Coronavirus: Advice for our cystic fibrosis patients during COVID-19 outbreak
What is cystic fibrosis?
Cystic fibrosis (CF) is an inherited, genetic condition that causes sticky mucus to build up in the lungs and digestive system. This is due to a reduced number of, or ineffective, proteins called ‘cystic fibrosis transmembrane conductance regulator’ (CFTR) and causes lung infections and problems with digesting food.
In the UK, most cases of cystic fibrosis are picked up at birth using the newborn screening heel prick test.
Symptoms usually start in early childhood and vary from child to child, but the condition gets slowly worse over time, with the lungs and digestive system becoming increasingly damaged.
CF is incurable and in severe cases a lung transplant may be recommended. However, new drugs Kaftrio, Sykmevi, Orkambi and Kalydeco have been shown to improve lung function and quality of life for some CF patients (see below).
Our cystic fibrosis service
Our cystic fibrosis service was established in 1994 and now looks after more than 350 adults with CF from the Eastern Region and beyond.
The service is part of the Cambridge Centre for Lung Infection (CCLI), and is supported by a multidisciplinary team including: six CF specialist consultants; three CF specialist nurses; a dedicated ward nursing team; research nurses; specialist physiotherapists, dieticians, pharmacists, social workers; a psychologist and psychiatrist; secretaries; and a management team.
Patients are seen in specialist CF clinics according to their sputum microbiology: no regular infection, non-epidemic Pseudomonas aeruginosa, epidemic Pseudomonas aeruginosa, Burkholderia cepacia complex, Mycobacterium abscessus and MRSA clinics occur weekly. The centre also provides a 24/7 emergency service for people with CF who are acutely unwell.
The Royal Papworth Adult CF service also provides specialist CF psychological medicine clinics, CF diabetes clinics with the Cambridge University Hospitals diabetes team, and specialist CF liver disease clinics with CUH hepatologists.
Annual CF transition clinics are performed jointly with the paediatric teams to meet children and families prior to their care moving to the adult service. We currently run transition clinics at Great Ormond Street Hospital in London, CUH in Cambridge, Ipswich Hospital, Luton & Dunstable Hospital, Kettering Hospital, Peterborough Hospital and Chelmsford Hospital. A link to a website containing useful information about transitioning from paediatric care to adult care at Royal Papworth Hospital NHS Foundation Trust is found below.
The inpatient facilities at Royal Papworth Hospital include 12 ensuite rooms on the CF ward on Floor 4 with a further six inpatient rooms on an adjacent ward, for patients with CF with more antibiotic resistant organisms. Each room contains air conditioning, high-speed WIFI, a flat screen TV and games console.
The outpatient facilities include 10 rooms in a dedicated CCLI area in the outpatient department, four of which are en-suite.
The hospital has some state-of-the-art features to make it as safe as possible for people with CF from a cross-infection prevention perspective:
- All outpatient clinic rooms, inpatient bedrooms and adjacent corridors have an enhanced ventilation system that will change the air every four minutes – this means that airborne bacteria and viruses will be extracted very quickly.
- All clinic rooms are cleaned with ultra violet disinfection between patients – this means that all bacteria living on surfaces (door handles, tables, chairs, and taps) will be killed.
- All inpatient bedrooms are cleaned with either ultra violet disinfection or hydrogen peroxide vapour disinfection between patients - this means that all bacteria living on surfaces (door handles, tables, chairs, taps) and in the air will be killed.
Project Breathe is an innovative home monitoring study for people with CF which enables each person to have a lung function monitor, oxygen sensor, scales and a Fitbit to measure vital indicators in their health from home. This gives patients more control over the health and a better understanding of when they are showing early signs of deterioration. The data can be viewed by clinicians remotely and at appointments to assist clinical decisions.