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Food and Water Safety
When your immune system is weak, it may be a good idea to watch not only what you eat, but also how you prepare your food. Some uncooked foods may put you in danger of bacterial or other infections. Avoid undercooked or raw meat or fish (although salt water fish is generally safe if prepared professionally). Meat should be well done (thoroughly cooked). Raw eggs and unpasteurized milk carry a risk of Salmonella infection. Avoid salad dressings (such as Caesar salad dressing) and eggnog if they are unpasteurized or contain raw eggs. Use pasteurized eggs (frozen or processed) rather than fresh eggs when making homemade ice cream, eggnog, and mayonnaise. When cooking eggs, make sure that the yolks and whites are firm, not runny.

Raw vegetables and fruit must be washed to remove germs. Cut off any mouldy parts. You can use grapefruit seed extract or bleach in the water when you wash these foods if you want to be extra careful. About ten to 20 drops of grapefruit seed extract or one teaspoon (4 millilitres) of bleach per litre of water should kill organisms on the surface of the vegetables or fruit.

Before you handle any food, wash your hands with soap. Wash them again after you touch any raw meat or fish. Try to buy your meat fresh or thaw it quickly. Use one cutting board for meat and another one for fruit and vegetables. Plastic cutting boards are easier to keep clean than wooden ones. Wash your cutting boards with hot soapy water immediately after use. Keep shelves, counter tops, cutting boards, refrigerators, freezers, utensils, and dish towels clean. Keep hot foods hot, cold foods cold. Properly cooking food can protect you from food poisoning. Heat kills bacteria. Most cookbooks give cooking times and temperatures for various foods. A minimum temperature of 60° Celsius (140° Fahrenheit) is necessary in order to
kill bacteria. When reheating leftovers or heating partially cooked foods, heat to a temperature of at least 70° Celsius (160° Fahrenheit). Don't taste before cooking is finished. If you are using a microwave oven, first heat the food at full
power, then heat for another five minutes at a lower power – 20 or 30 per cent.

Shopping for food

It's important to read food labels when shopping. Avoid products that may contain bacteria that can cause food poisoning. Use milk and cheese products only if they have been pasteurized. Avoid unpasteurized honey. Products that contain any raw or under-cooked meat or dairy products should be avoided, and so should products with a "best before" or "best used by" (expiry) date that has passed. Buy packaged peanut butter, rather than freshly ground peanut butter, which may grow mouldy.

It's a good idea to put packaged meat, poultry, or fish into a plastic bag before putting it in your shopping cart. This prevents drippings from touching other foods, which lowers the risk of bacteria from one food contaminating another. After shopping, get chilled and frozen foods into the refrigerator or freezer as soon as possible. Storing them in the car or even just carrying them around for a couple of hours can raise their temperature enough to allow bacteria to grow.

Eating out

Restaurants must follow guidelines established by the health department to ensure cleanliness and good hygiene. Always order meat medium to well done. Check how well cooked poultry or meat is by cutting into the centre of it. Fish should be flaky, not rubbery, when cut.

Order fried eggs well cooked, and avoid scrambled eggs that look runny. Caesar salad dressings and hollandaise sauce should also be avoided, if they contain raw eggs. If you're not sure about the ingredients in a particular dish, ask before ordering.

Raw seafood can pose a serious risk of food poisoning. Raw shellfish, like raw meat and poultry, may contain harmful bacteria. It's a bad idea to eat oysters on the half shell or raw clams. Lightly steamed seafood, like mussels and snails, may also contain harmful bacteria.

Food poisoning

You can't always tell by looking, tasting, or smelling if food has bacteria on it that can cause food poisoning. But such bacteria can cause serious infections in people with weakened immune systems. These infections can cause severe vomiting and diarrhoea, and are often hard to treat. This can further weaken your immune system. Most food poisoning is caused by food that's been badly handled or prepared. You can protect yourself by being careful about buying, preparing, and storing food. It's also useful to know about the following common, harmful bacterial infections and the foods you can get them from.

Many kinds of bacteria can cause food poisoning, but three kinds are especially dangerous to people with HIV:
  • Salmonellosis is the illness that can develop from eating foods containing Salmonella bacteria. It causes flu-like symptoms, and sometimes also nausea, vomiting, cramps, and diarrhoea. Symptoms can develop six to 48 hours after eating infected food, and may last up to a week. The foods that most often cause salmonellosis include raw or undercooked meat, poultry (chicken, turkey, etc.), and fish.
  • Campylobacteriosis, or Campylobacter infection, can cause belly pain, diarrhea (which can be watery and/or contain
    blood), nausea, headache, muscle pain, and fever. Symptoms begin two to five days after eating bad food and generally last seven to ten days. These bacteria are found in raw or undercooked poultry, unpasteurized milk, and unchlorinated water.
  • Listeriosis, the disease caused by Listeria, gives you flu-like symptoms: chills, fever, and headache, and sometimes also nausea and vomiting. These early symptoms can appear two to 30 days after eating the bad food, and can be followed by meningitis or encephalitis. Foods that can contain Listeria are unpasteurized milk and cheeses and raw or undercooked meat, poultry, and fish.

Water safety

Tap water and well water may contain harmful bacteria and parasites. What would be harmless levels of Cryptosporidum parvum (which causes cryptosporidiosis), microsporidium, and mycobacteria (like the germs that cause MAC) for most people can cause infections in people with HIV (especially if their T4 cell count is below 100). Water from a tap should be boiled for at least five minutes and then cooled before drinking. It can also be distilled (evaporated and then condensed into water again), or passed through a filter, such as a reverse osmosis filter. Carbon filters, such as Brita filters, are not effective against bacteria and parasites. Only bottled water that's distilled or ozonated is completely free of germs.


Contact Information
Name:  Sharron Cooney  Phone:  519-973-0222 ext. 229  Email:  scooney@aidswindsor.org
Name:  Lori Baxter Phone:  519-973-0222 ext. 223  Email:  lbaxter@aidswindsor.org
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Updated November 30, 2004

1168 Drouillard Rd., Suite B, Windsor, ON    N8Y 2R1  PH: 519-973-0222 or 1-800-265-4858  FAX: 519/973-7389