Typhoid Fever

Typhoid Fever 1. Class 1B report required. a. In case of typhoid fever, enteric precautions shall be maintained for not less than 4 weeks from date of onset, and urine and feces cultures for release from temporary carrier status shall not be taken earlier. A person diagnosed with typhoid fever or with growth of Salmonella typhi from feces, urine, blood, or other bodily source shall be considered a temporary typhoid carrier. Release from temporary carrier status and health department supervision shall be on the basis of not less than 3 consecutive negative cultures obtained from authenticated specimens of feces taken not less than 24 hours apart at least 48 hours after any antibiotic , and not earlier than one month after onset. If any one of this series is positive, the temporary carrier status shall be continued. b. During the first 6 months of the temporary carrier status, the patient may again be tested for release by securing not less than 3 consecutive negative cultures obtained from authenticated specimens at intervals of 1 month. If the patient is positive at the 6th month or if no test is made, the case is classed as a permanent carrier. Final release from permanent carrier status must be with the advice and consent of the State Epidemiologist, and cannot be considered unless 3 consecutive monthly cultures obtained from authenticated specimens collected at least 48 hours after any antibiotic, have been negative on examination by the Department of Health Laboratory or other laboratories approved by the Department of Health. c. Whenever the typhoid carrier status shall be declared by the local health officer and there is no patient history of typhoid during the preceding year, the patient shall be classed as a permanent carrier. d. No person classed as a carrier shall engage in handling of foods or foodstuffs for public consumption, nor shall such carrier offer to perform such services for any family (other than his or her own) or for any other group or institution, either private or public. No such carrier shall engage in providing domestic services for hire or provide direct client care in a nursing home or child day care center without the advice and written consent of the health officer. e. When any person is declared to be a carrier of typhoid, the local health officer shall collect pertinent information about the carrier. The necessity for imposing restrictions on the patient's activities shall be explained to the patient and the patient shall signify in writing his or her willingness to observe the carrier agreement and restrictions. A copy of the carrier information shall be forwarded immediately to the Epidemiology Program, Mississippi State Department of Health, in Jackson. f. When any known carrier of typhoid moves from the county, a copy of the carrier's history and agreements, together with the prospective future address of the carrier, shall be forwarded to the Mississippi State Department of Health by the local health officer of the county from which the carrier is moving. The original copy of the history and agreement shall remain as a part of the files of the county health department of the county from which the carrier has moved. g. All family or other close contacts of a case of typhoid or other salmonella infection shall submit specimens of their feces as required by the health officer and submit to any reasonable examination as may aid in the search for unknown carriers and sub clinical cases. h. All family or other close contacts of a carrier of typhoid or other salmonella infection shall be prohibited from handling foods or foodstuffs for public consumption until contact is broken and repeated negative laboratory examinations are reported. For salmonelloses, except typhoid, a series of 2 negative feces cultures taken not less than 24 hours apart at any time after contact is broken will satisfy this provision. For typhoid fever a series of 2 negative stools taken not less than 24 hours apart and not less than 14 days after contact is broken will satisfy this provision. i. The owner or operator of a house, hotel, apartment or other institution in which a typhoid carrier resides shall provide a sanitary method of excreta disposal which will not subject other occupants of the house, apartment, hotel or other institution or the general public to typhoid or paratyphoid infection. If the owner or operator of the property on which a carrier resides fails for due cause to provide such sanitary methods of excreta disposal, the carrier shall provide such facilities as meet approval of the Mississippi State Department of Health. j. Any typhoid carrier planning to change his/her place of residence or his/her occupation shall notify the local health officer in writing of such anticipated change. k. Whenever a case or carrier of typhoid is diagnosed it shall be the duty and responsibility of the local health officer to conduct a search for the source of the infection and for the food, water or person from whom it was acquired. Strict measures for assuring the safety of the water and milk supplies and of all foodstuffs should be instituted. l. Mandatory report and surveillance required.