April showers bring May flowers…and exposures

Dangers of Springtime Exposures for People with CGD

April’s arrival means that the much-anticipated sights and sounds of spring and summer are just around the corner. But springtime also ushers in seasonal challenges for people living with chronic granulomatous disease (CGD). Being diagnosed with CGD doesn’t mean you have to stay indoors, but a bit of knowledge can go a long way. Fungal and bacterial exposures are prevalent in everyday life, but springtime may bring additional exposures and there are some precautions that can be taken to avoid them and reduce infection risk. 

AVOIDING INFECTION

The following are several precautions to keep in mind:

• Swimming. Many physicians suggest that swimming should be confined to well-chlorinated pools. Ponds and brackish water, in particular, may expose patients to organisms that are specifically dangerous in CGD. Swimming in even large lakes and rivers carry some risk. Ocean bathing in clean areas appears to have a lower risk than swimming in bodies of freshwater and rivers.
• Shoes. Always wear shoes outdoors.
• Mulch. A major risk is the handling of garden mulch (shredded moldy tree bark) or potting soil. This type of exposure can cause a severe life-threatening pneumonia due to inhalation of the fungus Aspergillus and bacteria, which can live in decaying plant matter or soil. People with CGD should remain indoors during mulching in neighboring yards. Once the mulch is settled firmly on the ground and is not being spread or raked, it is much less of a danger to people with CGD.
• Spring cleaning. Individuals with CGD should avoid handling of dirt, as well as grass cuttings, decaying leaves, garden mulch (shredded moldy tree bark), and potting soil because they contain high levels of fungi and bacteria. As such, avoid activities such as turning manure or compost piles, repotting house plants, cleaning cellars or garages, removing carpets, performing demolition, digging in dirt, cutting grass, raking leaves, and hayrides.
• Playgrounds. Look for playgrounds without woodchips, as they can harbor fungi. Asphalt, rubber mats, and grass surfaces are fine. The risk here is more problematic for small children who may dig in or play with the woodchips. The risk to teenagers or adults from woodchip playgrounds is quite minimal from simply walking or running over the woodchips, and is no more risky than a walk on a path in the woods.
• Sports. In general, people with CGD should avoid sports or activities that involve kicking up or playing in dust and dirt. Baseball, for example, is not recommended for people with CGD, as "sliding into base" involves direct contact with dirt and dust. People with CGD report that they enjoy participating in a wide array of sports and outdoor activities, such as biking, yoga, tennis, running/jogging, ice hockey, riding scooters, skateboards, and golf. Even soccer played on a grassy field is likely a safe sport for people with CGD.

For more information about programs and resources for individuals and families living with CGD, contact IDF via Ask IDF or 800-296-4433.