Germs are hard to avoid. Everywhere you go, bacteria, viruses, and fungi are present. Most germs are harmless to healthy people, but they’re potentially dangerous to someone with cystic fibrosis.

The sticky mucus that collects in the lungs of people with cystic fibrosis is the perfect environment for germs to multiply.

People with cystic fibrosis can get sick from germs that don’t usually sicken healthy people. These include:

  • Aspergillus fumigatus: a fungus that causes inflammation in the lungs
  • Burkholderia cepacia complex (B. cepacia): a group of bacteria that cause respiratory infections and are often resistant to antibiotics
  • Mycobacterium abscessus (M. abscessus): a group of bacteria that cause lung, skin, and soft tissue infections in people with cystic fibrosis as well as healthy people.
  • Pseudomonas aeruginosa (P.aeruginosa): a type of bacteria that causes blood infections and pneumonia in both people diagnosed with cystic fibrosis and people who are healthy.

These germs are especially risky to people who’ve had a lung transplant because they have to take medication that suppresses their immune system. A dampened immune system is less able to fight off infections.

Bacteria and viruses can get into the lungs of someone with cystic fibrosis and cause an infection. Some viruses can easily be transmitted to another person with cystic fibrosis, which is called cross-infection.

Cross-infection can occur when someone else with cystic fibrosis coughs or sneezes close to you. Or, you can pick up germs when you touch an item, like a doorknob, that someone with cystic fibrosis has touched.

Here are 19 tips to help reduce your risk of cross-infections when you have cystic fibrosis.

Every sneeze or cough launches germs into the air. Those germs can travel as far as 6 feet. If you’re within range, they could make you sick.

As a precaution, keep at least that far away from anyone who’s sick. One way to estimate the length is by taking one long stride. That’s usually equivalent to 6 feet.

Try to stay away from anyone you know with your condition. People with cystic fibrosis get infections that healthy people don’t catch, and they’re especially likely to transmit those germs to others with the disease.

Avoiding germs and keeping good hygiene are both key to preventing infections. Follow these location-specific guidelines to stay healthy.

At school

Although cystic fibrosis is pretty rare, it’s possible for two people with the disease to attend the same school. If you or your child is in this situation, talk to school administrators about the 6-foot rule, and follow these tips:

  • Ask to be placed in a different classroom from the other person with cystic fibrosis. If that isn’t possible, at least sit on opposite sides of the room.
  • Ask to be assigned lockers in different parts of the building.
  • Have lunch at different times or at least sit at separate tables.
  • Schedule separate times for the use of common spaces such as the library or media lab.
  • Use different bathrooms.
  • Have your own water bottle. Don’t use the school’s water fountain.
  • Wash your hands or use an alcohol-based hand sanitizer throughout the day, especially after you cough, sneeze, or touch shared items like desks and doorknobs.
  • Cover your coughs and sneezes with an elbow or, better yet, a tissue.

In public

It’s hardest to avoid germs in a public place because you can’t control who’s around you. It’s also not going to be clear who in your vicinity has cystic fibrosis or is sick. Practice these precautionary guidelines:

  • Wear a mask when you go anywhere you could get sick.
  • Don’t shake hands, hug, or kiss anyone.
  • Try to avoid close quarters, like small bathroom stalls.
  • Stay out of crowded places, such as malls and movie theaters.
  • Bring along a container of wipes or a bottle of hand sanitizers, and clean your hands often.
  • Check to make sure that you’re up-to-date on all of your recommended vaccinations whenever you see your doctor.

At home

If you live with a family member or someone else who has cystic fibrosis, you both need to take extra precautions to avoid infection. Here are a few tips:

  • Try to follow the 6-foot rule as much as possible, even at home.
  • Don’t ride in cars together.
  • Never share personal items, such as toothbrushes, utensils, cups, straws, or respiratory equipment.
  • Make sure that everyone in your home — including yourself — washes their hands throughout the day. Wash before you handle food, eat, or take your cystic fibrosis treatments. Also, wash after you cough or sneeze, use the bathroom, touch a shared object such as a doorknob, and after you finish your treatments.
  • Clean and disinfect your nebulizer after each use. You can boil it, microwave it, put it in the dishwasher, or soak it in alcohol or hydrogen peroxide.

Having cystic fibrosis shouldn’t prevent you from spending time with friends and family. But you do need to be careful about being close to other people with the disease.

Keep a safe distance from anyone you know who has cystic fibrosis or is sick. If you aren’t sure what to do, contact the Cystic Fibrosis Foundation or ask your doctor about cross-infection prevention.