Missouri Code of State Regulations
Title 19 - DEPARTMENT OF HEALTH AND SENIOR SERVICES
Division 20 - Division of Community and Public Health
Chapter 22 - Typhoid Carriers
Section 19 CSR 20-22.010 - Supervision of Typhoid Carriers

(1) Any person whose feces or urine contains typhoid bacilli (Salmonella typhi) and is not ill shall be considered a typhoid carrier. If a typhoid carrier has had typhoid fever within the past twelve (12) months s/he shall be considered a convalescent typhoid carrier. If a typhoid carrier continues to have typhoid bacilli in his/her feces or urine for more than twelve (12) months after having typhoid fever or in the absence of a history of typhoid fever, s/he shall be considered a chronic typhoid carrier.

(2) A typhoid carrier shall be under the supervision of the health officer having jurisdiction. No typhoid carrier shall prepare, serve or in any way handle water, milk or milk products or any other food to be consumed by persons other than those in his/her immediate family.

(3) The health officer shall prepare a case history, including laboratory findings, for each chronic typhoid carrier within his/her jurisdiction and forward a copy to the Department of Health district health administrator in whose jurisdiction the carrier resides. Typhoid carrier record forms will be supplied by the Department of Health for this purpose.

(4) The health officer or his/her representative shall instruct chronic typhoid carriers regarding their infection and the measures necessary to avoid transmission of infection to others. Chronic typhoid carriers may be permitted by the health officer to be in free communication with others upon the signing of and adherence to the following typhoid carrier agreement; one (1) copy of which will be retained by the carrier; one (1) by the health officer; and a third forwarded to the district health administrator having jurisdiction or to the Department of Health.

(5) The typhoid carrier agreement shall read as follows:

To Whom It May Concern

Date: ________________________________

I __________________ , of ______________

hereby acknowledge that I am a typhoid carrier and that in order that I might be placed under modified isolation I hereby agree that:

(6) A health officer may release a chronic typhoid carrier from further supervision if the carrier submits, under the supervision of the health officer, six (6) consecutive feces specimens (for intestinal carriers) or urine specimens (for urinary carriers) at monthly intervals which are found to be culturally negative for typhoid bacilli. The release shall be in the form of a written dated statement, signed by the health officer, indicating that the patient has met the requirements for release from supervision and is no longer classified as a typhoid carrier. One (1) copy of this statement shall be given to the carrier, one (1) retained by the local health department and one (1) forwarded to the district health office having jurisdiction or to the Department of Health.