Travelling overseas on DMARDS


I am now on Avara, Mtx, & Prednisone ... and I am booked to go on a cruise to Papua New Guinea in February...Working on the (pretty safe) assumption that I will NOT be trekking through the jungle or engaging in extreme sports activities (as if!!) and that I will be smothering myself in insect repellent... I'm wondering what the situation will be with getting vaccinations and taking anti-malarial drugs... the travel guide is suggesting Cholera, Japanese Encephalitis, Hep A&B and malaria prophylaxis... (I've never even HEARD of Japanese Encephalitis!)

I'm thinking that, worst comes to worst, I can stay on the ship and not go on any shore tours... but I'm hoping to see something of the country!!

Any suggestions???

As Sybil says, you need a good travel doc who preferably has a clue about autoimmune diseases and lowered immune systems.

My experience? Malarone, the whiz bang anti malarial can certainly be taken with MTX and Pred - it even has plaquenil in it in case that helps! (I didn’t take it with Arava as well - make sure you check this).

Jap E was only ever recommended to me if I was to spend three months wandering around rice paddies - which I did, so I got it, but have not heard of it recommended for a shore trip from a cruise.

Hep A and B are great all-round vaccinations, I think there’s a version us immunocompromised can have, ask about it.

Cholera for me is 6 of one, half dozen of the other. My travel doc says it can supposedly can protect a little against many tummy bugs, but cholera itself is pretty characteristic, usually occurs in outbreaks for which warnings are broadcast to the international medical community, and I can’t see a cruise ship going any where near it.

There is also nothing wrong with contacting the cruise line themselves and having a discussion so you can feel that the ships doctor has everything on board you might need (I always found pred in particular tended to allow little opportunistic infections like odd tropical skin infections - easily fixed with the appropriate antibiotics).

Sounds like a lot of fun, don’t sweat the immunocompromised thing, and enjoy!

I just saw you are in QLD. If you are in Brisbane, go see Dr Deb the travel doctor. She is great and understands well the immunocompromised thing and even has a good knowledge of autoimmune diseases, as well as being a real expert in travel medicine.

Hi,Nangogirl. Be sure to do serious research into an anti-malarial that will work with your meds. I have operated in Papua New Guinea twice in my life and I have to tell you that Malaria is a terrible disease. Thankfully the attacks are less frequent as the years go by. Be sure to get expert advise on the anti-malarial combined with your medical history. Having said all that, I can tell you that you will enjoy the trip to no end. Papua is breathtakingly beautiful,a truly unspoiled tropical paradise… Just watch out for the mossies,and the Aussies,quite a few of them there too! Have a great trip.