SANTA CRUZ — After months of battling against a pair of bacterial outbreaks in Santa Cruz County, local health officials say they are ready to taper the response to one, but remain vigilant in the face of another.
County Health Officer Lisa Hernandez told the Sentinel that as of Wednesday, there had been 51 cases of the diarrheal illness shigellosis identified in the county since late February — up from 37 reported in March.
However, Hernandez said the most recent onset of the illness — which has as much as a seven day incubation period — for identified cases was March 29, which is a long enough gap to consider the outbreak “closed.”
“Two incubation periods would be 14 days and that’s why we consider the outbreak closed,” said Hernandez.
According to Hernandez, the Department Operations Center, which facilitates a coordinated response among the county and other jurisdictions, will remain activated for at least a couple weeks longer and sanitation resources, such as the portable restrooms and hand washing stations placed at Harvey West Park in Santa Cruz, will remain in place.
“Having the DOC remain activated at a certain level does allow us to have that nimbleness to reestablish the structure again if something changes, though we do not expect it to,” said Hernandez.
Initially, the outbreak has been occurring primarily in North County among individuals experiencing homelessness. But Hernandez confirmed that the outbreak did spread to the broader population, including at least three school-aged children. She said infection among the broader community was a matter of if not when, but emphasized that the county is not expecting there to be any more significant spread, though families and children should continue to practice good hygiene, such as regular hand washing.
Shigellosis is an infection derived from the bacteria Shigella. It is often spread after it has come into contact with an individual’s hands which then touch the mouth or food before it is eaten. It can also spread through ingestion of contaminated water.
Symptoms, which can start a day or two after infection and last about a week, include diarrhea, stomach pain/cramps and fever. The bacteria can sometimes be shed as many as four weeks after symptoms subside.
Syphilis outbreak
Public health officials are also still responding to an active syphilis outbreak, according to Hernandez, which has experienced a small uptick in cases.
As of Wednesday, Hernandez said the county had 14 syphilis cases — two more than the 12 that were reported in March. The vast majority of infections remain among people experiencing homelessness in South County.
“This outbreak is not closed,” said Hernandez. “We’re still responding to this outbreak in South County.”
She added that the county is continuing to rely on partners and providers in the Watsonville area with a focused “street medicine” approach that is led by the Homeless Persons Health Project, a division of the county’s Health Services Agency. Response work includes a mobile clinic, extensive outreach, education, testing and treatment.
By chance, that work is also being supported by a $150,000 grant the county’s public health department recently won from the National Association of County and City Health Officials prior to the outbreak.
“This is just another reminder that we, as a community, have to continue to support those experiencing homelessness,” said Hernandez.
Syphilis, known as the “great pretender” for its ability to mask itself with symptoms of other diseases, is a sexually transmitted illness that can spread to the brain or nervous system if it goes untreated. Early symptoms include firm, round sores, often around the genital region, lips or mouth. If treatment is not received, subsequent stages often feature a spreading of the rash and eventually damage to the body’s major organs.
Infections during pregnancy that are passed down to the child — congenital syphilis — can cause a miscarriage, premature birth or stillborn birth.
“Something that we are extremely worried about is congenital syphilis,” said Hernandez.
The county had three cases of congenital syphilis in 2022, she added, but so far none have been identified in the current outbreak.
To get connected with care call 831-454-4114. STD testing opportunities are at santacruzhealth.org/stdtesting.
By the numbers
Shigellosis: 51 cases, but spread has slowed. Health officials continue to monitor, but status of outbreak considered “closed.”
Syphilis: 14 cases. Still active outbreak, primarily in South County region among people experiencing homelessness.
*As of Wednesday
To connect with care call 831-454-4114. For STD testing, visit santacruzhealth.org/stdtesting.