How is cepacia spread?
It is assumed that B. cepacia complex is spread like other respiratory tract germs. High risk activities for the spread of cepacia are thought to be: activities which promote coughing (such as physiotherapy and exercise) that are performed within a small space; kissing or other intimate activities; sharing toothbrushes, drinking glasses or other implements that would transmit oral secretions.
What strains are prevalent in Vancouver?
First of all, B.cepacia complex itself is not common in people with CF. At BC’s Children's Hospital, only about 7% of CF patients currently have some strain of cepacia. Of these, most have genomovar II (“multivorans”) which is thought not to have a high degree of transmission between CF patients, and is often very sensitive to antibiotics. No patients currently have “genomovar III” (which is thought to be highly transmissible between CF patients, and in some cases associated with “cepacia syndrome” in which CF patients have become extremely ill). At this time, however, all strains must be considered potentially harmful and potentially transmissible to other CF patients.
Will I be told if I have B. cepacia complex?
Yes. A member of the CF team will inform you if you have acquired this bacterium (germ), and will talk to you and your family about what it may mean to your health, and how to avoid spreading it to other CF patients. At CF clinic, you would be asked to remain in your clinic room, and not socialize with other CF patients attending the clinic (or in hospital). Also, your pulmonary function test would be scheduled last.
What is the hospital segregation policy for patients with cepacia?
CF patients who culture positive for B. cepacia complex in their sputum are admitted to a separate ward from all other CF patients (including other patients with cepacia). Furthermore, they should not be in the same room as other CF patients; this includes the playroom, school room, gym, and teen lounge. Pulmonary function tests will be scheduled last for cepacia positive patients.
Can cepacia live in the room that a patient has just vacated?
It is unclear exactly how long cepacia will live on inanimate objects, but we do know that drying kills the bacteria so it is unlikely that an individual will “catch” cepacia from a table or computer, for example. In hospital, we believe it is safe for a cepacia negative individual with CF to enter a room that a cepacia positive person has just left.
Is it safe for my physiotherapist to treat me if they've just treated someone with cepacia?
Yes. In this instance, the physiotherapist would have worn a protective gown with the cepacia-positive patient, and thoroughly washed their hands afterwards, which are the recommended actions.
What can I do to prevent myself from getting cepacia from another patient in hospital?
First of all, be familiar with, and follow, hospital segregation policies. If you are unsure if someone with CF is in the playroom, teen lounge, etc, then ask a staff member to help you. If you are uncertain and there are no staff immediately available, you can either identify yourself as someone with CF who wants to make sure it’s safe to be there, or you can choose to leave the area. Staff members who can help you with this include nurses, child life staff, school teachers, volunteers, and any CF team member. Secondly, pay attention to good personal hygiene, especially frequent handwashing.
Can my nurse tell me who has cepacia, so I know to avoid them?
No. All information about CF patients is strictly confidential (including information about you!), unless permission is given. A person with cepacia may choose to identify themselves, but this is up to them. Also, please keep in mind that people with cepacia often feel singled out, so please be sensitive to this.
I’ve just learned that my good friend with CF now has cepacia. Can we visit each other if we both wear masks?
Although wearing a mask should reduce the risk of spread, they provide different and uncertain levels of protection. Therefore we advise against this, and recommend that you keep your “visiting” to emails and telephone calls. We realize that this is frustrating; please talk to a member of the CF team if you would like more information and/or support around this issue.
Where can I learn more about cepacia?
You may ask any CF doctor, nurse or physiotherapist. Online, you may use the search function on the CCFF Web site (www.cysticfibrosis.ca) or http://go.to/cepacia.