Being extra alert ... recognizing the signs of infection

Fighting cancer increases your risk of infection
Whatever type of cancer you are fighting, your body is at an increased risk of developing an infection because your disease is affecting the body’s normal defense against the infection. Since we know drugs and diseases that can decrease the normal body defenses against infection and the types of infection likely to occur in patients, most types of infection are potentially preventable and often treatable.

When your white blood cell count is low you may NOT have the usual signs and symptoms when developing an infection such as:

• Redness
• Swelling
• Pus formation (at the site of an injury or incision)
• Cough
• Sputum
• Nasal drainage (from a sinus or respiratory infection)

It is extremely important to be alert to any change in how you feel and report and discuss what you are feeling with your doctor or nurse. Your health care provider will tell you when you are getting treatment that may cause your white blood cell count to be lowered. Additional information to ask is when the white blood counts will most likely be at its low point. This will give you a gauge as to when your body is less likely to be able to fight off infection.

When to call your health care provider about the possibility of infection
Call immediately if you have: 

• A temperature greater than or equal to 100.5°F. (Check with your health care provider, you may be instructed to call for temperature greater than 100°F).
• Chills (rigors) or shakes
• Sudden onset of a new unexplained pain.

Call within 24 hours if you experience the following:

• Sore throat
• Sores in your mouth
• A white coating in your mouth, especially your tongue
• Signs of a bladder infection
• Burning with urination
• Blood in your urine
• Needing to urinate more frequently than normal

Seven "hot spots" for infection you can avoid

Infection cannot be completely prevented. However, there are things you can do to decrease the risk of infection. You are most susceptible to a bacterial infection about seven to 12 days after your chemotherapy infusion if your white blood cells are low. Bacterial infection does not commonly result from being in a crowded place. However, types of viral infections such as colds and flu are common and are transmitted easily from other people.

To help to decrease your risk of infection: (In general, it is fine to go to public places. (Avoid, if possible, tightly crowded places during the height of the cold/flu season.)

Wash your hands often:

• After frequent handshaking Before preparing food to eat
• After touching raw meat like chicken or steak Before eating
• After using the restroom After changing a baby's diaper
• After coming into direct contact with someone who is very young or very old
• After touching animals such as dogs or cats

Mouth care:

• Keep your mouth clean by brushing your teeth twice daily.
• Use soft toothbrush and mouth rinses without alcohol. Do not use floss. Check with your healthcare professional before having any dental work done.
• To help treat/prevent mouth sores, use a soft toothbrush and rinse three times a day with 1/2 to 1 teaspoon of baking soda and/or 1/2 to 1 teaspoon of salt mixed with 8 ounces of water.

Food Safety:

• Wash hands utensils, and surfaces with hot soapy water before and after food preparation.
• Keep raw meat, poultry, eggs and seafood away from ready-to-eat foods.
• Cook food well.
• Do not eat raw meat until you complete chemotherapy and your blood counts have returned to adequate levels.
• Keep cold foods cold.
• Refrigerate leftovers.
• Never thaw food at room temperature; thaw food in the refrigerator.
• Don't pack the refrigerator too full - cool air needs to be able to circulate to keep food cold and safe.
• Thoroughly wash all fruits and vegetables.

Pets:

• Do not change cat litter or clean up waste (urine or feces) from animals.
• Avoid contact with reptiles.
• Avoid cleaning fish tanks.
• Birds should receive a clean bill of health from a veterinarian.

Gardening/farming:

• Routine gardening is permissible using infection precautions.
• Strictly avoid an environment where mulch, hay, topsoil, etc. is being spread.
• Inhalation of environmental spores should be completely avoided.
• Gloves should be worn for contact with dirt.
• If walking through areas where soil, dust and fungal spores may be found in the air cannot be avoided, wearing a mask is preferred.

Camping/fishing/swimming:

• You should not drink water directly from lakes or rivers.
• Swimming can cause accidental ingestion of water.
• Hot tubs, sauna, and other communal baths are not recommended.
• Spelunking or cave exploration should not be done.

Housekeeping:

• Regular dusting, sweeping and washing are okay to clean if you feel well.
• Avoid cleaning or dusting areas where a lot of sediment can be aerosolized.
• Use common sense and avoid cleaning areas that have been untouched for years.
• Wear gloves for washing heavily soiled areas and commodes.