Risk of infection when participating in social life

Question

How high is the risk of infection for CF patients in different social activities, e.g. cinema, concerts, public transport? Should one generally advise all those who are affected to avoid large gatherings? How high is the risk compared to patients with other diseases (HIV, immunosuppressive therapy after organ transplant) really? Which criteria would you consider relevant for the counseling of affected patients and/or their parents?

Answer

Hello,

Since the world is full of potential infectious agents, one cannot generally avoid every risk. In large gatherings, however, there will always be people who are potential sources of infection. If the immune system is weakened, as for instance in case of a distinct lack of defense cells due to acquired immunodeficiency (AIDS) with an HIV infection or due to medication, the body cannot protect and defend itself effectively against infections. In this case, one has to balance benefit and risk – knowing that attending a concert can/will be considered a benefit by many people.

Apart from this general reflection, there is also the CF-specific view, which focuses on particular germs (mainly pseudomonas). These germs are present nearly everywhere too, and this bears special risks for CF patients. Your concrete question about how high this risk actually is cannot be answered reliably, since we usually do not know where our CF patients acquired “their” pseudomonas germ: in their own bathroom, at the pool, at a pop concert or a soccer game. Also, there are some patients who acquire the germ early, others who acquire it late, and still others who do not acquire it at all.

Given similar behavior, the likelihood of contact and acquisition is not different for patients with low immunity, but the probability of actually falling sick is greater in patients with pronounced immunodeficiency. For most areas of everyday life, however, there are no clear criteria. It is important that CF patients do not inadvertently spend time with patients who have an infection so that transmission of problem germs from one CF patient to the other is not bound to happen.

Unfortunately, a general question like yours cannot be answered more specifically.

Best wishes
Prof. Dr. TOF Wagner

11.11.2010