Updated at 1:51 p.m., Oct. 2, 2019

As of Oct. 2, no additional cases have been confirmed, according to Collin County health officials. The possible exposure at a Frisco elementary school has been ruled out.

Original story

Collin County health officials issued two separate alerts about typhoid fever this week after one confirmed case in a McKinney restaurant employee and possible exposure at a Frisco elementary school.

Health officials confirmed in a Sept. 20 news release that an employee at a McKinney restaurant contracted typhoid fever. Anyone who ate at Hat Creek Burger Co., located at 3321 S. Custer Road, between Aug. 18-22 may be at risk, according to the statement.

The county is urging anyone who thinks they may have been exposed to the bacteria to consult their health care provider.

The health department sent a separate letter to parents at Frisco's Talley Elementary School on Sept. 19 stating that the school may have possibly been exposed to the disease. As of Sept. 20, the exposure at the school has not been confirmed.

The restaurant employee's case is travel-related, according to the health department.

Typhoid fever is caused by salmonella serotype typhi bacteria, according to the Centers for Disease Control and Prevention.

The bacteria is spread through an infected person's stool when the bacteria comes in contact with objects, food or water that are put into someone else's mouth, according to the health department.

This strain of typhoid fever is "extensively drug resistant," the health department stated.

Symptoms can begin in as little as three days or as long as 60 days later, with an average range of eight to 14 days after exposure, according to the county. Symptoms include a fever up to 102-104 degrees, feelings of weakness, stomach pains, headache, diarrhea, loss of appetite and constipation or diarrhea, according to the statement. Patients may also get a rash of flat, rose-colored spots.

According to the county, the most important way to prevent the spread of this illness is through hand-washing, especially after using the restroom and before preparing food or eating.

“When we see diseases like this that have been virtually eradicated in the United States and then we have people that travel, and they come back in … it does generate concern in the public. But if we are all doing our job right, there should be no other cases,” Hat Creek spokesperson Pam Ritz said.

Hat Creek Burger Co. is urging anyone with questions or concerns to call its customer care line at 888-648-1613.

The elementary school is taking precautions as a result of the possible exposure, according to a Sept. 19 letter sent out by Talley Elementary principal Jamie Peden. Crews will be wiping all student desks and tables with disinfectant, cleaning and disinfecting all restrooms, clinics and offices, scrubbing all vinyl and cafeteria flooring with a disinfectant and defogging all classrooms to remove live bacteria or viruses, the letter stated.

Any suspicions of typhoid fever can be reported to Collin County Healthcare Services at 972-548-4707.

"Typhoid fever is not common in the United States, Canada, Western Europe, Australia, or Japan," according to the website for the Centers for Disease Control and Prevention, "but it is common in many other countries. It affects an estimated 22 million people worldwide each year. In the United States, about 350 people are diagnosed with typhoid fever each year."

Editor's note: This story has been updated to clarify that the employee had typhoid fever.