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School – two children with CF


our son Dennis will start school in summer. Currently we learnt that there is already another child with CF at that school (third grade). Now our doctor is concerned, because the girl at that school is “badly off” and already had several bacteria, among them pseudomonas.
Are we actually compelled to send our son to a different school?
Many thanks in advance,

Dear questioner:

This is not an uncommon situation in CF. However, your question is not easy to answer as there is no clear right or wrong.
On one hand it is highly unlikely that your son will have such a close contact to the other child with CF mentioned that a non-negilable risk of cross infection occurs. The chance to be confronted with Pseudomonas bacteria, which in general can be found in any everyday surrounding, thus also in the new school even without a child with CF, is doubtlessly several times higher.
On the other hand, there exists a certain possibility that both children come across each other in the schoolyard or the corridors or they will use the same gym or class room after the other. Even if the risk of infection is minimal as long as there is no direct physical contact or both children do not stay in one small room for a longer time period, it is important to recognize that there is some risk. However, this risk can be minimized further, if good hygienic precautions are taken (e.g. disinfection of equipment if one child with CF has expectorated secretions accidentally on it) and the two children would never be in the same room together. However, with children, it is sometimes difficult to guarantee a full segregation (meeting at school events, sports days, in the dinner hall etc) and then the risk increases.
Thus: The decision, if your child can go to the same school as the other child with CF depends on his particular environment, and needs an extensive discussion with you as parents about how secure you feel about segregation being maintained and therefore favour your child going to that school, considering the fact that the risk is very small. On the other hand you have to consider how difficult it would logistically be to send your child to another school in case the worries about the risk of cross-infection, which cannot totally be excluded, weigh too heavy.

With kind regards
Dr. H.-G. Posselt