Immunocompromised Travellers
- Introduction
- Medical Review
- General Travel Health Advice
- Vaccination
- Malaria
- Disease Prevention Advice
Introduction
The word “immunocompromised” means the body’s defence (or immune system) is weakened. It can happen due to genetic problems that people are born with (primary immunocompromise) or because of diseases, or treatments for diseases.
Examples of causes of immunocompromise:
- Chronic Diseases
- for example autoimmune diseases, chronic kidney failure
- Medicine used to treat chronic diseases
- for example azathioprine, methotrexate, cyclosporine, tacrolimus
- oral steroid tablets used to treat asthma and COPD can also cause immunocompromise
- Organ transplants
- Stem cell transplants
- Removal of spleen, or diseases causing the spleen to not work properly
- Cancer and the chemotherapy used to treat cancer
Infection is a major cause of ill health in people with immunocompromise. If you are immunocompromised and are planning to travel you need to consider how to stay healthy during your trip by following the advice below.
Medical Review
You should plan your trip well in advance of when you want to travel. A minimum of 8 weeks before you plan to leave you should arrange to speak with:
- your specialist medical team to ensure your health is at its best
- a travel medicine specialist for a travel risk assessment, including advice on reducing travel-associated disease risks, malaria and guidance on vaccines you might need
If you are travelling last minute, you may not have time to complete all vaccinations, but you should still get advice from a travel clinic on how to stay healthy during travel.
Travel Risk Assessment
Wherever your destination, a travel medicine specialist can advise you on how to stay healthy during your trip by discussing:
General Travel Health Advice
Infections are not the only health ‘risk’ you may face during travel. You should also consider:
Sun Exposure
Minimising Sun Exposure is important:
- Immunocompromise may lead to increased risk of tumours, including those of the skin.
- Immunocompromising medicine can have a side effect that causes your skin to burn more easily to the sun.
- You should check the side effects of your medication.
First Aid
Skin injury and infection is common in all travellers.
- You should be familiar with simple First Aid.
Accidents and Injury
Accidental injury or violence is a greater risk during travel than infectious disease and it is important you reduce this risk by carefully planning your itinerary and activities.
Travel Insurance/ Accessing Medical Care abroad
You must ensure you have appropriate Travel Insurance for your medical condition and planned activities. It should cover medical evacuation and repatriation (return you to your home country).
- In addition you should find out before you travel how to access reliable medical care during your trip.
Travelling with Medication
If you are immunocompromised you are likely to be taking regular medicine. There may be issues you need to consider if you are taking medicines abroad.
Vaccination
Before travel you should ensure you are up to date with all non-travel vaccinations recommended for your particular condition. This can be discussed with your Specialist or GP.
Recommended travel vaccines are the same whether you are immunocompromised or not. However, if you are immunocompromised you should be aware that:
- Some vaccines may not be given if you are immunocompromised, for example the yellow fever vaccine.
- This should be assessed and discussed with you at a travel consultation.
- The protection given by a vaccine may take longer to develop and may not be as strong compared to those who do not have immunocompromise.
- Additional booster vaccines may be required.
- As well as vaccination, you should follow additional advice on preventing infection.
Malaria
Malaria can be a life threatening illness that is caught from mosquito bites. If you are immunocompromised, you are not more likely to be bitten, but the malaria infection may be more severe.
To protect yourself you should:
- Be aware of the risk of infection:
- check the malaria section of the individual country pages to find out if you will be in an area with malaria
- Practise Mosquito Bite Avoidance
- Take antimalarial medicine if recommended:
- it is important that the travel advisor checks that the antimalarial medicine and your routine medicines do not interfere with each other
Disease Prevention Advice
Vaccines are not the only way to prevent infections. Not all infections can be prevented by a vaccine and simple health advice can protect you from most infections you may meet during travel.
Stomach and Gut Infections
Discuss Food and Water Precautions with your health advisor to reduce the risk of both vaccine preventable and non-preventable infections, e.g. hepatitis A, or salmonella infection.
Chest and ‘Air-borne’ Infections
If you are immunocompromised you should have been advised to be vaccinated against pneumococcal pneumonia and flu.
- check with your GP or specialist that you have had these
The risk of chest infections, and infections caught when people cough and sneeze (for example measles) can be reduced by practising strict:
Infections from Insects
Biting insects carry a wide range of infections and vaccines do not exist against the majority of these. To reduce the risk of infection you need to reduce the chance of being bitten by insects.
- See Insect Bite Avoidance for information
Infections from Blood or Sexual Contact
If you require medical treatment during your trip in an area where medical facilities are less developed than in the UK, you may be exposed to ‘blood borne infections’.
- See the Blood Borne Virus Infections page for advice on how to reduce your risk
If you are immunocompromised, sexually transmitted infections may be more severe or result in unusual symptoms.
- If you are sexually active during travel you should practice safe sex and be aware of sexual health risk during travel.
- See Sexual Health Risks page for more information