What Not to Do When You're Immunocompromised

When you're immunocompromised, your immune system doesn't work as it should to fight infections and disease. This can result from conditions like HIV and AIDS, diabetes, lupus, and cancer, or from a bone marrow or organ transplant. You can also become "immunosuppressed" from certain treatments, like chemotherapy and corticosteroids. To protect against illness, there are some things you should avoid.

Pet poop may carry parasites like Toxoplasma gondii or cryptosporidium (crypto). These can infect anyone, but immunocompromised people are more likely to get seriously ill. Wear gloves to clean the litter box or cage, or ask someone else to do it. Afterward, wash your hands thoroughly. Stay away from reptiles, amphibians, and farm animals. Ask your doctor and vet how to stay safe.

Fresh fruits and veggies can spread foodborne illnesses. Wash any produce you plan to eat raw with running (and uncontaminated) water. Peel fruits before you eat them. Use a brush to scrub hard-skinned items like potatoes and carrots. Don't soak produce in the sink, which may harbor bacteria. In particular, stay away from raw or lightly cooked sprouts, like alfalfa sprouts.

Even chlorinated water and saltwater can contain bugs like crypto. Never swallow water when you swim in a pool, lake, river, or ocean. Don't drink from springs or private wells. Depending on water quality in your area, even tap water – and ice made with it – could be risky. It may be best to drink only bottled water, or use a filter.

Sexually transmitted infections can be more serious when you’re immunocompromised. Parasites like crypto may also spread through sexual contact. Avoid activities involving oral-anal or oral-genital contact, or use barrier protections like dental dams or condoms. Thoroughly wash your hands and genitals with soap and water after sex.

Smoking itself weakens your immune system, raising your risks for many diseases and infections. It can even lead to autoimmune conditions like rheumatoid arthritis, in which your immune system attacks healthy body tissues. And it harms your lungs, leaving less healthy tissue to fight off respiratory illnesses like COVID-19. Ask your doctor about the best ways to quit.

A weak immune system makes you vulnerable to food poisoning and can make it more serious if you get it. So raw fish, as well as uncooked meats like steak tartare, are off the table. Other no-nos include:

• Uncooked or undercooked eggs
• Rare burgers and steaks
• Soft cheeses like brie and Camembert, as well as blue-veined cheese
• Uncooked deli meats like bologna and turkey breast
• Self-serve buffets and salad bars

Mosquitoes and ticks spread infections that can be serious for those with weak immune systems. Before heading outdoors:

•  Use bug repellent with effective ingredients like DEET or picaridin.
•  Wear protective clothing.
• Avoid wooded and brushy areas.

Check pets and yourself for ticks on your return. If you're traveling to an area prone to mosquito-borne illnesses, ask your doctor about medicine to ward off disease.

Bug spray isn't the only protection you need when you head out to work in your yard. Soil contains bacteria and mold that could lead to fungal infections. Wear gardening gloves to guard against cuts and scrapes to your hands, which give bacteria a way to enter your body. Long pants and long sleeves help, too. In some cases, your doctor may recommend that you avoid contact with soil.

It's true that you should forgo most "live" vaccines – those containing a weak form of the disease-causing virus – like the yellow fever vaccination. But "inactivated" vaccines, like the flu and pneumonia shots, are made from dead viruses. They're generally safe, and they're important to protect against infections. Your doctor can tell you which are right for you.

When you’re immunocompromised, you're more likely to get COVID-19, get seriously ill from it, and stay sick longer. Use these protections:

• Get a COVID-19 vaccine, including suggested boosters.
• Take medicine (Evusheld) to boost your immune system response and prevent infection.
• Wear a high-quality mask when you're around others.
• Avoid crowded indoor events.