(AP) – The city and county of San Diego failed to quickly control a Hepatitis A outbreak last year that grew to be among the largest seen in the U.S. in decades, according to a state audit released Thursday.
The county lacked a concrete Hepatitis A prevention plan that led to a delay in getting the most vulnerable residents vaccinated, and mass vaccinations did not happen until after a health emergency had been declared, according to the audit conducted by the state auditor at the request of lawmakers.
The disease killed 20 people, most of them homeless. More than 580 were infected and nearly 400 people were hospitalized.
The city was also slow to respond, according to the audit. Six months into the outbreak, the city began power-washing streets and installing hand-washing stations and public restrooms downtown, where streets were lined with tents of homeless people.
Hepatitis A is a highly contagious liver disease spread through dirty hands and other contact.
The county did not share sufficient information with the city when the outbreak was detected in March 2017, causing the city to not fully recognize the seriousness of what was happening and delaying its response, the audit found.
The report recommended the Legislature encourage local health officers to quickly notify and direct governmental entities to control the spread of communicable diseases. It also recommended detailed response plans and better collaboration between the different entities.
The California Department of Public Health should amend its disease outbreak response plan to include asking jurisdictions to set vaccination targets, establish dates to meet those targets, and determine needed resources, the report said.
San Diego city government officials “agree with the recommendations, particularly that the city and county should strengthen their relationship as it relates to responding to regional emergencies,” said city chief operating officer Kris Michell.
San Diego County’s Health and Human Services Agency had no immediate comment, said spokesman Craig Sturak.