If our own immediate history of first contact encounters bears out, millions or billions of earthlings will be wiped out by some alien contagion.
And that's if they aren't armored leech-like bloodsuckers latching onto our brains for sustenance - which would be considered a congenial exchange on their world(s).
We'll just have to wait and see what first contact will be like. But we are probably the Aztecs in this exchange.
An ETI's "bugs" most likely won't affect us, nor ours them. Look how few diseases are trans-species here on Earth, where everything at least uses the same basic systems (DNA, proteins, etc.).
Odds are that life from another planet will have basic differences from Earth life that make cross-species contamination impossible.
I recognize, though, that "unlikely" is not the same as "impossible" and chance might deal us the Ace of Spades, and we get invaded by displaced ETIs looking for a new home, who have a devastating disease they are adapted to, but that wipes us out.
I just wouldn't bet on it.
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