Travelers with immune-mediated inflammatory diseases: Are they different?

Abstract

Background Patients with immune-mediated inflammatory diseases (IMIDs) increasingly benefit from improved health due to new therapeutic regimens allowing increasing numbers of such patients to travel overseas. This study aims to assess the proportion of IMID travelers seeking advice at the Travel Clinic of the University of Zurich, Switzerland, and to determine whether demographics, travel, and vaccination patterns differ between IMID- and non-IMID travelers. Methods Pre-travel visits and differences between IMID- and non-IMID travelers were assessed; logistic regression was used to adjust for confounders. Results Among 22,584 travelers who visited the Zurich Travel Clinic in a 25-month period, 1.8% suffered from an IMID, with gastroenterological and rheumatic conditions being the most common; 34.2% were using immunosuppressive or immunomodulatory medication. The reasons for travel and the destinations did not differ between IMID- and non-IMID travelers, Thailand and India being the most common destinations. IMID travelers stayed less often for longer than 1-month abroad and traveled less frequently on a low budget. Inactivated vaccines were similarly administered to both groups, while live vaccines were given half as often to IMID travelers. Conclusions The increasing numbers of IMID patients, many using immunosuppressive or immunomodulatory therapy, show similar travel patterns as non-IMID travelers. Thus, they are exposed to the same travel health risks, vaccine-preventable infections being one among them. Particularly, in view of the fact that live attenuated vaccines are less often administered to IMID patients more data are needed on the safety and immunogenicity of vaccines and on travel-specific risks to be able to offer evidence-based pre-travel health advice.