Utah Admin. Code R386-702-13 - Special Measures for Control of Typhoid
Because typhoid control measures depend largely on sanitary precautions and other health measures designed to protect the public, the local health department shall investigate each case of typhoid and strictly manage the infected individual according to the following:
(1) Standard precautions are required for
cases during hospitalization. Use contact precautions for diapered or
incontinent patients during illness. Hospital care is desirable during acute
illness. Release of the patient from supervision by the local health department
shall be based on three or more negative cultures of feces, and of urine in
patients with schistosomiasis, taken at least 24 hours apart. Cultures must
have been taken at least 48 hours after antibiotic therapy has ended and not
earlier than one month after onset of illness as specified in Subsection
R386-702-13(6). If any of these cultures is positive, repeat cultures at
intervals of one month during the 12-month period following onset until at
least three consecutive negative cultures are obtained as specified in
Subsection R386-702-13(6). The patient shall be restricted from food handling,
child care, and from providing patient care during the period of supervision by
the local health department.
(2)
Administration of typhoid vaccine is recommended for household members of known
typhoid carriers. Household and close contacts of a carrier shall be restricted
from food handling, child care, and patient care until two consecutive negative
stool specimens, taken at least 24 hours apart, are submitted, or when approval
is granted by the local health officer according to local
jurisdiction.
(3) If a laboratory
or physician identifies a carrier of typhoid, the attending physician shall
immediately report the details of the case by telephone to the local health
department or the Office of Communicable Diseases, Utah Department of Health
and Human Services using the process described in Section R386-702-6. Each
infected individual shall submit to the supervision of the local health
department. Carriers are prohibited from food handling, child care, and patient
care until released in accordance with Subsection R386-702-13(4)(a) or
R386-702-13(4)(b). Reports and orders of supervision shall be kept confidential
and may be released only as allowed by Subsection
26B-7-217(2)(c).
(a) Any person who harbors typhoid bacilli
for three but less than 12 months after onset is defined as a convalescent
carrier. Release from occupational and food handling restrictions may be
granted at any time from three to 12 months after onset, as specified in
Subsection R386-702-13(6).
(b) Any
person who continues to excrete typhoid bacilli for more than 12 months after
onset of typhoid is a chronic carrier. Any person who gives no history of
having had typhoid or who had the disease more than one year previously, and
whose feces or urine are found to contain typhoid bacilli is also a chronic
carrier.
(c) If typhoid bacilli are
isolated from surgically removed tissues, organs, including the gallbladder or
kidney, or from draining lesions such as osteomyelitis, the attending physician
shall report the case to the local health department or the Office of
Communicable Diseases, Utah Department of Health and Human Services. If the
person continues to excrete typhoid bacilli for more than 12 months, the person
is a chronic carrier and may be released after satisfying the criteria for
chronic carriers in Subsection R386-702-13(6).
(4) The local health department shall report
typhoid carriers to the Office of Communicable Diseases, and shall:
(a) require the necessary laboratory tests
for release;
(b) issue written
instructions to the carrier; and
(c) supervise the carrier.
(5) Requirements for Release of
Convalescent and Chronic Carriers: The local health officer or their
representative may release a convalescent or chronic carrier from occupational
and food handling restrictions only if at least one of the following conditions
is satisfied:
(a) for carriers without
schistosomiasis, three consecutive negative cultures obtained from fecal
specimens authenticated by the attending physician, hospital personnel,
laboratory personnel, or local health department staff taken at least one month
apart and at least 48 hours after antibiotic therapy has stopped;
(b) for carriers with schistosomiasis, three
consecutive negative cultures obtained from both fecal and urine specimens
authenticated by the attending physician, hospital personnel, laboratory
personnel, or local health department staff taken at least one month apart and
at least 48 hours after antibiotic therapy has stopped;
(c) the local health officer or their
representative determine that additional treatment such as cholecystectomy or
nephrectomy has terminated the carrier state; or
(d) the local health officer or their
representative determines the carrier no longer presents a risk to public
health according to the evaluation of other factors.
Notes
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