Reporting & Investigation of Typhoid Fever

Table of Contents

A. Purpose of Surveillance and Reporting

  • To identify whether the case may be a high risk for spread to others (e.g., a diapered child, child care attendee, healthcare provider, or food handler) and, if so, to prevent further transmission.
  • To identify transmission sources of public health concern (e.g. a restaurant or a commercially distributed food product) and to stop transmission from such sources.

B. Laboratory and Healthcare Provider Reporting Requirements

Iowa Administrative Code 641-1.3(139) stipulates that the laboratory and the healthcare provider must report. The preferred method of reporting is by utilizing the Iowa Disease Surveillance System (IDSS).  However, if IDSS is not available to your facility the reporting number for IDPH Center for Acute Disease Epidemiology (CADE) is (800) 362-2736; fax number (515) 281-5698, mailing address:

Iowa Department of Public Health, CADE
Lucas State Office Building, 5th Floor
321 E. 12th Street
Des Moines, IA 50319-0075

Postage-paid disease reporting forms are available free of charge from the IDPH clearinghouse.  Call (319) 398-5133 or visit the website healthclrhouse.drugfreeinfo.org/cart.php?target=category&category_id=295  to request a supply.

C. Local Public Health Agency (LPHA) Follow-up Responsibilities

Case Investigation

It is the LPHA responsibility to complete an investigation by interviewing the case or legal guardian of the case and others who may be able to provide pertinent information. Using IDSS is the preferred method of conducting the investigation. Much of the information can be obtained from the case’s healthcare provider or the medical record.

Use the following guidelines in completing the investigation:

  • Accurately record the demographic information, date of symptom onset, symptoms, and medical information.
  • When asking about exposure history (food, travel, activities, etc.), use the usual incubation-range for typhoid fever (8 – 14 days).
  • If possible, record any restaurants at which the case ate, including food items(s) and date consumed.
  • Ask questions about travel history and outdoor activities to help identify where the case became infected.
  • Ask questions about water supply because typhoid fever may be acquired through water consumption.
  • Household/close contact, school, work, travel, and food handler questions are designed to examine the case’s risk of having acquired the illness from, or potential for transmitting it to, these contacts.
  • Ask if the patient knows others who had a similar illness about the same time.
  • If several attempts have been made to obtain case information, but have been unsuccessful (e.g., the case or healthcare provider does not return your calls or respond to a letter, or the case refuses to divulge information or is too ill to be interviewed), please request help from CADE epidemiologists (800) 362-2736.

After completing the investigation and gathering the information, enter the information into IDSS, or FAX the report form with supporting laboratory documentation to (515) 281-5698 or mail (in an envelope marked “Confidential”) to the IDPH/CADE mailing address.