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SAN DIEGO (AP) — A San Diego County grand jury report faults local response to a recent hepatitis A epidemic and recommends improving lines of communication to prepare for future health emergencies.

The San Diego Union-Tribune newspaper says the 20-page report released Thursday commends officials for effectively contacting at-risk residents and getting them vaccinations.

But the grand jury criticizes the county and the city for inadequate coordination that delayed sanitation procedures that could have slowed the spread of hepatitis A.

The report recommends updating the county’s emergency operations plan and designating a medical professional to report directly to the San Diego mayor.

The outbreak killed 20 people and sickened 577 between November 2016 and October 2017.

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Information from: The San Diego Union-Tribune, http://www.utsandiego.com

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