Infection risk and neutropenia
Managing your risk of infection
There are ways to lower your risk of getting an infection if you have blood cancer.
On this page we’ve listed things you can do to help you lower your risk of infection. Some will be things we've all been more aware of since the coronavirus pandemic, which has highlighted how simple hygiene practices and social distancing can protect us from infection.
Your healthcare team will also give you advice on how to minimise your risk of getting an infection. They may provide you with a treatment alert card or diary which explains this in more detail.
If anyone in your medical team tells you to go to hospital because of a suspected infection, you should go at once. Infections can be severe and can get worse quickly.
See also our information on coronavirus.
Basic hygiene tips
- Clean your hands frequently with soap and water or hand sanitiser.
- Clean cuts, scrapes and grazes with warm water, soap and an antiseptic.
- Avoid sharing food, cups, cutlery or personal items such as toothbrushes.
- Make sure your food is stored and cooked properly (see food safety below).
- Avoid handling any animal waste, such as litter trays or manure (it’s generally safe to pet or stroke animals, as long as you wash your hands thoroughly afterwards).
- Avoid changing the water in flower vases.
- Avoid people who have infections or who are sick.
- Avoid crowded places like public transport, festivals and shopping centres.
- Wear protective gloves when gardening and doing housework.
- Take good care of your mouth.
- Shower or bath daily and use lotion to stop your skin from becoming dry and cracked.
- Try to keep fit and well by eating a healthy diet and staying as active as possible.
If you have a low neutrophil count (you’re neutropenic), you may need to change some of the foods you eat and take extra care about the way you store, prepare and cook your food. See our page on neutropenic diet.
If you have blood cancer, especially if it causes neutropenia (a low level of white blood cells called neutrophils), you should follow food safety and hygiene advice about shopping, cleaning, storing, preparing and reheating food, as well as eating out. This will help you to reduce the chances of getting an infection from your food (food poisoning).
These food safety dos and don’ts are rules that everyone should follow, but are particularly important for people with weakened immune systems.
- Don’t buy food with damaged or broken packaging.
- Don’t buy food from fridges or freezers that are overloaded, as the food might not be cold enough.
- Buy your chilled and frozen foods last on your shop and get them home as quickly as possible. If you’re not able to get your shopping home immediately, use an insulated container or cool bag to keep food at the right temperature.
- Buy foods in small, individual packets. Avoid large packets: once they’re opened they’re hard to reseal safely, so there’s more chance that bacteria could infect them.
- Always check ‘use by’ and ‘best before’ dates on packaging before you buy food.
- Try to buy pre-packed deli items. If you have severe neutropenia, you should avoid deli counter foods.
- Avoid shops where raw and cooked meats are stored in the same fridge or in a deli counter without a separating wall.
- Keep your freezer below -18°C. Make sure food is still frozen solid when you take it out of your freezer.
- Keep your fridge between 0°C and 5°C. You can check the temperature with a fridge thermometer.
- Don’t overload your fridge or freezer, as this will increase the temperature inside.
- Store your cooked food at the top of your fridge.
- Don’t put hot food in your fridge, as this will increase the temperature of the food in the fridge, making all of the food less safe to eat.
- Store raw or defrosting meat or fish at the bottom of your fridge in a covered container, so it doesn’t leak or drip.
- Always store your eggs in the fridge
- Always check and stick to the ‘best before’ or ‘use by’ dates on your food.
- Follow the manufacturer’s instructions when you’re using and storing food.
- Always wash your hands with soap and warm water before preparing food.
- Always wash your hands after going to the toilet.
- Thoroughly dry your hands using a separate towel or kitchen paper. Don’t use a tea towel.
- Cover any cuts and grazes with a waterproof plaster.
- Keep pets away from work surfaces, food and dishes.
- Make sure any cloths, sponges and clothes are regularly bleached, disinfected or changed.
- Disinfect your work surfaces regularly.
- Clean your tap spouts regularly.
- Clean the roof and inside of your microwave regularly.
- Change or wash your chopping boards and utensils between preparing raw and cooked items, to avoid spreading germs from raw food. Ideally you should have three boards, which you might like to colour code to make things easier: one for raw meat, one for cooked meat and one for other foods.
- Wash fruit and vegetables thoroughly before eating.
- Wash the tops of cans before opening them.
- Defrost meat and poultry in the fridge and not at room temperature, as bacteria grows quickly at room temperature.
- Pre-heat the oven to make sure food is cooked at the recommended temperature.
- Cook all food thoroughly and make sure it’s piping hot all the way through before eating.
- Cook meat until all the juices run clear.
- Always follow the manufacturer’s guidelines and don’t reduce cooking times.
- Cover food and allow it to cool to room temperature before putting it in the fridge or freezer. Don’t put hot food in your fridge, as this will increase the temperature of the food in the fridge, making all of the food less safe to eat.
- Reheated food should be eaten within 24 hours of preparing or defrosting it.
- Don’t reheat food more than once.
- You can use microwaves to defrost food and to heat pre-prepared food but always follow the manufacturer’s instructions.
- Eat rice as soon as it’s cooked, and don’t reheat cooked rice, as harmful bacteria can survive the heating process.
- Do not refreeze defrosted food.
- Make sure food is piping hot when it arrives and that it’s cooked all the way through.
- Check restaurant hygiene ratings at ratings.food.gov.uk.
- Choose freshly prepared food from good-quality restaurants. To minimise infection and avoid cross contamination, avoid salad bars, street vendors, market stalls, buffets, all-you-can-eat restaurants and ice-cream vans.
- Avoid foods which have been left out on display such as doner kebab meat.
- Ask your healthcare team for advice about eating out in restaurants or visiting crowded places.
Practical tips and real stories to help you with everyday life