AIDS Victims, Elderly Warned of Food Risks

Giving an ailing resident of a nursing home a soft-cooked egg or a thin AIDS patient some juicy, raw oysters to tickle their appetites may sound like a good idea, but health officials warn that it could prove deadly.

The Food and Drug Administration and the federal Centers for Disease Control are trying to educate the elderly, as well as AIDS-infected people and other high-risk groups, about the dangers of food-borne infections.

Anyone can get sick from the harmful microbes, such as salmonella and listeria, that may lurk in unpasteurized milk, unwashed fruits and vegetables and raw animal products, including eggs, shellfish and meat.

But health officials say people with weakened or aging immune systems are hit particularly hard by food-borne infections, and are far more likely to develop the life-threatening situation in which infection spreads throughout the bloodstream.

Not only are the aging of America and the AIDS epidemic increasing the number of people at risk for food-borne infections, but the prevalence of infection-causing microbes in food also appears to be on the rise.

“Sooner or later these two curves are going to intersect,” said Douglas Archer of the FDA’s Center for Food Safety and Applied Nutrition.

Studies have found that people infected with the human immunodeficiency virus, or HIV, are 20 times more likely to be stricken by salmonella infection than their healthy counterparts. And people with full-blown AIDS are 200 to 1,000 times more likely to come down with listeriosis.

May Intensify Infection

In addition to causing severe and often recurring gastrointestinal illness in HIV-infected people, Archer said, food-borne microbes may act as a factor to speed up the deadly progression of AIDS.

There are no exact figures on the food-borne infection risk among the elderly, but Archer said people over 70 have the highest incidence of listeriosis, as well as the highest fatality rate, of any age group.

“At one time we felt pregnant women were the group at highest risk for food-borne infections, but that has turned out not to be the case,” Archer said.

Although their risk is not as high as once thought, the FDA microbiologist cautioned pregnant woman to pay special attention to food safety because food-borne infections are often fatal to the fetus.

Archer attributed older people’s susceptibility to food-linked infections to their aging immune systems, as well as their higher incidence of other diseases, such as cancer and diabetes, that boost the risk of such infections.

The government is preparing a video, to be released in August or September, that will counsel HIV-infected people about their dietary choices. Archer said it is not so much the type of food that people decide to eat that poses a threat, but the way it is prepared.

Official Offers Advice

“We are certainly not suggesting limiting protein intake, but to cook it well,” said Archer, who added that food-borne infection “is one aspect of AIDS that people certainly can control.”

The FDA official offered several pieces of advice, which he said apply to both the elderly and AIDS patients, on how to protect against food-borne infection.

* Avoid raw or undercooked meat, milk, eggs, seafood and other animal products.

Within the last year, the FDA learned that at least one strain of salmonella has been found in the yolks of uncracked eggs. Previously, it had been thought the microbe could only enter the egg through fractures in the shell.

Federal officials have sent pamphlets to nursing homes and hospitals urging them not to give their patients whole eggs, but to use pasteurized, liquid egg instead. Archer said it is unlikely that cooked eggs with runny yolks would have reached the 145-degree temperature needed to kill salmonella bacteria.

* Use good hygiene in the kitchen.

That includes thoroughly scrubbing vegetables and fruit, and carefully washing hands, utensils and counters after handling uncooked animal products.

HIV-infected people should be particularly careful about working with uncooked food if they have cuts or sores on their hands, Archer said, because it offers food-borne microbes “a good portal” to enter the body.

* Be alert when eating in restaurants and outside the home.

People at high risk for food-borne infection should not be afraid to ask restaurants about their ingredients and food-handling procedures, or be shy about sending back undercooked food.

Some salad dressings, soups and sauces, such as mayonnaise, contain uncooked or lightly cooked eggs and should be avoided. Raw eggs are also whipped into many so-called health and athletic drinks.