Physiotherapy, treatment of two CF patients one after the other

Question

Hello,
my question is about physiotherapy. The situation is acutally like this, that just after our child, another child with CF comes for therapy. This is happening like this:
Our child is for 60 minutes in the treatment room, then it leaves the room and the other child is already waiting in the antechamber that is quite small.
In this office there is only the treatment room and the waiting area in the antechamber. It is a flying change. I did not realize yet, that the therapeutic devices are disinfected. I do really not feel well in this situation, especially as the other child is coughing increasingly. I do not know this from our child and therefore I am worrying....
Unfortunately, there is nowhere another possibility, to get a CF physiotherapy. And furthermore it is in this office like this, that the physiotherapist is only working there for these two hours on that special day, as she is working full-time at a hospital. However, there, all out-patients have been "dissmissed".
I would be pleased about your advice concering the germ problem.
Many thanks.

Answer

Dear questioner,
without a detailed knowledge of the local circumstances it is in general difficult to give a judgement only because of the general description. For sure one has to admit, that there could be in general an infection risk in case of direct or indirect CF patient contact in connection with physiotherapy and especially in case of insufficient hygiene (dependet on contact times, germ spectrum of treated patients, disinfection measures, local conditions, hygiene of the room-air, disinfection of hands etc). On the one hand I would like to attract your attention to the recommendations of the KRINKO [German commission for hopsital hygiene and infection prevention] concerning hygiene issues in case of CF, that can answer some questions in my opinion. Furthermore, I regard it to be of special importance, that you discuss your worries with the physiotherapist in charge and ask concretely, if the procedures (disinfection, segregation of patients) are regulated e.g. in a hygiene plan and are also followed. In case a time-based segregation is not possible, the contact times (waiting area) should be minimized (also the usage of a face mask can be considered). The office has the resposibility to takes measures, in order to minimize the risk of germ transmission. In case the answers are not satisfying and you have no confidence in the local hygiene management, I can only recommend to consider alternatives.

Best regards,
PD Dr. Michael Hogardt

06.05.2016