food safety for persons with AIDS

Source: USDA

Persons with Acquired Immunodeficiency Syndrome (AIDS) are susceptible to many types of infection including illness from foodborne pathogens. They are at higher risk than are otherwise healthy individuals for severe illness or death. Affected persons must be especially vigilant when handling and cooking foods. The recommendations provided here are designed to help prevent bacterial foodborne illness.

Why Do Bacteria Endanger People with AIDS?

When the AIDS virus damages or destroys the body's immune system, the person becomes more vulnerable to infection by foodborne bacteria and other pathogens. For example, the common pneumonia, which is caused by a bacterial infection of the lungs, can occur in any individual but occurs much more frequently in persons with AIDS. In addition, when pneumonia strikes a person with AIDS, it causes a more severe illness and is thus more dangerous.

What Types of Foodborne Bacteria are of Particular Concern to Persons with AIDS?

Certain types of foodborne illness are caused by bacteria which can grow on food. The bacteria can infect humans when the food is improperly handled or inadequately cooked. As with many other types of infections, persons with AIDS are at higher risk for developing severe illness or dying from these illnesses. Three types of bacteria are of particular concern for persons with AIDS: Salmonella, Campylobacter jejuni, and Listeria monocytogenes.

Salmonella bacteria are the most common cause of foodborne illness. The bacteria are commonly found on raw or undercooked meats (especially poultry) and can be found in eggs even before they are cracked open. Salmonellosis can affect anyone, but occurs almost 100 times more frequently in persons with AIDS than in otherwise healthy persons. Furthermore, Salmonella infections, which occur in persons with AIDS, can be particularly difficult to treat and are more likely to lead to serious complications.

Illness from Campylobacter jejuni is also caused by a bacteria that can sometimes be found on food, especially raw poultry. This illness occurs about 35 times more frequently in persons with AIDS than in otherwise healthy persons. Many persons contract this form of food poisoning by improperly handling or cooking poultry. Raw milk and contaminated drinking water can also be sources of Campylobacter infections.

Listeriosis is caused by Listeria monocytogenes which can be found on many different types of food. Listeria infections are much more common in persons with AIDS than healthy people. Listeria infections in AIDS patients are usually severe and are often fatal. Listeria monocytogenes can be acquired from a variety of foods including soft cheeses that are unpasteurized and some ready-to-eat foods such as hot dogs or deli meats.

How Can Persons with AIDS Prevent Foodborne Illness?

Food must be handled safely at every stage from purchase through consumption. Critical points are transporting perishable foods home from the store immediately; prompt, safe storage; thorough cooking to destroy bacteria and other pathogens; and prompt refrigeration of leftovers.

How to Shop Safely for Perishable Food

When shopping for raw and cooked perishable foods, be sure the food is being stored at a safe temperature in the store. Don't select perishable food from a non-refrigerated aisle display. Never choose packages which are torn or leaking. To guard against cross-contamination, put raw meat and poultry into a plastic bag so meat juices won't drip on other foods, such as lettuce and fruit that will be eaten raw. Put refrigerated or frozen items in the shopping cart last, and take food home immediately.

Deli Foods
When ordering food from the deli department, be sure the clerk washes his hands between handling raw and cooked items, or puts on new plastic gloves. Don't buy cooked ready-to-eat items which are touching raw items or are displayed in the same case. Although the risk associated with foods from deli counters is relatively low, persons at risk may choose to avoid these foods or thoroughly reheat luncheon meats and hot dogs before eating.

Shelf-Stable Foods
Don't purchase cans that are dented, leaking, or bulging; food in cracked glass jars; or food in torn packaging. Tamper-resistant safety seals should be intact. Safety buttons on metal lids should be down and should not move or make a clicking noise when pushed.

Although product dating is not required by Federal regulations, observe any "use-by" dates found on products. Do not use if beyond expiration date! Follow carefully the handling and preparation instructions on product labels to ensure top quality and safety.

Food Storage At Home
Immediately refrigerate or freeze perishable foods after transporting them home. Use a refrigerator thermometer to be sure the refrigerator is cooling to 40 °F or below; the freezer should be at 0 °F.

Refrigerator. Make sure thawing juices from meat and poultry do not drip on other foods. Leave eggs in their carton for storage and don't place them in the door of the refrigerator. Keep the refrigerator clean. Store ground meat, poultry, and fish up to 1 or 2 days; other red meats, 3 to 5 days. After cooking, use within 3 to 4 days, or freeze for longer storage.

Freezer. Food stored constantly at 0 °F will always be safe. Only the quality suffers with lengthy storage. It is of no concern if a product date expires while the product is frozen. Freezing keeps food safe by preventing the growth of microorganisms that cause both food spoilage and foodborne illness. Once thawed, however, these microbes can again become active, so handle thawed items as any perishable food.

Pantry. Store canned foods and other shelf stable products in a cool, dry place. Never put them above the stove, under the sink, in a damp garage or basement, or any place exposed to high or low temperature extremes. Store high acid foods such as tomatoes and other fruit up to 18 months; low acid foods such as meat and vegetables, 2 to 5 years.

Food Handling At Home
Foodborne illness can be caused by improper food handling or preparation in the home. Wash, utensils, can openers, cutting boards, and countertops in hot, soapy water before and after coming in contact with raw meat, poultry, or fish. Wash kitchen towels and cloths often in hot water in a washing machine. Wash hands with soap and warm water before and after handling food, and after using the bathroom, changing diapers, or handling pets.

Eating Out
Many cases of foodborne illness are caused by restaurant, take-out, and deli-prepared foods. People at risk should avoid the same foods when eating out as they would at home. Meat, poultry, and fish should be ordered well done; if the food arrives undercooked, it should be sent back.

Cutting Boards
Research shows that nonporous surfaces, such as plastic, marble, tempered glass, and pyroceramic are easier to clean than wood. Wood surfaces are considered porous.

Regardless of the type of cutting board you prefer, wood or a nonporous surface, consider using one for fresh produce and a separate one for raw meat, poultry, and seafood. This will prevent bacteria on a cutting board that is used for raw meat, poultry, or seafood from cross-contaminating a food that requires no further cooking.

Cutting boards need to be maintained and monitored for cleanliness. They should be washed with hot, soapy water or placed in the dishwasher. Solid hardwood cutting boards are dishwasher safe; however, wood laminates should not be washed in the dishwasher.

After thoroughly washing your cutting board, you can sanitize it with a solution of 1 tablespoon of unscented, liquid chlorine bleach in 1 gallon of water. Once cutting boards of any type become excessively worn or develop hard-to-clean grooves, they should be discarded.

Cooking Food Safely
Do not eat raw or undercooked meat, poultry, fish, or eggs. For people with AIDS, the most important thing is to use a food thermometer to be sure foods have reached a safe minimum internal temperature.

Cook foods to the following safe minimum internal temperatures as measured with a food thermometer:

• Beef, veal, and lamb steaks, roasts, and chops may be cooked to 145 °F.
• All cuts of pork to 160 °F.
• Ground beef, veal and lamb to 160 °F.
• Egg dishes, casseroles to 160 °F.
• Leftovers to 165 °F.
• Stuffed poultry is not recommended. Cook stuffing separately to 165 °F.
• All poultry should reach a safe minimum internal temperature of 165 °F.

When reheating foods in the microwave, cover and rotate or stir foods once or twice during cooking and check the food in several spots with a food thermometer.

Safe Handling of Leftovers
Bacteria begin to multiply rapidly in the "danger zone" between 40 °F (recommended refrigerator temperature) and 140 °F. Therefore, bacteria on food left out at room temperature will become unsafe in a matter of hours. Refrigerate leftovers at 40 °F or below or freeze (0 °F) as soon as possible. Never leave perishable food out of refrigeration longer than 2 hours, 1 hour in air temperatures above 90 °F.

Divide leftovers into shallow containers. This encourages rapid, even cooling. Cover with airtight lids or enclose in plastic wraps or aluminum foil. Use leftovers within 3 to 4 days.

Safe Reheating of Leftovers
Even though foods may have been safely cooked, bacteria from the air or people's hands can contaminate the leftovers. Always reheat leftovers thoroughly in a conventional or microwave oven or on the stove top. When reheating foods in the microwave, cover and rotate or stir foods once or twice during cooking. Always test reheated leftovers in several places with a food thermometer to be sure they reach 165 °F throughout. The food should be steaming hot.

Traveling Abroad
Persons with AIDS should take additional precautions when traveling abroad. Boil all water. Drink only canned or carbonated bottled drinks or use beverages and ice made with boiled water. Avoid uncooked vegetables and salads. All fruit should be peeled. All foods should be cooked thoroughly and eaten while still hot.

For additional food safety information about meat, poultry, or egg products, call the toll-free USDA Meat and Poultry Hotline at 1-888-674-6854; for the hearing-impaired (TTY) 1-800-256-7072. The Hotline is staffed by food safety experts weekdays from 10 a.m. to 4 p.m. Eastern time. Food safety recordings can be heard 24 hours a day using a touch-tone phone.

The media may contact the USDA Meat and Poultry Hotline at (301) 504-6258.

Centers for Disease Control (CDC) National AIDS Hotline (toll-free, Eastern time):

• English service: 1-800-342-2437 (7 days a week, 24 hours a day)
• Spanish service: 1-800-344-7432 (daily 8 a.m. to 2 a.m.)
• TDD service for the deaf: 1-800-243-7889 (10 a.m. to 10 p.m., M-F)

Last Modified: August 18, 2006
Posted July 2008