Food-safety principles for people with HIV

The Department of Health offers the following food-safety guidelines for people with compromised immune systems.

Raw and undercooked chicken, meat, fish and eggs, unpasteurised milk and water that does not come from a tap are the main dangers.

Cooking and eating defensively

Children are often taught about hygiene from a very early age. It becomes second nature in adults and may easily be taken for granted in healthy people. People with HIV/Aids are at a higher risk of infections by germs that are carried in food and water. Extra care and awareness of the steps to take to lower this risk is needed.

Personal hygiene around food

• Always wash hands thoroughly with soap and water (preferably warm water) before touching food. Do this every time between touching raw and cooked food.
• It is very important to wash your hands after touching pets and other animals, after visits to the toilet and after sneezing or blowing your nose.
• Cover all wounds to prevent contamination of food during preparation and handling.

Clean and safe water

• In South Africa it is generally safe to drink water from a tap. If you get your water from a river or well, drink the water only after boiling it.
• Use the bleach method to make the water safe when it is not possible to boil the water. Add one teaspoon (5ml or one capful if the bottle has a screw cap) of bleach to 25 litres of water. Mix it well and let it stand for two hours (or preferably overnight) before using it.
• Store clean and safe water in a clean container with a lid or cover with a cloth.
• Cool drinks and ice cubes should also be made with water that is clean and safe.

Safe food shopping

• It is safer to buy food in amounts that can be eaten before they spoil. It is sometimes cheaper to buy food in bulk, but without a fridge for safe storage this is not useful. For example, any meat not used within two days should be frozen.
• Do not use canned food if the can bulges or if it is dented or leaking. Do not be tempted by discounts on damaged cans.
• When buying cold meats and cheese, pre-packed and sealed products are safer. Cold meats that have been in the display case for some time are not safe.
• Do not buy cracked eggs. It is wise to inspect the eggs in the shop before they are bought.
• Many foods now have “Sell by”, “Best before” and “Use by” dates. Read the labels. It is not safe to buy foods after their “Sell by” date. Do not be tempted to do so even if the price is marked down. Check the food in your kitchen and throw away any food that has reached the “Best before” or “Use by” date, even if it still looks good. Do not taste food that you think might be spoiled.

Safe foods

• If you are not sure where food comes from or how it has been prepared, it is safer not to eat it. If you have any doubt, do not eat it.
• Make sure the food is kept away from pets and other animals.
• Always keep food well covered to prevent flies and other insects from reaching it.

Fruits and vegetables

• Wash all fresh fruits and vegetables. If it is not possible to wash them properly, peel your fruits and vegetables. A mixture of one teaspoon of bleach added to one litre of clean water can be used to wash fruits and vegetables.
• Throw away any fruits or vegetables that are mouldy or rotten.

Milk and dairy products

• Use only pasteurised milk. Pasteurisation is a process whereby milk is heated to a very high temperature, which destroys harmful germs. Look for the word “PASTEURISED” on the label. It might not be safe to drink home-produced milk. Home-produced milk should be boiled before use.
• Throw away mouldy cheese. Cutting off the mouldy part of the cheese is not good enough. Avoid blue-veined cheese and soft cheese which contain live moulds. This is not considered safe for people with HIV/Aids.

Meat

• Do not eat raw meat, poultry and fish, not even in small amounts.
• Cook meat thoroughly until it is cooked right through. If it is still pink inside, it is not safe for you. When eating in a restaurant, order your meat well done.

Eggs

• Do not eat raw eggs. Always cook eggs until the white is cooked and the yolk (the yellow section) is firm.
• It is not safe to add raw eggs to milk shakes.
• Do not use cracked eggs. The cracks allow germs to enter.
• Wash the eggs before breaking them.

Keep cold foods cold and hot foods hot

• Keep frozen foods frozen.
• Hurry home with frozen food. Food warms up and defrosts in warm vehicles. This allows germs to grow before you get home to re-freeze the food.
• Plan your shopping and pick up frozen foods last. If you know you are going to be long, pack the frozen food in a cooler bag.
• Foods frozen at home can only be kept safely for 30 days in the freezer compartment of a fridge. Germs can grow even in the freezer.
• Once frozen food has been defrosted, it should be used as soon as possible. It is not safe to freeze the defrosted food again.
• It is not safe to defrost frozen meat at room temperature. Room temperature gives germs the chance to grow and they may make you sick. Defrost frozen meat or other frozen foods in a fridge if you have one. Microwave ovens are also good for defrosting frozen food quickly.
• If you do not have a fridge, keep the food in a cool place away from the sun while it is defrosting.
• Once food has been cooked it should be eaten as soon as possible. It is not safe to store foods that have cooled down at room temperature.
• Any leftovers should be stored in a fridge if possible. Warm foods should be allowed to cool down before putting it in a fridge. Food should not be left out for any longer than two hours. Use airtight containers or cling wrap to protect foods in storage. If you do not have a fridge, keep the food covered and in a cool place.
• Do not keep food at room temperature for more than two hours. Be careful about eating cold, cooked food that has been kept at room temperature for longer than this. This often happens at parties and large functions such as weddings. Many healthy people have suffered stomach upsets after such events. When you are infected with HIV you need to be extra careful.
• When you eat leftovers of cooked food, you should reheat them to a high temperature to make sure that you kill all germs first. It is not safe to simply warm the food up.

Take extra care when travelling

Food safety standards are not the same everywhere. When people travel, they come into contact with new germs that their bodies are not used to. Our immune systems are not prepared for this and it can be a problem even for healthy people.

Diarrhoea is a common consequence. When the immune system is weakened by HIV/Aids, it is easier to get sick from food and water. Extra precautions should be taken when travelling. It is advisable to drink water only after boiling. Alternatively, only bottled and canned drinks or water should be drunk.

Source: DOH, 2007