Travel Tips for Primary Immunodeficiency

Primary immunodeficiency (PI) doesn’t mean you can’t travel to visit friends or family or explore different parts of the world. But it will take more planning than it would for someone without immune concerns.

“Doing a little homework pre-trip and discussing your plans with your immunologist or infectious-disease doctor can help you be the most prepared to have a safe and enjoyable travel experience with family or friends,” says Stephen A. Thacker, MD, a pediatric infectious disease specialist at MUSC Children’s Health in Mount Pleasant, South Carolina.

While it’s not possible to eliminate every possible threat to health — even for people without PI — a basic understanding of risks and resources available at your destination and a plan for any potential curveballs that may happen along the way will make the trip a better experience for everyone involved.

Planning Ahead for Health and Safety

Whether you’re traveling as an adult with PI or with a child with PI, “Preparation is protection,” is a good motto to follow, says Dr. Thacker.

After you decide on your travel dates and destination, the next step is talking with your immunologist, infectious-disease specialist, or a travel medicine clinic before you go, he says.

“That conversation should cover your baseline health, where you’re going, the season of travel, and the activities you hope to do,” he says. Depending on your answers, the guidance can be very different on how to be most prepared to have a safe and really enjoyable travel experience, says Thacker.

For international travel, try to schedule a visit with your immunologist or a travel health specialist at least four to six weeks before you leave to give you enough time to review medications and prevention strategies, says Thacker.

The same pre-travel visit can also cover malaria prevention medication, insect-bite precautions, and whether any destination-specific vaccines are appropriate for you, says Thacker.

Staying Safe in Transit

Travel days often mean shared air, shared surfaces, crowds, and disrupted routines.

The good news is that flying itself is generally safe for people with primary immunodeficiency, says Thacker.

“But we can improve that safety even more by wearing a high-quality mask such as a well-fitted KN95 or N95 mask, especially in crowded airport terminals,” says Thacker.

Long travel days can also make it easy to forget the basics: Make time for snacks and meals, and stay hydrated, says Thacker.

Food and Drink

Food and water choices can make a big difference in whether a trip goes smoothly, especially during international travel.

To reduce the risk of illness from contaminated food or water while traveling:

Choose safe water. If you’re not sure the local water is safe, drink sealed bottled water. Use bottled or boiled water to brush your teeth, and avoid ice unless you know it was made with safe water, Thacker says. Bottled or boiled water is recommended when water is not drinkable or comes from a well.

Be careful with raw produce. Raw fruits and vegetables may need extra caution, especially during international travel. Thacker recommends choosing produce you can peel yourself. Washing or peeling fruits and vegetables can also reduce risk.

Skip higher-risk foods. Make sure meat, poultry, fish, and shellfish are thoroughly cooked, and avoid unpasteurized, or “raw,” dairy.

Be selective about where you eat. Trying local food can be one of the best parts of travel, but Thacker advises being cautious with street food carts or places where hygiene practices may be uncertain, especially during international travel.

Even when people try to do all the “right” things, traveler’s diarrhea is pretty common, says Thacker. “I usually have families prepare a ‘go pack’ for that scenario with oral rehydration supplies, as well as an antibiotic if needed that is prescribed before they travel,” he says.

Planning Ahead for Medical Needs

Medication planning should start well before packing day, especially if you use treatments that require refrigeration, needles, infusion supplies, or careful timing.

“Keep your medication supplies and all your important medical documents with you, in your carry-on luggage or personal item,” says Thacker.

It’s also a good idea to keep medications in their original containers with prescription labels and to tell security staff if you have medications or supplies that need screening. Medically necessary liquids, gels, freezer packs, IV bags, pumps, and syringes can generally go through TSA screening in U.S. airports, but they must be declared and screened.

“I typically recommend a brief physician letter describing the patient’s diagnosis, the medications they need, and any emergency management guidance your doctor would want to offer,” says Thacker.

That letter can also help if you need medical care while away. A clinician who is seeing you or your child for the first time may not know the details of your immune condition, current medications, or emergency plan.

If you receive immunoglobulin replacement therapy (IVIg or SCIg) or another treatment that is difficult to transport, ask your care team whether your schedule can be adjusted. “In some cases, your doctor may shift dosing or temporarily change how treatment is given so that you do not have to travel with the medication,” says Thacker.

Emergency planning is not pessimistic: It’s one more way to make the trip less stressful.

“No one’s ever going to fault a parent for being overprepared,” says Thacker.

Before you go, look online or make some phone calls to find out the closest appropriate hospital or care center near your destination and how long it takes to get there, especially if you are traveling with a child with PI, he says.

Other preplanning and paperwork tips include:

Check your coverage before you go. If you’re traveling out of state or outside the United States, find out whether your health insurance covers medical care at your destination.

The Takeaway

• People with primary immunodeficiency can travel for the same reasons anyone else does, but extra planning can make the trip safer and smoother, especially for international trips or remote destinations.
• Talk with your immunologist, infectious disease specialist, or a travel medicine clinic before you go so your precautions match your health, destination, season, and activities.
• Infection control, food and water safety, and medication planning can lower the chance that illness or missing supplies will disrupt your trip.
• Carry key medical information, know where to get care at your destination, and plan for delays or emergencies before you leave.