NAC441A.720. Typhoid fever.

     1. The health authority shall investigate each report of a case having typhoid fever, as identified by the finding of a person infected with or excreting Salmonella typhi organisms upon testing of a clinical specimen by a medical laboratory, to:

     (a) Confirm the diagnosis;

     (b) Determine the extent of any outbreak;

     (c) Identify any contacts;

     (d) Identify any carriers of the infection;

     (e) Identify the source of the infection;

     (f) Determine if the case is employed in a sensitive occupation or is a child attending a child care facility; and

     (g) Determine if there is any contact residing in the same household as the case who is employed in a sensitive occupation.

     2. A person excreting Salmonella typhi shall not work in a sensitive occupation unless authorized to do so by the health authority. The health authority may authorize a person excreting Salmonella typhi to work in a sensitive occupation if at least three fecal specimens collected from the case:

     (a) At least 24 hours apart;

     (b) At least 48 hours after cessation of antimicrobial therapy; and

     (c) At least 1 month after onset of the illness,

Ê fail to show Salmonella typhi organisms upon testing by a medical laboratory.

     3. A contact residing in the same household as a case having typhoid fever shall not work in a sensitive occupation unless he or she has submitted at least two fecal specimens, collected at least 24 hours apart, for examination by a medical laboratory, is asymptomatic and is authorized to work in a sensitive occupation by the health authority. If a specimen submitted for examination shows Salmonella typhi organisms, the contact shall be considered a case subject to the provisions of this section.

     4. A person who excretes Salmonella typhi for not less than 4 weeks and not more than 1 year after onset of acute illness is a convalescent carrier and shall not engage in a sensitive occupation unless at least three consecutive fecal specimens and three consecutive urine specimens, taken at least 1 month apart, fail to show Salmonella typhi organisms upon testing by a medical laboratory.

     5. A person who excretes Salmonella typhi for more than 1 year after onset of acute illness is a chronic carrier and shall not engage in a sensitive occupation unless six consecutive fecal specimens, taken at least 1 month apart, and six consecutive urine specimens, taken at least 1 month apart, fail to show Salmonella typhi organisms upon testing by a medical laboratory.

     6. A carrier of Salmonella typhi is subject to the supervision of the health authority until released from the status of a carrier by the health authority.

     7. The health authority shall instruct a person excreting Salmonella typhi of the need and proper method of hand washing after defecation.

     8. An infant or child excreting Salmonella typhi shall not attend a child care facility or school until released to do so by the health authority. The health authority shall instruct a child care facility where an infant or child who is excreting Salmonella typhi is attending of the need and proper method of hand washing and other practices for the control of infection which prevent the transmission of typhoid fever.

     9. If a case having typhoid fever is in a medical facility, the medical facility shall provide care to the case in accordance with enteric precautions or other appropriate disease specific precautions.

     (Added to NAC by Bd. of Health, eff. 1-24-92; A by R087-08, 1-13-2011)