Preventing Infection

Children with cancer often have weak immune systems due to cancer or cancer treatments. This means they are more vulnerable to illnesses and infection. Patients and families can help prevent illnesses and lower risk of infection by following some simple steps.

Wash Hands

The best way to prevent infection is to wash hands often with soap and water. An alcohol-based hand sanitizer can also be used. Health care providers and caregivers should follow good hand hygiene when giving care.

Practice Good Personal Hygiene

Simple daily self-care is important to prevent infection. This includes brushing teeth and good mouth care, daily bathing, protecting the skin, and following the medical team’s advice for wound and line/catheter care.

Keep Patient Areas Clean

For some children with weak immune systems, even dust and dirt can have harmful germs. Basic cleaning of floors and surface areas can help reduce risk of infection. Special attention should be given to any areas where the child receives medical care. Toys and other objects that children use can carry germs. Wipe down toys and electronics regularly. Wash soft toys, blankets, and linens in hot water. Change bed sheets and linens often.

Avoid Contact

Stay away from people who are sick. Even colds can be dangerous for patients with a weak immune system. Some patients may need to wear special masks to filter germs from the air. Family members who are ill can wear masks to reduce risk of spreading germs to the patient.

Get Vaccinated

Caregivers and family members should follow recommendations for vaccines, including flu (influenza) and whooping cough (pertussis). Patients should be vaccinated based on their doctors’ advice. Some patients with weak immune systems are not able to receive certain vaccines, especially live vaccines. This makes it even more important for people around them to have vaccines.

Watch for Loose Stools

Diarrhea in cancer patients can be due to chemotherapy, radiation therapy, or infection. Wash hands and disinfect surfaces. Wear gloves when changing diapers.

Be Aware

Things you might not usually think of can be a source of infection for children with weak immune systems. Talk to your medical team about these potential risks:

Fresh flowers – Flowers and plants can have bacteria and fungus which may be harmful.
Pets and Animals – Avoid contact with animals that are not pets. Make sure pets have had shots, are in good health, and are bathed regularly.
Dirt and Soil – Some patients may become sick from Aspergillus and other germs in dust and dirt.
Crowds and Swimming Pools – Some children need to avoid these places to reduce risk of illness.

Think About Food Safety

Wash hands before preparing and eating foods, and keep food preparation areas clean. Store and cook food properly. Wash fruits and vegetables before eating. Talk to your doctor about any foods to avoid, and follow dietary instructions.

Infection Risk and Cancer

Children with weak immune systems are not able to fight off germs as well as people with healthy immune systems. Common illnesses such as RSV or the flu can be very dangerous for children with cancer. Some patients may also be at risk for infection from Aspergillus, a common fungus found in the air. Children with low immunity get infections more easily and have more trouble recovering from infections when they occur.

Respiratory Syncytial Virus (RSV) is a common virus that usually causes cold-like symptoms such as a cough and runny nose. In most healthy people, RSV will clear up on its own. In infants and people with weak immune systems, RSV can be much more serious.

RSV can lead to inflammation of the airways in the lungs and lung infection (pneumonia). Cancer treatments such as chemotherapy and hematopoietic cell transplant (also known as bone marrow transplant or stem cell transplant) can put children at higher risk for respiratory infection. Research shows that low levels of lymphocytes can help identify patients who are more likely to get sick with RSV.

RSV respiratory infection can be difficult to treat. Therapies include breathing treatments and antiviral drugs. Hospitalization and oxygen to assist breathing may also be needed. The best way to prevent RSV infection is by washing hands often and staying away from people who show signs of illness.
Influenza (Flu) is a respiratory illness caused by a virus. The virus spreads easily person to person through the air (coughing, sneezing) or by touching surfaces with the virus. The illness may cause serious problems for people with weak immune systems. The best way to prevent the flu is to get a flu vaccine each year. Family members and health care providers who are vaccinated help protect patients from the flu.

The most common way the flu spreads is through droplets in the air. When people cough, sneeze or talk, droplets can spread to people up to 6 feet away. People with the flu may be able to spread the virus before they even know they are sick. They may be contagious for 7 days or longer after becoming sick. To protect against the flu, wash hands often. Cover coughs and sneezes. Stay away from people who are sick. Clean surfaces with a disinfectant, especially if someone is ill.

A child or family member with flu-like symptoms should be tested for the virus. Antiviral drugs can help reduce the severity of the illness. Close monitoring is important for patients with weak immune systems.
A common fungus called Aspergillus can cause serious problems in patients with weak immune systems. Aspergillus is found in the air both indoors and outdoors. Healthy people breathe in the fungus all the time and do not get sick. For children going through certain cancer treatments, Aspergillus can cause an infection called Aspergillosis. Aspergillosis can take different forms, often as a sinus infection or lung infection. Infection in the lungs is serious and can be hard to treat. Fever, shortness of breath, headache, and coughing are some of the symptoms of an infection. Treatment for Aspergillosis may include steroids and anti-fungal medications.

Aspergillosis Prevention

Exposure to the Aspergillus fungus spores causes Aspergillosis. It is not spread person to person. Aspergillus is always in the air and cannot be avoided completely. However, there are steps that can help limit exposure.
- Wear a mask. The doctor may recommend that a patient wear a mask to filter Aspergillus particles out of the air. An N-95 mask is a special type of mask that can filter the small fungus spores from the air.
- Avoid dust outdoors. Limit exposure to dusty areas such as dirt roads or construction sites, and avoid gardening or other outdoor activities involving dirt and soil. Ask a doctor if you are unsure if an outdoor activity is safe.
- Reduce dust indoors. Use a damp cloth with a cleaner (disinfectant or wood surface spray) to remove dust and keep it from flying in the air. Have the child leave the room during cleaning. Avoid bringing dust and dirt in the house through shoes and clothing. If working outdoors, shower and change clothes before contact with the child.
- Use air filters. Inspect and replace furnace and air conditioner filters regularly. Use HEPA (High-Efficiency Particulate Air) filters on vacuum cleaners. A portable room air purifier with a HEPA filter can be used in the room where the child spends the most time.
- Keep carpets clean. Vacuum often with a vacuum cleaner that has a HEPA filter. Change the bag or empty the canister on the vacuum cleaner before it gets too full. Replace carpet if it is too soiled.
- Check for mold. Inspect and clean wet areas including showers, shower curtains and bathtubs. Keep an eye out for mold or mildew that may grow where water collects.

—
Reviewed: June 2018