pond water

Question

Can a child with CF play in a pond (fishing, sailing,..) or accidentally fall in the water without additional risks?

Answer

Chronic pulmonary infection by specific bacteria such as Pseudomonas aeruginosa is the biggest problem for patients with cystic fibrosis. The Pseudomonas bacterium is present in the whole environment but is mainly found in stagnant water. There is a hype around this topic among patients and among some caretakers. A lot of rules are imposed on children and parents in order to avoid potential contamination sources. The question is whether these changes have a significant effect on a Pseudomonas aeruginosa contamination risk or not. On this topic there are new data that made it possible to take a clear position.

The EPIC study searched for the best treatment for initial Pseudomonas infections. A part of this study also examined which factors determine the age of a first Pseudomonas infection. This large study of almost 1000 patients shows that especially the genotype (the CF mutation type) of the patient determines whether an infection with Pseudomonas will occur sooner or later. There is no influence of pool and jacuzzi use, nursery or other environmental factors and habits. So there is really no reason to impose major restrictions on any nice family activity. And the use of pools (and maybe even jaccuzi) can certainly not be discouraged. In practice, this means that you should not be afraid of letting your child play in a pond, fish, sail or other nice fun activities.
Prof. Kris de Boeck

11.12.2012

11.12.12
Even if the underlying genetics is unquestionably the most important factor determining the risk of early Pseudomonas acquisition, recommendations of experts concerning the avoidance of environmental risk factors differ substantially. Here are some points, trying to explain this situation:
1. There is no unequivocal evidence to support the idea of general restrictions concerning all kinds of "Water sports and fun".
2. There is no unequivocal evidence against such risks related to all kinds of "Water sports and fun".
3. There is the need to weigh the Pros and Cons according to individual factors like genetically determined susceptibility, quality of water (likelyhood of PA), type of sport or fun activity (inhalation probability is different in swimming, sailing, and fishing).
So our written recommendation as well as any kind of personal advice in the doctor's office is always a compromise, hopefully the best possible compromise taking into account fears and wishes of the patient and parents and doctors. One statement cannot be the right one for all patients, but there is a spectrum of possible interpretations which should be taken as the basis for shared decision making by empowered patients.
TOF Wagner