San Diego, California - The County of San Diego released an After Action Report today that summarizes the County’s response to an unprecedented hepatitis A outbreak that began in early March 2017.

A local public health emergency was declared on September 1, 2017, and stayed in effect until January 23, 2018.

The purpose of an after action report is a self-evaluation to document an agency’s response after an emergency. This Hepatitis A Outbreak After Action Report looks at the County’s response to the local health emergency and actions taken during the outbreak to assess what worked well, what could be improved, and a plan for making recommended improvements.

Among the 21 recommendations in the report:

  • Enhancing the use of an incident command structure to coordinate regional actions, including convening a group of County and regional executive leadership from affected areas that meets regularly
  • Ensure more County staff not normally assigned to emergency situations are trained so that they may be utilized for large-scale, long-lasting or unique public health emergencies
  • Work with local healthcare providers to ensure that people who work with homeless individuals and drug users receive the HAV vaccine and that all healthcare providers enter the vaccinations into the immunization registry
  • Educate all County jail inmates on hepatitis A risk and encourage them to be vaccinated

The report also highlights several novel approaches taken to combat the outbreak including the use of foot teams. The teams paired up County Health and Human Service Agency public health nurses with homeless outreach workers and public safety officers who were deployed to provide vaccinations and education in homeless encampments, difficult to reach areas near river beds, in canyons and at locations that provide services to homeless people.

The complete report is available online.