Bacteria, contagious for a non-CF-patient?

Question

We seem to notice that when grandma has visited our 3-year old daughter with CF that she gets worsening of her COPD or bronchitis. Often to the degree that she needs prednison and antibiotics. Is there a possible connection? Could it be that our daughter carries a virus or bacteria that is contagious for grandma and vice versa? Grandma does not have cystic fibrosis.

Answer

Thank you for this interesting question.

Children with CF who cough indeed nearly always have an infection. Often the initial problem is a viral infection. Viruses are organisms that are smaller than bacteria and antibiotics do not have an effect on viruses. These viruses are however very contagious and can spread to the environment and thus make other people sick (mechanism of droplet infection). Older people with an underlying lung problem are especially vulnerable to this.

As result of viral infections the mucosa of the airways is damaged and patients with CF can get a bacterial infection. These need to be treated with antibiotics. In case of young patients with CF, it is often an infection with Staphylococcus or Haemophilus influenzae. Further down the road Pseudomonas becomes an important cause of infection. Most of the time these bacterial infections are contracted from the environment, infection from patient to patient is much less common.

Most of the bacteria typical for CF do not cause problems in healthy people. People with underlying lung disease such as COPD can be more vulnerable for these bacteria. It is thus important to prevent transfer of infection from one patient to the other.

Transfer of bacteria can occur by several routes: direct contact between people or contact via objects. This type of contact can be very well prevented by good hand hygiene. Avoiding close contact such as kissing and separating material that is used for feeding (for instance cups or tumblers).
Patients are more contagious when they are seriously ill and cough a lot. Here is the importance of preventing droplet infection. When a patient coughs or sneezes small droplets with bacteria can survive on flat surfaces. When the other person touches this surface, he can get infected. Again the most important hygienic measure is cough hygiene that means: sleeve (better than hand) before your mouth when you cough and disinfecting your hands regularly. This means frequent washing of the hands (normal soap is sufficient) especially after coughing or sneezing, around toilet moments and meals.
Droplet infections can be prevented by keeping a distance of about 1 meter. This has to be explained to children with CF but is difficult to put into practice in the case of toddlers.

In conclusion it is possible that patients with CF do infect people with chronic lung disease. This is also the case for toddlers without CF who have viral infections. The chance of infecting other people can be diminished by good hand hygiene and by avoiding close contact.

We hope that this information is useful for you.
Prof. Kris De Boeck

08.05.2012