Contact with a lung transplant recipient

Question

Hello,
the husband of my son’s future nanny has undergone lung transplantation. Is there a risk of transmission of infection between these 2 persons? My son is colonized by Staphylococcus aureus; is this dangerous for the nanny’s husband? And if some day my son will be colonized by Pseudomonas is there a risk of transmission of infection?
Do you propose to replace the nanny? I am quite happy with this nanny as she has similar standards of hygiene: regular hand washing, avoiding sick people, no plants, no vases, very frequent disinfection with bleach water...
What is your appreciation ?

Answer

Hello,
I presume that the nanny’s husband has not been transplanted for CF ... and that these 2 persons (the husband and your son) will not be in any physical contact (?).
As far as your son is concerned, I think that there is no risk and even there will be some advantages as the future nanny is aware of the implication of a respiratory disease and of the necessary hygienic precautions in order to protect him.
As far as the transplanted husband is concerned, the bacteria colonizing your son are - a priori – not dangerous because one has to imagine that he transmits them to the nanny (who is in good health) and then that the nanny transmits them to her husband. This is not very likely, especially if there is regular hand washing.
If the Staph. aureus becomes resistant to methicillin (MRSA), however, the situation could become more complicated.
On the other hand, your son - if he is still a young child (you have not given his age) – will invariably become infected with multiple viral strains present in the community. These viruses are easily transmissible to the nanny and, thus, to her husband and could be potentially dangerous to his graft. This is also true for the varicella virus, which is very dangerous for lung transplant recipients. However, the nanny will have exactly the same problem with another young child, who is not afflicted by CF.
So, I would take this nanny, but discuss with her the potential dangers of viral transmission/infections in order to protect her husband.
Sincerely yours,
Christiane Knoop

26.09.2013