Hours after Collin County Health Care Services released information Friday about a travel-related case of typhoid fever confirmed in August in McKinney, the Frisco ISD said it is currently investigating a possible case at an elementary school.

Collin County health officials said Friday people who ate at the Hat Creek Burger Co., 3321 South Custer Road, between Aug. 19 and Aug. 22 may have come in contact with the extremely drug-resistant strain of XDR salmonella typhi and could still develop symptoms.

Pam Ritz, a spokesperson for the restaurant, said a worker who contracted the virus had traveled out of the country and only became ill three days after returning to work. The worker was at the restaurant on Aug. 19 to Aug. 22 before showing symptoms.

Ritz said the worker was sent home when he became ill and was later confirmed to be suffering from typhoid fever. No other employees or customers have reported symptoms of the illness in the past month and strict sanitation procedures have been followed at the restaurant, the spokesperson said.

Friday afternoon, officials with the Frisco Independent School District said a student at Talley Elementary is being investigated for having typhoid fever as well. The district said the student is only suspected of having contracted the virus and that it has not yet been confirmed.

Frisco ISD told parents in a letter that the Talley campus is being disinfected.

It is not clear if the cases are related or if the strains of the virus are the same.

Dr. Jawaid Asghar, chief epidemiologist for Collin County Health Care Services, said the disease could be transmitted by a sick person who did not wash their hands after using a toilet before touching the food of a healthy person.

He said the McKinney case is the first confirmation of the XDR salmonella typhi strain in Texas.

"This is extremely drug resistant," Asghar said. "It is resistant to drugs we can normally give for typhoid."

The worker is still receiving care for the illness and has not returned to work but has improved, Asghar said.

Hat Creek Burger Company has set up a hotline for customer questions or concerns. The number is 1-888-648-1613. People with questions can also call Collin County Health Services at 972-548-4707

Ashgar said the risk of transmission of the disease from that one sick person is very low but the press was notified to warn people who were in the restaurant during those three days to seek medical attention if they become ill.

Symptoms of salmonella typhi may include sustained fever as high as 103-104 degrees. Infected individuals may also feel weak, or have stomach pains, headache, diarrhea, or loss of appetite and constipation more often than diarrhea in adults. In some cases, patients have a rash of flat, rose-colored spots. Symptoms can begin in as little as three days or as long as 60 days, with an average range of 8-14 days after exposure.

Salmonella is spread through the stool of a person with the bacteria. Objects, food or water put into someone's mouth that has bacteria on them can cause the illness.

The most important way to prevent the spread of this illness is through careful hand-washing by everyone. Hands must be washed after using the restroom. Hands must also be washed before preparing food and before eating. Alcohol based hand rubs are effective when soap and water are not available.



Experts say Typhoid Fever is common in countries throughout south Asia.

More information from the U.S. Centers for Disease Control and Prevention (CDC) can be found online.