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Germs And How To Avoid Them

By Jan Tate, CF Nurse Specialist, Starship Children’s Hospital

(This article was originally posted in the Auckland Branch E-News in May)

Parents with children with CF often worry about contamination by “germs” and work hard to protect them from becoming unwell with “germs” in their lungs. There are bacteria, viruses, fungi, moulds or mildew and all of us can come in contact with any of these “germs” in our everyday life. We need to understand about “germs”, how they can affect people with CF and how we can control or manage them.

Organisms are passed between people by direct contact – touching a person who already has a virus e.g. kissing, hugging and shaking hands or indirect contact – touching something that already has germs on them – such as door handles, money, toys, or maybe touching your face or nose with dirty hands. Food or drinking water can be contaminated or we may have indirect contact with environmental reservoirs e.g. soil, water, vegetation.

Organisms can be droplet or airborne and can travel on dust particles or respiratory droplets passed on by coughing or sneezing – person to person in the air. The amount of exposure is different for different organisms – e.g. viruses like chickenpox, influenza, measles or whooping cough can be contracted from another by a brief encounter in the supermarket or in a school room. What can we do to help control germs in our homes or environment? Here are some suggestions:

  • Good hand hygiene for everyone – this means good hand-washing with soap and water and drying well OR using hand gel at other times. A good rule of thumb is if the hands are visibly dirty or after using the toilet or before eating – use an antibacterial soap, if not use hand gel.
  • Cover your mouth when coughing or cough into your elbow. If using tissues – discard in the rubbish and wash or gel hands.
  • Live in a warm, dry, well ventilated home – good insulation.
  • Clean your home regularly by vacuuming and damp-dusting: floors, bathrooms, sinks, toilet – regular housework! Change sponges, brushes, dishcloths, towels frequently but don’t go “over the top” remembering these organisms thrive in wet, warm places so reduce these areas and keep them dry.
  • Try to contain outside areas where “germs” may live – get rid of stagnant water, clean up drains, cover rotting vegetation. Try and limit contact with compost bins or worm farms.
  • Flowers in vases need to have frequent water changes – a small amount of bleach in vases can help reduce the number of bacteria.
  • Keep young children away from pot plants, especially if dirt is warm and damp. Put up on a higher level where small fingers can’t reach.
  • Wash cuddly toys and blankets regularly limiting exposure to dust.
  • Clean kitchen and bathroom surfaces regularly with detergent or white vinegar.
  • If toilets are in a bathroom – keep toothbrushes in a cupboard away from toilet spray. Change toothbrushes at the change of seasons – 4 times a year.
  • Keep the lid down on the toilet when flushing – this helps to limit the amount of spray in a bathroom area.
  • Bath toys: throw away the toys that retain water. Clean bath toys regularly and keep dry
  • Pour boiling water or diluted bleach into drains to keep the S-bend clean
  • Use disposable cloths for cleaning. Kitchen sponges can harbour more bacteria than any other kitchen tool – wash in hot water, dry and change regularly.
  • Clean fridges and dishwashers regularly.
  • Black or pink areas in a bathroom or laundry point to known bacteria – wipe away with bleach or white vinegar.
  • Caution with rotting vegetables in the kitchen cupboard – rotting onions can have black spots which can be harmful to a child with CF

Other recommendations for PWCF:

  • Advise family and friends to stay away if they have a “head cold” or the flu
  • Try to avoid being around buildings where demolition is happening – dust from old building walls can harbour fungi, moulds or mildew
  • Avoid spas or baths with bubbles – agitation in the water can have bacteria in the droplets
  • Empty and dry children’s plastic swimming pools each day in the summer months – stagnant green water can grow pseudomonas.
  • All people in NZ need to learn to swim so if swimming in a public pool ensure they are well chlorinated – check how the pools are cleaned and maintained – ask questions. Swimming in the sea is perfect for people with CF.
  • Sandpits need to have adequate drainage and kept covered to protect from animals
  • Baches or holiday homes that catch the rain water from the roof need adequate filtration system to help limit bacteria. Water tanks, if not properly treated, can harbour bacteria in the water.
  • Everything is a balance when you have a child with CF.  They need to experience everyday life like other children and should be encouraged to try all new experiences. You cannot place them in a “bubble” and over protect them, but you can be aware of their vulnerable lungs and help protect them from being exposed to bacteria, viruses etc.

Please ask at clinic or call me (Jan) if you have any questions about this article.