Illinois Administrative Code
Title 77 - PUBLIC HEALTH
Part 690 - CONTROL OF NOTIFIABLE DISEASES AND CONDITIONS CODE
Subpart D - DETAILED PROCEDURES FOR THE CONTROL OF NOTIFIABLE DISEASES AND CONDITIONS
Section 690.730 - Typhoid Fever and Paratyphoid Fever (Reportable by telephone, facsimile, or electronically as soon as possible, within 24 hours)
Universal Citation: 77 IL Admin Code ยง 690.730
Current through Register Vol. 48, No. 38, September 20, 2024
a) Control of Case
1) Persons in Non-sensitive Occupations
Cases with typhoid fever in non-sensitive occupations shall not return to their occupation until the following are completed:
A) Termination of the acute illness (absence
of fever); and
B) Receipt of
education on transmission of the bacterium that causes typhoid fever from the
local health authority.
2) Food Handlers, Adult or Child Day Care
Attendees or Staff, Health Care Workers, or Persons in Other Sensitive
Occupations
Cases with typhoid fever who are food handlers, adult or child care attendees or staff, health care workers, or persons in other sensitive occupations shall not work or attend day care until:
A) Termination of the acute illness (absence
of fever); and
B) Receipt from the
local health authority of education, including educational materials, on
transmission of the bacterium that causes typhoid fever; and
C) Submission of three consecutive stool
specimens negative for Salmonella Typhi, S. Paratyphi A, S. Paratyphi B
(tartrate negative) or S. Paratyphi C, taken not less than 24 hours apart,
following clinical recovery of the patient, and the initial specimen preferably
30 days after onset. The first release specimen shall not be obtained less than
48 hours after completion of antimicrobial therapy. Once specimen submission
begins, specimens shall be submitted at least once per week until the case is
released or reclassified.
3) If a case of typhoid fever is identified
with no foreign travel to an endemic area within 60 days of onset of illness,
the local health authority shall conduct an investigation to determine the
source of illness. The investigation may include testing of close contacts,
food handlers, adult or child care attendees or staff, health care workers, or
persons in other sensitive occupations, or other measures deemed appropriate by
the local health authority in consultation with the Department to identify the
source of illness.
4) A
convalescent carrier is defined as:
A) A case
of acute typhoid fever with onset in the last 12 months, but no longer
symptomatic, and
B) With one or
more specimens (collected within 12 months of symptom onset) positive for
Salmonella Typhi, S. Paratyphi A, S. Paratyphi B (tartrate negative) or S.
Paratyphi C.
5) A
chronic carrier is defined as:
A) A person who
excretes typhoid bacilli in feces or urine and has had no symptoms of typhoid
disease during the past 12 months; or
B) A person who was an acute typhoid fever
case who excretes typhoid bacilli for 12 months or longer after onset of
typhoid fever; or
C) A person who
harbors typhoid bacilli at a site where excretion is likely (including a
patient with culture-positive bile or another clinical specimen following
cholecystectomy), but had no symptoms of typhoid disease during the past 12
months; or
D) A person with
culture-proven acute typhoid fever more than 12 months earlier who has not
submitted three negative stool specimens as described in
690.730(a)(2)(C).
6) Convalescent and chronic
carriers shall complete and sign a typhoid fever carrier agreement. (See
Section 690.30(d)(3))
The local health authority shall keep on file all signed agreements for their
jurisdiction.
7) Convalescent and
chronic carriers of typhoid fever shall not work as food handlers, adult or
child care staff with direct care of children or the elderly, health care
workers, or in other sensitive occupations. (See Section 2310-510 of the
Department of Public Health Power and Duties Law)
b) Control of Contacts to a Case
1) All contacts to cases who are food
handlers, adult or child care attendees or staff, health care workers, or
persons in other sensitive occupations shall not work or return to day care
until submission of two consecutive stool specimens negative for Salmonella
Typhi, S. Paratyphi A, S. Paratyphi B (tartrate negative) or S. Paratyphi C.
Specimens shall be taken not less than 24 hours apart. If the contact is
symptomatic, specimens shall be following clinical recovery of the patient and
the first release specimen shall not be obtained less than 48 hours after
completion of antimicrobial therapy.
2) Contacts to cases may include travel
companions and other members of a tour group that has recently traveled to a
country or countries where typhoid fever is endemic. If any of these contacts
have symptoms of typhoid fever within 60 days prior to or after the onset of
the case's symptoms, they shall submit two consecutive stool specimens negative
for Salmonella Typhi, S. Paratyphi A., S. Paratyphi B (tartrate negative), or
S. Paratyphi C. Specimens shall be taken not less than 24 hours apart and shall
be following clinical recovery of the patient. The first release specimen shall
not be obtained less than 48 hours after completion of antimicrobial
therapy.
3) When a confirmed case
of typhoid fever occurs in a food handler, the other food handlers at the
facility shall be considered contacts to the case and submit two consecutive
negative stool specimens obtained at least 24 hours apart, and not sooner than
48 hours after the last dose of antimicrobials, if administered. Local health
authorities, in consultation with the Department, may require two consecutive
negative specimens from food handlers at the facility before food handlers
return to work if there is reason to believe that these individuals may be the
source of the illness or could transmit disease. If this does not occur, food
handlers shall be restricted from their occupations if they do not begin
submitting specimens within one week after notification, and specimens shall be
submitted at least once per week until two consecutive negative specimens are
obtained, or the individual shall be restricted from working.
c) Control of Convalescent and Chronic Carriers
1) Carriers shall notify any
physician, hospital, or other institution providing medical care or day care
(adult or child) program of their carrier condition to assure proper
precautions are taken.
2) A chronic
carrier shall submit specimens of his or her stool in outbreak instances or
when posing a public health risk.
3) A chronic carrier shall report his or her
address, occupation, and place of employment, in person or in writing to the
local health authority, upon request of the Department, including in outbreak
instances or when the local health authority determines the carrier poses a
public health risk based on the person's employment or other activities that
may expose others to infection.
d) Sale of Food, Milk, etc. (See Section 690.30(b).)
e) Laboratory Reporting
1) Laboratories shall report to the local
health authority patients who have a positive result on any other laboratory
test indicative of and specific for detecting Salmonella Typhi, S. Paratyphi A,
S. Paratyphi B (tartrate negative), or S. Paratyphi C infection.
2) Laboratories shall forward clinical
materials positive for Salmonella Typhi, S. Paratyphi A, S. Paratyphi B
(tartrate negative), or S. Paratyphi C to the Department's laboratory in
accordance with the Department's specimen submission criteria, which can be
accessed at:
https://dph.illinois.gov/topics-services/lab-testing-services/general-requirements.html.
3) Laboratories shall report and submit to
the Department's laboratory any Salmonella Typhi, S. Paratyphi A, S. Paratyphi
B (tartrate negative), or S. Paratyphi C isolates from food resulting from an
outbreak investigation, or upon request.
Disclaimer: These regulations may not be the most recent version. Illinois may have more current or accurate information. We make no warranties or guarantees about the accuracy, completeness, or adequacy of the information contained on this site or the information linked to on the state site. Please check official sources.
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