Section R386-702-13 - Special Measures for Control of TyphoidBecause 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.Utah Admin. Code R386-702-13
Amended by Utah State Bulletin Number 2015-1, effective 12/15/2014Amended by Utah State Bulletin Number 2016-5, effective 2/11/2016Amended by Utah State Bulletin Number 2017-4, effective 1/27/2017Amended by Utah State Bulletin Number 2018-2, effective 1/2/2018Amended by Utah State Bulletin Number 2019-22, effective 11/1/2019Amended by Utah State Bulletin Number 2020-18, effective 9/8/2020Amended by Utah State Bulletin Number 2023-07, effective 3/14/2023Amended by Utah State Bulletin Number 2024-05, effective 2/12/2024, exp. 6/11/2024 (Emergency)Amended by Utah State Bulletin Number 2024-11, effective 5/29/2024