Some simple house cleaning rules to follow when preparing the home for a patient who has just had an SCT or BMT. While many of these suggestions may appear to go beyond the call of duty, the fact is opportunistic infections are the single largest cause of death from transplants. The recommendations below are from patients not doctors (other than the neutropenic diet restrictions). As such feel free to use or ignore them as befits your own level of comfort. However that old saying of "better safe than sorry" certainly is applicable here. This also gives you a bit more feeling of participating in your own health and recovery.
1. Bleach solution is 1 part chlorine bleach to 10 parts water. (you can buy a spray bottle at most hardware stores)
2. Bleach solution is only good for 24 hours then must be discarded
3. Surfaces sprayed with a bleach solution may be left to air dry or wiped with a paper towel, but must never be wiped with a reusable cloth.
4. All bathroom surfaces must be washed or cleaned as usual, then sprayed with a bleach solution, counters, floors, sinks, taps, mirrors, handles, toilets (in their entirety) bathtub, shower head, faucets, anything that a human may touch. Exceptions are cloth or fabric things that will fade. Those items should be washed in hot water (towels) or washed with a disinfecting cleansing product (wallpaper)
5. All kitchen surfaces must also be super cleaned. A bleach solution should be used on the floor, counters sinks fridge/stove surfaces, light switches, etc. While it may not be good to bleach your cupboards, the handles should be wiped with a bleach solution. Be sure to place your kitchen drain stoppers in the dishwasher (you should be doing this every day anyway)
6. Light switches in the rest of the `house should be cleaned with bleach solution. Be careful though as bleach will fade paint so it is best to just wet a cloth with bleach solution and wipe the switches.
7. No bar soap allowed. All bathrooms should be equipped with liquid soap dispensers.
8. Dedicated bath towels for the patient, which no one else may use. They must be replaced daily.
9. In the kitchen there should be a liquid soap dispenser. Hands should be washed after handling ANY meat or anything else suspect. Only paper towels should be used to dry hands in the kitchen.
10. Neutropenic diet restrictions are in effect. ( http://www.acor.org/leukemia/neutro.html ) Follow it closely. You cannot eat any leftovers unless they are heated thoroughly, no fresh fruit or veggies unless they are cooked, or thick skinned so they can be peeled (like a banana) If it is more than 24 hours old it is not likely safe. You can’t just scrape off mould and serve the rest and call it safe.
11. Duct work should be cleaned and if possible sanitized at the same time. This is not essential but should be considered. It is less important during those no-heat, no-air conditioning times of year, like spring and fall.
12. Carpet cleaning: Steam clean all carpeting. Steam cleaning is best because of the heat. This ranks low on the “must do” scale but ranks high on the “better safe than sorry” scale. Probably the best time would be in the week just before the patient is released from the hospital.