CF and swimming in the sea

Question

I have a question whether CF patients are not allowed to swim in stagnant water. And how is it with swimming in the sea?

Answer

Dear

Participating in sports is healthy, also for patients with CF! The fear of contracting an infection with Pseudomonas, a bacterium that indeed thrives well in a moist environment, should thus not overpower everything else. Swimming is a pleasant and intensive sport.

There is some discussion whether swimming is- or is not- good for patients with CF (see also previous questions on sports, swimming pool, saline, lakes etc. and Pseudomonas). Especially in stagnant and warm water Pseudomonas will grow well. In lakes and ponds Pseudomonas can occur. There is however no scientific proof that CF patients who swim in stagnant water (read lakes) will contract Pseudomonas infection more often. There is more concern about hot water pools (tropical swimming pools, hammams) because in that situation a sort of aerosol will be formed that can contain high concentrations of the Pseudomonas bacteria. These aerosols are then breathed in during visiting such a pool and in case of CF patient can cause an infection. That is why swimming in tropical pools is contraindicated.

Swimming in a well maintained public swimming pool is allowed: the addition of a sufficient amount of chlorine to the water will kill the Pseudomonas bacteria. Pseudomonas can at times be cultured from sea water but the high concentrations of salt will make sure that Pseudomonas does not survive well. Furthermore the current and relatively cold temperature of sea water will inhibit the growth of the Pseudomonas bacteria. Swimming in the sea is therefore not a problem for patients with CF.

Kind regards,
dr. Mieke Boon and K. De Boeck

24.03.2011