For the CGD community, it’s the eternal question at Christmas: To tree or not to tree?

Each year, as the holidays roll around, those in the chronic granulomatous disease (CGD) community who celebrate Christmas wonder if they should get a real Christmas tree.

It is a question that newly diagnosed families have, as well as those who have been living with CGD for years.

While doctors’ opinions may differ, Dr. Harry Malech, Chief of the Laboratory of Host Defenses at the National Institute of Allergy and Infectious Diseases at the National Institutes of Health, said there is no scientific data available regarding whether the presence of a live Christmas tree in the house increases the indoor level of fungal spores, he could provide guidance based on ancillary information.

“Live plants that are not diseased are to my knowledge not a significant source of fungal spores,” said Dr. Malech. “And even decaying plant matter on a forest floor that is not disturbed by digging is not a major source of fungal spores into the air. That is why it is perfectly safe for a CGD patient to take a walk through the woods or in a park. Even house plants are not an issue except when repotting them.”

“If care is taken to obtain a fresh Christmas pine tree that is healthy without any obvious rotten areas or disease, my opinion is that it is safe to bring it into the home for the holiday,” said Dr. Malech.

In terms of caring for the tree, he does advise taking some precautions.

“It is important to keep it well watered and to discard it before it dries out and begins to drop needles. Remember also that the standing water used to water the tree will grow Burkholderia cepacia, but even that is not a problem unless it is aerosolized, and a CGD patient should not be the one to water the tree or change the water for the Christmas tree.”

Yet, the eternal question remains: to tree or not to tree?

We took an informal poll of the CGD community and here are some responses:

“I had one growing up, and didn't have any problems that I'm aware of,” said Stephen Hurley, a patient with CGD. “My mom did the filling of the water, so I didn't have to get too close. We eventually switched to a fake tree though, because my mom was getting allergies. I have a fake tree on my own right now because I don't want to risk anything, since I'm so close to a cure.”

Other members of the CGD community have had real trees too growing up. “Our family, especially my mom and I LOVE Christmas, so we never failed to get one every year, and I never had a problem,” said Leo SeungYun Lee. “I would help out as much as I could besides cleaning the little tree scraps that would fall off after you get it home and rip off the covering.”

Yet, SeungYun Lee added that he will be getting an artificial tree this year to try it out. According to our responses, most members of the CGD feel that is the way to go.

In fact, Kathi Karl Narlock has not had a real tree for almost three decades.

“We haven't had a real Christmas tree since Nick was born,” said Narlock. “He is 27 years old now.”

Although no one has attributed an infection to a real tree, one member of our community reported having an experience that was downright scary and disappointing for the family.

“The last time we had a real Christmas tree was last year, it grew mold and had a weird smell,” said Veronica Becerra.  “So we had to dispose of it right away, and there was no Christmas tree for Christmas. Now we have to look into buying a fake one.”

Many families within the CGD community say they don’t “pine” for a real tree at all. Indeed, some report fully enjoying their artificial trees. Meanwhile, others have developed their own creative and fun ways to celebrate the holiday.

“We have never had a real tree,” Angela Pauling. “We hang ornaments from a small wrought iron tree and in other places around the house. We’ve never done a fake one either because they get so dusty. We find other fun ways to decorate and other traditions to focus on instead of a tree.”

“We have had the same artificial tree since before my kids were born and it's still so gorgeous and full,” said Janet Leone Daniello.

“My brother and I had a live tree once, but our doctor advised against it, so it was back to the fake one, which is just fine for me, as I’m living on my own now,” said Craig Adams. “For the pine scent, I just buy a car freshener pine scent that you would hang from your rearview mirror… cheesy but so awesome!”

This content should not be used as a substitute for professional medical advice. In all cases, patients and caregivers should consult their healthcare providers. Each patient’s condition and treatment are unique. The benefits and risks of any treatment should be discussed with the patient's provider.