s a feuding family. That’s also why we had so many problems with maintenance and with upgrades in the park.”

Pratt, who is running for mayor against Bass, also called on private developers like Rick Caruso to step in and save the Bowl. (Caruso’s team noted his rebuilding nonprofit is looking into how to help residents of the Bowl.)

Ross is a fan of Pratt’s proposition. “We need those kinds of people — we need Rick Caruso. That would be great,” Ross said. To sweeten the deal: “I’ll cook for him. I would make him all his favorite dishes.”

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A virus without a vaccine or treatment is hitting California. What you need to know

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A virus without a vaccine or treatment is hitting California. What you need to know

A respiratory virus that doesn’t have a vaccine or a specific treatment regimen is spreading in some parts of California — but there’s no need to sound the alarm just yet, public health officials say.

A majority of Northern California communities have seen high concentrations of human metapneumovirus, or HMPV, detected in their wastewater, according to data from the WastewaterScan Dashboard, a public database that monitors sewage to track the presence of infectious diseases.

A Los Angeles Times data analysis found the communities of Merced in the San Joaquin Valley, and Novato and Sunnyvale in the San Francisco Bay Area have seen increases in HMPV levels in their wastewater between mid-December and the end of February.

HMPV has also been detected in L.A. County, though at levels considered low to moderate at this point, data show.

While HMPV may not necessarily ring a bell, it isn’t a new virus. Its typical pattern of seasonal spread was upended by the COVID-19 pandemic, and its resurgence could signal a return to a more typical pre-coronavirus respiratory disease landscape.

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Here’s what you need to know.

What is HMPV?

HMPV was first detected in 2001, according to the U.S. Centers for Disease Control and Prevention. It’s transmitted by close contact with someone who is infected or by touching a contaminated surface, said Dr. Neha Nanda, chief of infectious diseases and hospital epidemiologist for Keck Medicine of USC.

Like other respiratory illnesses, such as influenza, HMPV spreads and is more durable in colder temperatures, infectious-disease experts say.

Human metapneumovirus cases commonly start showing up in January before peaking in March or April and then tailing off in June, said Dr. Jessica August, chief of infectious diseases at Kaiser Permanente Santa Rosa.

However, as was the case with many respiratory viruses, COVID disrupted that seasonal trend.

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Why are we talking about HMPV now?

Before the pandemic hit in 2020, Americans were regularly exposed to seasonal viruses like HMPV and developed a degree of natural immunity, August said.

That protection waned during the pandemic, as people stayed home or kept their distance from others. So when people resumed normal activities, they were more vulnerable to the virus. Unlike other viruses, there isn’t a vaccine for human metapneumovirus.

“That’s why after the pandemic we saw record-breaking childhood viral illnesses because we lacked the usual immunity that we had, just from lack of exposure,” August said. “All of that also led to longer viral seasons, more severe illness. But all of these things have settled down in many respects.”

In 2024, the national test positivity for HMPV peaked at 11.7% at the end of March, according to the National Respiratory and Enteric Virus Surveillance System. The following year’s peak was 7.15% in late April.

So far this year, the highest test positivity rate documented was 6.1%, reported on Feb. 21 — the most recent date for which complete data are available.

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While the seasonal spread of viruses like HMPV is nothing new, people became more aware of infectious diseases and how to prevent them during the pandemic, and they’ve remained part of the public consciousness in the years since, August and Nanda said.

What are the symptoms of HMPV?

Most people won’t go to the doctor if they have HMPV because it typically causes mild, cold-like symptoms that include cough, fever, nasal congestion and sore throat.

HMPV infection can progress to:

  • An asthma attack and reactive airway disease (wheezing and difficulty breathing)
  • Middle ear infections behind the ear drum
  • Croup, also known as “barking” cough — an infection of the vocal cords, windpipe and sometimes the larger airways in the lungs
  • Bronchitis
  • Fever

Anyone can contract human metapneumovirus, but those who are immunocompromised or have other underlying medical conditions are at particular risk of developing severe disease — including pneumonia. Young children and older adults are also considered higher-risk groups, Nanda said.

What is the treatment for HMPV?

There is no specified treatment protocol or antiviral medication for HMPV. However, it’s common for an infection to clear up on its own and treatment is mostly geared toward soothing symptoms, according to the American Lung Assn.

A doctor will likely send you home and tell you to rest and drink plenty of fluids, Nanda said.

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If symptoms worsen, experts say you should contact your healthcare provider.

How to avoid contracting HMPV

Infectious-disease experts said the best way to avoid contracting HMPV is similar to preventing other respiratory illnesses.

The American Lung Assn.’s recommendations include:

  • Wash your hands often with soap and water. If that’s not available, clean your hands with an alcohol-based hand sanitizer.
  • Clean frequently touched surfaces.
  • Crack open a window to improve air flow in crowded spaces.
  • Avoid being around sick people if you can.
  • Avoid touching your eyes, nose and mouth.

Assistant data and graphics editor Vanessa Martínez contributed to this report.

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