Melissa, if you sisters doctor is still refusing to refer them to a CF center (which is really where her son should be tested anyways for the utmost accuracy) it is really going to depend on her insurance. More than likely she is going to need a referral because a CF center is considered a specialist, but she should double check that with her insurance. But, she may run into this current doctor being unwilling to refer her-even if she talks to him again. If that continues to be the case, she should find another primary doctor who is contracted with her insurance . She may even be able to talk to the doctor before her appointment to see if the doctor would be willing to refer her son to a CF center at her request. I would push for this, because I know you know that with CF the eariler a proper diagnosis is given, and the earlier treatments are started the better chance the child will have at lengtheing their life and being a bit healthier.
Also, about the crosscontamination, that can be a tricky one. There are actually a lot of CFers on this board who are friends and see eahother in person, there are also a number of CFers who are dating and or married and they both have CF. The really only very dangerous thing is the B. Cepcia, more than likely every CFer is going to contract Pseudmonas in their life and that is handled pretty well by medications right now. If your nephew has CF too, it is really going to have to be a decision between you and your sister (and spouses) as to their contact, but just keep in mind that you only live once and which is worse, sharing a pseudmonas bug but getting to grow up close and seeing eachother, or getting psuedmonas a little later in life but not being able to spend time with your favorite cousin, miss out on family events... it is a difficult desision, but they are also going to make up their own minds when they are older despite the cross contamination statistics.
Julie-RN (wife to Mark 24 w/CF)