Food Safety During Cancer Treatment

This information explains what foodborne illness is. It also explains how to handle food safely to help prevent foodborne illness.

What is foodborne illness?

Foodborne illness (often called food poisoning) is an illness that comes from a food you eat.

Sometimes, bacteria, viruses, or parasites attach to food and grow. You can’t always see, smell, or taste them. When certain bacteria, viruses, or parasites contaminate (get into) the food you eat, they can cause foodborne illness.

Who is at risk?

Foodborne illness can happen to anyone, but some people are more likely to get it than others. For example, people who have a weakened immune system from cancer and cancer treatment are at higher risk of getting a foodborne illness.

Some people (such as people who’ve had a stem cell transplant) may need to take extra steps to avoid foodborne illness. Your healthcare team will tell you if this applies to you.

What are the symptoms?

Foodborne illness usually happens within 1 to 3 days after eating the contaminated food. But, it can also happen within 20 minutes or up to 6 weeks later. Symptoms of foodborne illness include:

• Vomiting (throwing up)
• Diarrhea (loose or watery bowel movements (poop))
• Pain in your abdomen (belly)
• Flu-like symptoms (such as fever above 101.3 °F (38.5 °C), headache, body aches, and chills)

If you have any of these symptoms, contact your healthcare provider right away.

What steps can I take to prevent foodborne illness?

It’s important to handle food safely to lower your risk of getting a foodborne illness. Foodborne illness can be serious or even fatal.

To help keep yourself safe from foodborne illness, follow these 4 simple steps: clean, separate, cook, and chill.

Clean Clean your hands and surfaces often.

• Wash your hands with warm water and soap for at least 20 seconds:
  • Before and after handling food.
  • After using the bathroom, changing diapers, handling garbage, or handling pets.
• Wash cutting boards, dishes, utensils (forks, spoons, and knives), and countertops with hot soapy water after preparing each food item.
• Use a glass or plastic cutting board instead of a wooden one. Glass and plastic are easier to clean.
• Use paper towels to clean up kitchen surfaces, if you can. Bacteria, viruses, and parasites can grow on wet or dirty cloth towels and sponges.
  • If you use cloth towels, wash them often using hot water.
  • If you use a sponge, squeeze out all the water after each use. Replace it every 2 weeks.
     
• Use an antibacterial cleaning spray to clean surfaces. Look for products that have bleach or ammonia (such as Lysol® or Clorox®).
• Rinse all produce (such as fruits and vegetables) under running water. This includes produce with skins and peels that aren’t eaten (such as bananas and avocados). Scrub firm produce (such as melons, oranges, and lemons) to clean them.
  • If you use a produce brush, clean it every 2 to 3 days by putting it in your dishwasher or washing it with hot, soapy water.
• Avoid produce that has bruises or blemishes.
• Clean the lids of canned goods before you open them.

Separate Separate raw meats from other foods.

• Put raw meats, poultry, and seafood into individual bags in your shopping cart and grocery bags. This will keep any liquids that leak from getting onto other foods.
• In your refrigerator, don’t store raw meats, poultry, or seafood above produce and other foods that you don’t cook before eating.
• Use one cutting board for produce and a separate one for raw meats, poultry, and seafood.
• Never put cooked food on a plate that previously held raw meat, poultry, seafood, or eggs unless the plate has been washed in hot, soapy water.
• Don’t reuse marinades used on raw meats, poultry, or seafood unless you heat them to a boil first.
   

Cook Cook to the right temperature.

• Use a food thermometer to check the internal temperature of meat, poultry, seafood, and egg products when you’re cooking them. These foods must be cooked to a certain temperature to destroy any harmful bacteria. This is called the safe minimum internal temperature.
• Color and texture can help you know when foods are cooked, but they’re not reliable ways to tell if the food is cooked enough to be safe. The best way is to use a food thermometer.
• Cook eggs until the yolk and white are firm. Only use recipes in which eggs are cooked or heated thoroughly.
• When cooking in a microwave oven, cover, stir, and turn the food to make sure it’s cooked evenly. If the microwave doesn’t have a turntable, rotate the dish by hand once or twice during cooking. Always wait about 10 minutes after the food is done before checking the food’s internal temperature with a food thermometer. This lets the food finish cooking.
• When reheating sauces, soups, or gravy, heat them to a boil.
• Eat reheated leftovers within 1 hour.
• Don’t reheat leftovers more than once. If you don’t finish the food that you reheated, throw it away. Don’t put it back in the refrigerator.

Chill Chill foods promptly.

• Make sure the refrigerator temperature is 40 °F (4 °C) or below and the freezer temperature is 0 °F (-18 °C) or below.
• Refrigerate or freeze meat, poultry, eggs, seafood, and other perishables (foods that can go bad) within 2 hours of cooking or buying them. If the temperature outside is above 90 °F (32 °C), refrigerate or freeze them within 1 hour.
• When it’s hot out, use an insulated bag or cooler with ice or frozen gel packs to bring perishables home after shopping.
• Never defrost food at room temperature (such as on the countertop). Defrost food in the refrigerator, in cold water, or in a microwave. If you use cold water or a microwave, cook the food right away once it’s defrosted.
• When you marinate food, always marinate it in the refrigerator.
• Divide large amounts of leftovers into shallow containers before refrigerating them. This helps them cool more quickly.
• Eat leftovers within 2 days.

Are there any foods I should avoid?

Some foods are more likely to cause a foodborne illness than others. It’s best to avoid these foods. Examples include:

• Raw or undercooked meat, poultry, seafood (including sushi), eggs, and meat substitutes (such as tempeh and tofu)
• Unpasteurized or raw milk, cheese, other dairy products, and honey
• Unwashed fresh fruits and vegetables
• Raw or uncooked sprouts (such as alfalfa and bean sprouts)
• Cold or uncooked deli meats (cold cuts) and hot dogs

Can I eat at restaurants?

It’s okay for most people to eat at restaurants. If you had a stem cell transplant, ask your healthcare team when it’s safe for you to eat at restaurants. Follow these guidelines when eating at restaurants to lower your risk of getting a foodborne illness.

• Choose the restaurant carefully. You can see a restaurant’s recent health inspection score by visiting the local Department of Health (DOH) website.
• Order food that’s properly cooked. Send back any meat, poultry, fish, or eggs that are undercooked. Food that’s steaming hot is usually safer than room temperature and cold foods (such as sandwiches and salads).
• Refrigerate any leftovers within 2 hours of eating out. Reheat them until they’re steaming hot (165 °F) and eat them within 2 days.
• Avoid foods that may have raw, unpasteurized eggs (such as Caesar salad dressing, fresh mayonnaise or aioli, and hollandaise sauce).

Some restaurant foods are riskier than others. These include:

• Foods from buffets and salad bars.
• Food that isn’t cooked to order (such as fast food and other foods stored under heat lamps).
• Containers used by many people (such as condiments and milk at a cafe).
• Any food handled by employees without gloves or utensils.

Take-out food, delivery food, and food from food trucks can also be riskier because food may not be kept hot or cold enough during transit.