What’s the risk of Alemtuzumab?

• Your immune cells are dramatically reduced when taking alemtuzumab. Until the immune system recovers you have a greater risk of contracting infections through food, such as listeriosis. This could lead to septicaemia and meningitis.
• The average time for the immune system to recover is 3 months.

What can I do?

• A week before you start alemtuzumab treatment, follow all these guidelines. This will reduce your risk of contracting listeriosis through food.

• Avoid high-risk foods:

  • Buffets
  • Pre-prepared salads
  • Ready-to-eat seafood (e.g. smoked fish) and raw seafood (e.g. some sushi)
  • Precooked meat products (e.g. pate, sliced meat)
  • Pre-prepared fruit or vegetable drinks unless pateurised or canned
  • Unpasteurised milk or any foods made from it (pasteurisation is the only way to destroy bacteria)
  • Ice cream made from raw milk
  • Ice cream if not served straight from the freezer (e.g. soft ice cream from ice cream vans)
  • Unpasteurised soft cheese (e.g. brie, camembert) unless cooked thoroughly and served hot
  • Ready-to-eat foods stored for longer than one day in the refrigerator
  • Raw vegetables unless made yourself with thoroughly-washed vegetables

• Eat safe foods:

  • Freshly prepared and cooked foods to be eaten immediately
  • Hard cheeses, cheese spreads and processed cheeses
  • Freshly pasteurised or UHT milk and yoghurt
  • Tinned and pickled food
  • Vegetables and salads you have washed and prepared yourself

• Prepare food safely:

  • Stick to use-by dates
  • Keep your kitchen clean
  • Wash, peel, then rewash all raw vegetables, salads and fruits before eating
  • Thoroughly cook all animal-origin foods, including eggs
  • Ensure reheated food reaches at least 70°C all the way through
  • Ensure food is evenly and thoroughly heated when using microwaves

• Store food correctly:

  • Keep food covered
  • Refrigerate all cooked food within one hour
  • Consume food within a day of opening
  • Put stickers on your food to remind you when you opened/cooked it
  • Check your fridge is below 5°C and recheck once a week
  • Only defrost food at the bottom of the fridge (to stop dripping)
  • Don't defrost food in the microwave or oven
  • Clean the inside of your fridge once a week with hot water and liquid soap, then rinse

• Be careful when eating out:

  • Avoid buffet and street foods
  • Avoid salads and raw vegetable dishes
  • Avoid ice
  • Check food hygiene ratings at ratings.food.gov.uk
  • Only eat food if it's served piping hot
  • Tell anyone cooking for you, or living with you, about these guidelines
  • Remember: it is OK to enquire about how food is cooked when eating out

What do I do after treatment?

• Continue to follow these guidelines until your health team advises you otherwise
• If you develop a fever, severe muscle aches, confusion or vomiting contact your hospital. They may want to examine you and do a blood test.
• If you develop listeriosis you will be treated with antibiotics and you can continue alemtuzumab treatment once the infection has cleared.

What do I need to do now?

• Check the temperature of your fridge is below 5°C
• Dispose of all foods past their ‘use-by’ date
• Place food stickers on each refrigerated item
• Read our guidelines on food storage
• Clean you fridge thoroughly with soap and water

Frequently Asked Questions

• Can I eat eggs?

  Yes, if cooked through i.e no runny yolk.

• How should I store eggs?

  Eggs can be stored at room temperature.

• Can I eat meat?

  Yes, if fully cooked and piping hot.

• Can I eat rare/medium steak?

  No, all meat must be fully cooked through.

• Can I eat ready meals?

  Yes, if fully cooked and piping hot.

• Which yogurts are safe?

  All pasteurized yogurts in packets/tubs are fine, including probiotic.

• Can I cook, chill and reheat meals?

  Yes, if chilled when stored under 5 degrees, then fully cooked and piping hot & consumed within 2 days of original preparation.

• Can I eat smoked meat/fish?

  Yes, if fully cooked after smoking.

• Should I avoid ice?

  Avoid ice in public. It is fine to make ice using a clean ice tray at home.

• How should I safely store food in the fridge?

  Store raw meat and poultry in clean, sealed containers on the bottom shelf of the fridge. Keep cooked meat separate from raw meat and ready-to-eat foods.

Further information

• Visit food.gov.uk
• If you have any outstanding questions please ask your MS team or consult your listeriosis prevention pack.