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Cross-infection

Viral infections

Viral infections (like the common cold and the flu) are caught from other children and adults, and in this regard, children with CF are the same as every one else. The important difference is that we know that in children with CF, a viral infection can lead on to a bacterial infection and both together can cause airway irritation and a prolonged rattly cough. This is why we treat what would otherwise be considered to be viral infections with antibiotics. It is very difficult to avoid catching viral infections - especially in nurseries and schools. We want children with CF to grow up as normally as possible and this means that they should attend nursery and school as normal. We do recommend that where possible children with CF, especially children under 5 years of age, avoid visiting friends or families where someone has a bad cold. If someone else in the immediate family has a bad cold, then simple hygiene measures, such as hand washing and using diposable tissues with are thrown away immedaitely after use, should be followed.

Bacterial infections

Nearly all bacterial airway infections in children with CF (like Staph, H.flu and Pseudomonas) come from the environment rather than other children (with CF or otherwise). There have been reports of some bacterial infections spreading from one person with CF to another - this is called cross-infection. This is most likely with certain strains of bacteria - such as the so-called epidemic forms of Pseudomonas. To minimise the risk of cross-infection we try to keep children with CF away from each other when they come to the hospital - this is called segregation. This should apply to outpatient visits (where children go direct to an outpatient room rather than waiting in a communal area), as well as attendance for investigations such as ultrasounds and x-rays. Segregation is particularly important during stays in hospital. Children with CF should not share the same ward areas - so should either be in a cubicle, or if they are in an open bay, should be the only child with CF in that bay. Children with CF must not share any toilet or washing facilities, and care should be taken that they are not in communal areas such as play areas or the hospital school rooms at the same time.

Children and their families should be encouraged to use hand gels before and after attending the hospital, and in particular before and after handling any equipment such as spirometers for measuring lung function.

Children with high risk infections (MRSA, cepacia and NTM - see the tab on 'bugs') are either seen at the end of clinic, or on a different clinic day, so that no other children use the same room on the same day. During inpatient stays they will either be the only child on a particular ward with CF, or they will be confined to a cublicle with ensuite bathroom facilites.