Trip to Africa with Crohns:O? Is it doable?

[Hanny]

Hi Everyone, My names Hannah and I'm 16 years old dealing with Crohn's disease for 4 years now.
This summer I was offered a once in a lifetime trip to Africa, Free!
For 2 weeks In August I'd be travelling to Sierra Leone to experience the culture and help the people.

However, before I can get excited for this trip I need to find out if it's even possible with this disease. Currently, I'm not severely sick, I mean things definitely aren't perfect: still cramps, bloating and booking it to the bathroom for usually 30 minutes in the morning... but I mean I've had worse and learned to deal with now.

As for medicine I've tried: pentasa, methotrexate (orally and injectable) the dreaded prednisone (experienced the moon face to prove it) and currently Remicade which has somewhat helped diminish my symptoms.

I've heard Remicade is an immunosuppressant so:
Am I even able to get the shots and meds needed to travel?
- yellow fever, typhoid, hep a, b, malaria pills and dukoral?
(yellow fever is not recommended for those who are immunosuppressed as it is a live vaccine)
- is having crohns down there just a bad idea in general
- is everyone on Remicade immunosuppressed?

If anyone has any answers to these questions that would be great!

- Hannah xo

 

[shamrock15]

Check with your GI on this. If you can't get the needed shots, it is going to be a huge risk to go. Some vaccines like hep you can get.

For remicade, just time it so your infusions don't fall within the two weeks you are gone. Try to aim to have it evenly spaced on either side so it is at full effect. Some people with crohn's actually do better in developing countries and find their symptoms subside while they are there.

In any case, check with your GI to make sure you can get vaccinations that are needed. With proper preparation, you should be able to enjoy an amazing trip!

 

[Orchid]

There are killed or deactivated versions of most major vaccines you are likely to need, and most antimalarials are designed to work on the parasite and don't interact with the immune system. But you still need to get an exhaustive list and bring it to your GI and have them check it. Even if you can get all your needed vaccines, many immunocompromised people don't develop enough antibodies to ensure their success and require booster shots.

You are immunocompromised, seriously so. Remicade works by preventing TNF-alpha from binding to cells, a keystone of the immune system responsible for apoptosis in infected cells, and to prevent replication of viruses. Without enough of it any infection is serious because the body cannot hit the kill switch on infected cells or slow the spread of various invaders.

It's your choice, but I caution you to think about it and seriously discuss this with your GI.

 

[nogutsnoglory]

I would hate to see you miss out on a great opportunity. Yes, your immune system is not up to par due to Remicade but it doesn't mean you are highly at risk, it's just elevated.

Most shots are de-activated and are safe for those on immune suppressants. You would need to discuss the risks with your Remicade prescribing doctor and see if you can get all those shots as non-live vaccinations. Live would be too dangerous. If you can get the vaccines and you are otherwise feeling ok, your doctor will probably ok the trip.

 

[sfmreb2]

When I went to Egypt my GI dr put me on Cipro 2 weeks before I left and continued a week or 2 after I got back. I had no problems. Just be. Careful what you eat and drink. Have a great trip. I was on remicade when I went.

 

[PsychoJane]

I am a bit ambivalent regarding what I will say here. Sierra Leone is maybe not the first place I would go considering the health situation. I do understand that its an opportunity that you have to go there. I normally don't feel the need to seek medical advice when I travel but I choose my destinations carefully. This one would really be one I would ask an external opinion about provided that the Remicade do complexify the situation.

My hypochondriac side seems to be the most afraid by the actual Ebola situation. This would be the first factor making me avoid the destination atm. August is still far on that perspective though it leaves time for it to settle.

It also appears that Sierra Leone requires to show a proof for the yellow fever vaccination from all the travelers (9months and up) that are coming to the country. http://wwwnc.cdc.gov/travel/destinations/traveler/none/sierra-leone
However, yellow fever, as you said, is contraindicated for patients on biological agents. I don't know if exception can be made for people that have a particular conditions like us.

Also, if there are risks for yellow fever, it also means there are chances for dengue fever for which there is no treatment but for which the risks are less important overall.

I would both ask advices from my GI and from a specialized travel clinic of your area.