AIDS and Food Safety

Overview
People with Acquired Immunodeficiency Syndrome (AIDS) are more susceptible than other people to many types of infections, including severe illness or even death from foodborne pathogens. Affected persons must be especially careful when handling and cooking food. The recommendations provided here are designed to help prevent foodborne illness.

I have been living with HIV for about 18 years now and I have had AIDS for 14 years. I live and work in New York City. People who know I have AIDS ask how I got it. I guess most people are curious or afraid of contracting it themselves. Some people with HIV like to say the disease does not discriminate, so what's the difference with how they got it? Nevertheless, I think you should know my story. I contracted AIDS from skin-popping cocaine in the 1980s when that was a popular thing to do in bars. People shared needles, but we didn't think there was much risk since there was rarely blood involved.

Personally, I don't eat meat of any kind in order to reduce my risk of foodborne illness. I will eat fresh fish occasionally, but I am a vegetarian most of the time. I have found that drinking bottled water is the safest way to avoid a bad case of diarrhea. I have water delivered that is ozonated, distilled and follows the HIV water guidelines. It is not a good idea to drink spring water if you know you are HIV positive. You risk bacterial infections; I learned that the hard way, and ended up in the hospital.


Why Does Bacteria Endanger People with AIDS?

When the AIDS virus damages or destroys the immune system, AIDS-infected individuals become more vulnerable to infection by foodborne bacteria and other pathogens. For example, listeria, which is a bacteria that can be found on unpasteurized cheese or deli meats, can occur in any individual, but occurs much more frequently in persons with AIDS. In addition, when listeriosis strikes a person with AIDS, it causes a more severe illness and is thus more dangerous. I recommend eating a healthy diet to support your immune system. This will help keep you strong and keep your energy and weight stable.

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

Certain types of foodborne illnesses are caused by bacteria that 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 is 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. Salmonellosis can affect anyone, but occurs almost 100 times more frequently in persons with AIDS than in otherwise healthy persons. Furthermore, salmonella infections can be particularly difficult to treat and are more likely to lead to serious complications in people with AIDS.

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 people 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 in a variety of foods including soft cheeses that are unpasteurized and some ready-to-eat foods such as hot dogs or deli meats. Listeria infections are much more common in persons with AIDS than in healthy people. Listeria infections in AIDS patients are usually severe and are often fatal.

Symptoms

Symptoms of slmonellosis include fever, abdominal cramping and diarrhea. Symptoms of campylobacter can also cause fever, abdominal cramping and diarrhea, and the diarrhea is sometimes bloody. Symptoms of listeriosis include fever, body aches, nausea, diarrhea and may progress to headache, stiff neck and seizures.

Prevention

How Can Persons with AIDS Prevent Foodborne Illness? Food must be handled safely at every stage, from purchase through consumption. It is critical to transport perishable foods home from the store immediately. Prompt, safe storage of foods, thorough cooking to destroy bacteria and other pathogens and prompt refrigeration of leftovers can all help to reduce your risk of foodborne illness.

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 that are torn or leaking. To guard against cross-contamination, put raw meat and poultry into a plastic bag so that meat juices do not drip on other foods, especially fruits and vegetables that will be eaten raw. Put refrigerated or frozen items in the shopping cart last, and take your 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 that 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. Another option is to thoroughly reheat luncheon meats and hot dogs until they are steaming before eating, as this eliminates many foodborne pathogens.

Canned Foods
Do not purchase food that comes in cans that are dented, leaking or bulging, cracked glass jars, or 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 and do not consume foods that are beyond the expiration date. Carefully follow 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 degrees F or below; the freezer should be at 0 degrees 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 and other red meats for 3 to 5 days. After cooking, use within 3 to 4 days, or freeze for longer storage.

Freezer
Food stored constantly at 0 degrees F is usually safe. Typically, the quality or texture of food suffers with lengthy storage. 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 you would 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 anyplace exposed to extreme temperature. Store highly acidic foods such as tomatoes and other fruit up to 18 months; low acid foods such as meat and vegetables can be stored for 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 they come 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-prepared meals, take-out and deli-prepared foods. When eating out, people at risk should avoid the same foods they would avoid 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 and harbor fewer foodborne pathogens. Wood surfaces are considered porous. Regardless of the type of cutting board you prefer, consider using one for fresh produce and a separate one for raw meat and seafood. This will help prevent cross-contamination. Cutting boards should be washed with hot, soapy water or placed in the dishwasher. After thoroughly washing your cutting board, you can sanitize it with a solution of 1 tsp. chlorine bleach in a 1 qt. 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, it is very important to use a food thermometer to be sure meats reach at least 160 degrees F. Roast whole poultry to 180 degrees F and poultry breasts to 170 degrees 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 degrees F (recommended refrigerator temperature) and 140 degrees F. Therefore, food left out at room temperature will become unsafe in a matter of hours. Refrigerate leftovers at 40 degrees F or below or freeze (to 0 degrees F) as soon as possible. Never leave perishable food out of refrigeration longer than 2 hours, or 1 hour in room temperatures above 90 degrees F. Divide leftovers into shallow containers. This encourages rapid, even cooling. Cover with airtight lids or enclose in plastic wrap or aluminum foil. Use leftovers within 3 to 4 days.