Ink enthusiast Jamie Rosa is not a novice to the tattoo chair.
"I think I'm excited for the pain to be done," Rosa said with a laugh.
Today, she's getting a tattoo at Buju Tattoo in Mission Hills. She has more than a dozen already, but this one has special meaning -- it's the state of California with poppies coming out of San Diego. She said she wanted to show her love for the city where she was born and raised.
For such an important piece, she said she chose Buju Tattoo because of the artist, Jasmine Wright, and because it's clean.
"[The clean environment] is probably the first thing you notice," said Rosa.
But the Food and Drug Administration released a recent warning saying even very clean shops can lead to tattoos infected with Mycobacterium chelonae -- tattoos that are covered with scabs and pus. Unlike Hepatitis or MRSA, this bacteria is found in tainted ink, not needles. If left untreated, it can lead to organ infection, lung disease and in some rare cases, death.
According to the Centers for Disease Control and Prevention, there have been 22 confirmed, 4 probable and 27 possible cases in the country. It's affected four states so far -- Washington state, Colorado, Iowa and New York.
In some cases, water was added to make dark ink lighter -- a process the manager at Buju said is standard.
The issue is that if non-sterile water is used, like tap, deionized or even filtered water, it can contain bacteria. The bacteria is so strong, adding alcohol or witch hazel won't kill it.
"Mycobacterium forms spores and those spores are very, very hardy," said Dr. Paul Pockros of Scripps Health. "The spores can often live for years or even decades."
Pockros said mycobacterium naturally occur in many water and dirt sources. But it's the nature of tattooing -- puncturing the skin over and over again -- that makes the risk of exposure so high.
Pockros said the cases seen in other states may only be the tip of the iceberg, and that it may not be long until there are cases closer to home.
"I think it could easily be spread," said Pockros. "This could easily occur in California."
This may lead San Diegans to wonder what is being done.
10News asked the Department of Environmental Health, which inspects tattoo parlors, what they're doing to protect consumers. DEH officials said they're sending out emails " to relay information and other important updates to the industry."
However, consumers like Rosa said it's not enough to give her peace of mind.
"It can be very nerve-wracking thinking about those things," said Rosa. "If something can be done, it should."
Rosa said nothing, not even potentially deadly bacteria, can outweigh the feeling of a fresh piece of art.
"I'm a happy customer. My new tattoo is really meaningful and it's more than what I wanted," said Rosa.