Food Safety for People with Weakened Immune Systems

Some health conditions, as well as treatments for certain diseases, can weaken your immune system. When your immune system is weak, it can be harder for your body to fight disease, so you are more likely than the general population to get food poisoning, and to have serious health effects as a result.

Some examples of conditions or procedures that can weaken your immune system and your body’s ability to fight germs are:

  • Alcoholism
  • Cancer
  • Chemotherapy/Radiation treatments
  • Diabetes
  • Organ transplant
  • Taking high doses of drugs, such as steroids or immune suppressants
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Because of this higher risk, people with weakened immune systems or those preparing food for them must practice proper food-handling techniques to kill pathogens and avoid cross-contamination. Foodborne illness, which is caused by eating food that contains harmful bacteria, parasites, or viruses, can be severe and sometimes deadly.

If you have any conditions that can affect your immune system, talk to your doctor about your increased risk of food poisoning. If you are at increased risk, it is very important that you be careful about what you eat and how you store, prepare and cook your food.

What is food poisoning?

Food poisoning (also known as foodborne illness or food-related illness) is caused by eating food that has been contaminated by bacteria, viruses or parasites.  Food can become contaminated by these microorganisms at any time before you eat it, including at home during handling, storing and cooking food.

There are many signs of food poisoning, but most types cause one or more of the following:

  • nausea
  • vomiting
  • diarrhea
  • stomach pain and cramps
  • fever and chills

Symptoms can start within hours after eating the contaminated food, or sometimes not until days or even weeks later. Usually, people recover quickly and completely.

However, food poisoning sometimes causes serious complications, including death. This is the case for people who are more at risk for both food poisoning and related health complications, like those with a weakened immune system.

Food Safety Tips for when your white blood cell count is low+

Recommended Avoid (do not eat)
Meat, poultry, fish, tofu, and nuts Ensure all meats, poultry, and fish are cooked thoroughly.

Use a food thermometer to be sure that meat and poultry reach the proper temperature when cooked.

When using tofu from the refrigerated section (not shelf-stable), cut it into 1-inch cubes or smaller and boil 5 minutes in water or broth before eating or using in recipes. You don’t have to do this if using aseptically packaged, shelf-stable tofu.

Vacuum-sealed nuts and shelf-stable nut butters

Raw or lightly cooked fish, shellfish, lox, sushi, or sashimi

Raw nuts or fresh nut butters

Eggs Cook eggs until the yolks and whites are solid, not runny

Pasteurized eggs or egg custard

Pasteurized eggnog


Raw or soft-cooked eggs. This includes over-easy, poached, soft-boiled, and sunny side up.

Foods that may contain raw eggs, such as Caesar salad dressing, homemade eggnog, smoothies, raw cookie dough, hollandaise sauce, and homemade mayonnaise


Milk and dairy products Only pasteurized milk, yogurt, cheese, or other dairy products Soft, mold-ripened or blue-veined cheeses, including Brie, Camembert, Roquefort, Stilton, Gorgonzola, and blue cheese

Mexican-style cheeses, such as queso blanco fresco, since they are often made with unpasteurized milk


Breads, cereal, rice, and pasta Breads, bagels, muffins, rolls, cereals, crackers, noodles, pasta, potatoes, and rice are safe to eat as long as they are purchased as wrapped, pre-packaged items, not sold in self-service bins. Bulk-bin sources of cereals, grains, and other foods
Fruits and vegetables Raw vegetables and fruits and fresh herbs are safe to eat if washed under running water and lightly scrubbed with a vegetable brush. Fresh salsas and salad dressings found in the refrigerated section of the grocery store. Choose shelf-stable salsa and dressings instead.

Any raw vegetable sprouts (including alfalfa, radish, broccoli, or mung bean sprouts)


Desserts and sweets Fruit pies, cakes, and cookies, flavored gelatin; commercial ice cream, sherbet, sorbet, and popsicles


Commercially prepared and pasteurized jam, jelly, preserves, syrup, and molasses


Unrefrigerated, cream-filled pastry products

Raw honey or honeycomb. Select a commercial, grade A, heat-treated honey instead.


Water and beverages Drink only water from city or municipal water services or commercially bottled water.

Pasteurized fruit and vegetable juices, soda, coffee, and tea


Water straight from lakes, rivers, streams, or springs

Well water unless you check with your cancer care team first

Unpasteurized fruit and vegetable juices

Sun tea (Make tea with boiling water, and use commercially prepared tea bags instead.)

Vitamin- or herbal-supplemented waters (These provide little, if any, health benefit.)


+ Adapted from Grant BL, Bloch AS, Hamilton KK, Thomson CA. American Cancer Society Complete Guide to Nutrition for Cancer Survivors, 2nd Edition. Atlanta, GA: American Cancer Society; 2010.


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