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Food Safety for Persons with AIDS
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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 teaspoon chlorine bleach in a quart
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 meat, fish,
eggs, and casseroles reach at least 160 °F. Roast whole
poultry to 180 °F; poultry breasts to 170 °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.
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Food Handling Recommendations For People With AIDS
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Food |
Recommendations |
Meat, fresh |
Cook to 160 °F. After cooking, refrigerate in cool shallow containers within 2 hours; use within 3 to 4 days. |
Ground: hamburger, meat loaf, etc. |
Cook to 160 °F. |
Steak tartare, carpaccio |
Do not eat. |
Poultry, fresh whole, unstuffed |
Cook to 180 to 185 °F. |
Stuffed poultry |
Not recommended. Cook stuffing separately to 165 °F. |
Breasts, roasts |
Cook to 170 °F. |
Thighs, wings |
Cook to 180 °F. |
Ground turkey, chicken |
Cook to 165 °F. |
Deli sliced meats |
Avoid or heat before eating until steaming hot. |
Hot dogs |
Heat until steaming hot. |
Eggs, fresh |
Never eat raw. Don't buy eggs with cracked or dirty shells. Cook yolk and white until firm, not runny. |
Egg products, liquid or dried |
Use egg products labeled "pasteurized." Avoid products with raw eggs, like Caesar Salad and mousse. |
Fish |
Never eat raw. Cook to 160 °F or until flakes easily with a fork. |
Shellfish |
Never eat raw. Use only shellfish that are closed. Bring to a boil; continue boiling 3 to 5 minutes after shells open. When steaming, cook 4 to 9 minutes from the start of steaming. Discard any shellfish that do not open during cooking. |
Home canned foods |
Boil 10 minutes before eating. Use within 1 year of canning. |
Commercially canned foods |
Safe to eat without further cooking. Refrigerate after opening; use leftovers within 3 to 4 days. |
Fruits, fresh |
Rinse well under cool, running water. Discard any with mold. Don't let cut fruit sit at room temperature; refrigerate it promptly. |
Vegetables, fresh |
Rinse well under cool, running water. Consume raw or cook. After cooking, refrigerate in shallow containers within 2 hours; use within 3 to 4 days. |
Milk, cheese |
Use only pasteurized products. |
Bakery products |
Store in refrigerator; do not eat any with mold. |
Dry products: pasta, beans, rice, cereal, etc. |
Safe in the pantry unless products get wet and moldy. After cooking, refrigerate in shallow containers within 2 hours; use within 3 to 4 days. |
Condiments: mayonnaise, mustard, ketchup, pickles, etc. |
Use a clean knife when dipping into jars. Keep jars refrigerated. Don't use homemade mayonnaise made with raw eggs. |
Leftover cooked foods |
Reheat to 165 °F or until steaming hot. |
Baby food |
Don't feed baby from jar; remove serving amount to a small dish. Discard any uneaten food. Store opened jars of strained fruits and vegetables in refrigerator 2 to 3 days; meats and eggs, 1 day. |
Infant formula, milk |
Discard any unused formula or milk left in bottle after feeding; store fresh bottles of formula 2 days in refrigerator; milk, 5 days. |
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.
Information is also available from the FSIS Web site: http://www.fsis.usda.gov
EMail: mphotline.fsis@usda.gov
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)
August 2004
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