Low Blood Counts and Fever — During Chemotherapy

Hand washing is the single most effective way to prevent infection during chemotherapy. Wash your hands before eating, after using the toilet, after being in any public space, and whenever you have touched a surface others have handled. Alcohol-based sanitiser works well when a sink is not available. Ask any visitor to wash their hands before touching you or anything in your room — this is not an unusual request during chemotherapy.

When your blood count is low, some foods carry a higher risk of bacterial contamination. Avoid raw or undercooked meat, fish, and eggs. Choose freshly cooked food rather than food that has been standing for hours or reheated multiple times. Wash all fruit and vegetables carefully before eating. If you are unsure about tap water quality, drink boiled or sealed bottled water. Ask your oncology team or a dietitian which specific precautions apply to your treatment and your situation.

When your neutrophil count is low, your body cannot fight infections the way it normally would. Crowded indoor spaces — busy markets, public transport, waiting rooms — increase your exposure to bacteria and viruses. Ask any family member or visitor who has a cough, cold, stomach upset, or any active illness to stay away until they have fully recovered. This is not an overreaction. It is what the evidence supports during the high-risk period of your cycle.

Chemotherapy can cause mouth sores and gum inflammation, which create small breaks in the lining of your mouth that bacteria can enter through. Rinse your mouth gently after every meal using the solution your team recommends. Use a soft toothbrush and brush carefully twice a day. Tell your team about any mouth sores, white patches, or mouth pain — these can be signs of infection that need treatment. Do not use any mouth rinse or oral gel without asking your team first.

Your skin is a barrier against infection, and any break in it is a potential entry point for bacteria. This includes scratches, pressure sores, and the site of any central line or PICC line. Keep the area around any catheter or line clean and dry according to your team's specific instructions. Report any redness, swelling, warmth, or discharge around a line site to your team the same day. Do not scratch skin that is irritated or dry — ask your team for a safe moisturiser instead.

Some medicines available over the counter — including pain relievers and cold remedies — can reduce fever, which is the main warning sign of a serious infection. Masking a fever delays treatment that could save your life. Some herbal preparations, Ayurvedic medicines, and nutritional supplements also interact with chemotherapy or affect your blood count in ways that are not always predictable. Tell your team everything you are taking, including traditional remedies and vitamins, before you take them. This is not a judgement — it is information your team needs to keep you safe.