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Healthcare workers on Remicade, traveling and working in TB-endemic countries

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Posted 5/21/2017 7:44 PM (GMT 0)
Hello all,

I realize this is a weird question but really not sure who to ask. I am a rising 4th year medical student and I am supposed to be spending 2 months in Ghana as part of my 4th year, in a hospital there. I am on Remicade, and aside from the fact that I can't get the Yellow Fever vaccine (live), my GI doctor is basically forbidding me from going because TB is endemic there.

Does anyone on this forum work in healthcare + is treated with Remicade + has worked in a developing country for a time? Or...does anyone know any doctors/nurses on Remicade who have? thinking something like Doctors without Borders. I find it hard to believe that there are no healthcare professionals on Remicade that do medical mission trips, but my doctor has me thinking I'm crazy.

Thanks so much in advance!
Posted 5/21/2017 9:28 PM (GMT 0)
Sounds pretty risky to me. A live, weakened vaccine (adapted to a non-human host) is a lot less risky than being exposed to people who have the human variety of an illness. And they're telling you not to get live vacines. With a weakened immune system I'd pass on the Ghana trip.

Heathcare works on remicade do well within US borders, I'd stay far away from endemic areas though... Get TB and no more Remicade (or other tnf-alpha biologics) for you, that's the risk in it. That and an aggressive like tb illness with a weakened immune system.
Posted 5/22/2017 10:42 AM (GMT 0)
True what you said about the no more biologics thing...hadn't thought about it. I appreciate your feedback, thank you!
Posted 5/22/2017 12:53 PM (GMT 0)
Not gonna lie, it's a little risky.
Out of my first flare I had 2 remicade infusions. 4 months after that I volunteered as a nursing student throughout east Africa. I wasn't able to get the live Malaria vaccine and had to resort to taking pills. Wasn't able to get Yellow Fever vaccine and had a medical exemption card in case I was stopped at the border/customs. I worked in very clean privatized hospitals as well as run down public facilities and the worry of contracting an infection was always in the back of my mind.
Luckily I am no longer on any biologics/am in remission and have peace of mind when I travel to Africa. You need to take precautions more seriously. Be careful with food, drink, sleep under a secure mosquito net, don't wear open toed shoes, good bug repellent etc. 2 months isn't too long of a time. Maybe try to stay in the city or avoid time spent in the villages.
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