Last year, I had a lung transplant. Since I am in great shape, I want to fulfill a life-long dream: a trip to Central Africa. Would anti-viral vaccines be risky for me? If so, what should I do to guard against infections?
You did not choose the safest destination for a lung transplant recipient, even a healthy one. The risk of infection in Central Africa is quite high, unless you stay in the bigger hotels. Moreover, the quality of health care in these countries is usually far below North American standards. That being said, I contacted an infectious disease specialist to answer your question. He believes that anti-viral vaccines pose a theoretical risk: they stimulate the immune system, which could, in theory, result in rejection of the transplanted lung. Given this possibility, it would be better to abstain. However, you may use other effective preventive measures: for hepatitis A, you can receive gamma globulin injections instead of a vaccine. These are antibodies that provide good temporary protection. Malaria and intestinal infections are very common in these countries. To guard against malaria, you need to apply bug repellent (select the one with the highest concentration of DEET), always sleep under a mosquito net and take oral anti-malarial medication before, during and after your trip. To prevent intestinal infections that cause fever and diarrhea, take the usual precautions (drink only bottled water or boiled beverages, peel raw fruits and vegetables before eating them) and use ciprofloxacin if you contract travellers’ diarrhea. So before travelling to any “exotic” country, it is important to consult a specialist in a specialized travellers’ clinic in order to get the best preventive measures adapted to your destination and health.