Cross infection

Cross infection, or cross contamination, occurs when one person spreads an infection to another, either directly or indirectly. Find out how cross infection affects people with cystic fibrosis and how to minimise the risk. We're in the process of updating our infection control guidelines, which we hope to finalise and publish in the coming months.

What is cross infection?

People with CF are vulnerable to different bacteria or 'bugs', which grow in their lungs. While these bugs are usually harmless to people who don't have CF, they can settle in the lungs (colonise) and be harmful to people who have CF. These bugs can be easily transmitted from one person with CF to another.

Cross infection occurs when one person spreads these dangerous bacteria to another either directly, such as with physical contact, or indirectly, such as coughing or when someone touches something that another person with cystic fibrosis has touched, such as a glass, cutlery or medical equipment.

The risk of cross infection increases the longer people with CF are in close proximity to one another. It's recommended people with CF don't have physical contact with each other.

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How is cross infection managed?

The risk of cross infection is taken extremely seriously in the CF community and often the wider community are not aware of these risks. Children’s hospitals in New Zealand require young people with CF to wear a mask during appointments to protect them and reduce the risk of transmitting these bugs. Many adults also choose to wear masks during hospitalisation to reduce the risk of cross infection.



It's recommended individuals with cystic fibrosis wear a surgical mask rather than the fabric-based environmental mask such as a Vog mask. This is because Vog masks are not approved to protect against the spread of pathogens in a clinic or hospital setting. These masks are intended for use against environmental particles such as dust, pollen and other particles found in air pollution.

At school

Ideally only one child with CF will be enrolled at a school, but New Zealand is a small country it's inevitable two or more children with CF may need to attend the same school.

In this instance, families should be aware that there are two (or more) children with CF at the school and a strict plan put in place to minimise the risk of the children coming into close contact with each other.

See our CF at School page for more information.

Safe distances

There is less risk of transmission of 'bugs' outdoors, but meeting indoors, travelling with other people with cystic fibrosis or spending time with them socially has a high level of risk. We recommend people with cystic fibrosis don't have physical contact with each other, or in situations where this isn't possible we recommend keeping a safe distance of at least four meters.

The safest way for people with cystic fibrosis to speak to each other is online, over the phone or through text messages. We have Facebook pages to help support online conversations.

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Which bugs can be passed on through cross infection?

Pseudomonas aeruginosa

Pseudomonas aeruginosa is a ‘bug’ people with CF pick up usually from the environment. This can usually be kept under control with early antibiotic treatment. Most people with cystic fibrosis will acquire this infection during their lives and unfortunately it can become resistant to antibiotics and cause problems.

There are concerns people with cystic fibrosis can be more at risk from Pseudomonas they pick up from each other than the strains they get from the environment, which is one of the reasons why people with CF are kept separate at hospital clinics.

Burkholderia cepacia complex

Burkholderia cepacia complex (or B.cepacia for short) is an extremely serious infection for people with CF because this bug is difficult to treat. Research has shown people with CF can get B.cepacia from the environments and from other people who are infected with this bacteria.

B.cepacia can be transmitted through direct contact (such as kissing) or indirectly (touching objects where the bacteria maybe present, such as doorknob. In some cases having B.cepacia may prevent a person with CF being offered a lung transplant.

Nontuberculous Mycobacterium (NTM) abscesses

The group of bacteria that make up the different types of NTM are ‘cousins’ to the bacteria that cause tuberculosis (TB). These infections are very hardy and can survive many disinfectants and harsh environmental conditions.

The symptoms caused by NTM infection can vary between people, from causing no symptoms to causing symptoms such as a severe cough, fatigue and weight loss.

Further information

Cross infection is taken very seriously by both Cystic Fibrosis New Zealand and the CF community. If you’d like to know more about cross infection, have any concerns or would like some advice, please contact your local CF field worker.