I rather have a bad flare than a horrible disease. 2 weeks is not long to be without those types of meds you are asking about.

=)

Of course, it's not my decision to make, but coming from a math background, I just want to know the PROBABILITY of those diseases. Since if she goes off those meds, the chance of a TWO MONTH flare is 100%. Not nice. Don't like the choices.

i have so many pneunominas, African travel would be a lot nicer. i stop all the time for infections and the flares are inevitable and frequent. At least the purpose is a freely wonderful chosen trip with all those great memories and pictures and blogs and thoughts and tales when one returns and not another darn tooting infection.

I'm sitting here in flare times whatever thinking how the neurosurgeon said no orencia and no nsaids times 2 months after this surgery, period. sigh.

i'm with Jen

you travel, you play, you follow the rules :) just the way it goes

hugs
Ros

typhoid is spread through contaminated food and water. if she's going on a mission trip, i'd guess she may not be staying in a four star hotel with filtered water. malaria is spread by simple mosquito bites. central africa particularly is worrisome; it's part of the 'meningitis belt' and that disease is very active from december to june. yellow fever is also a serious concern in central africa; the central african republic and ivory coast governments require proof of yellow fever vaccinations for all travelers. she may want to verify if any of these immunizations are required by the local african government for entry.

yes, there is a 100% chance she will go into a flare. however, depending on the area of africa she is going to visit, there are huge risks for many of these extremely serious diseases. how hard is it going to be for her to avoid mosquito bites? to be certain she is avoiding contaminated food and water?

to me, even the potential risks of contracting any of those diseases without immunization would deter me from visiting. i would probably go off of all meds and get the immunizations or not go. i understand the desire to serve others, but i have to take care of myself first.

most of the literature i found mentions about 4.4% of people traveling to countries with these disease contract the disease; however the study does NOT account for vaccinated versus unvaccinated people. i would think in her case being unvaccinated and on a mission trip (probability of her being in undesirable conditions is very high) makes her probability of contracting one of these diseases much higher.

Disease would be worse

Stephgas is correct about some countries requiring a vaccination certificate. So she could end up denied entry. She couldnt have one anyway without stopping mtx for three months.

I would keep on with the mtx myself but also would be too chicken to go where such serious illnesses likely. I do travel and weigh up the risks. Have a current yellow fever vaccination as had that in a period when off mtx for about 18 months. The risk factors for those two diseases depend on location and disease activity. If it isnt especially around in the community where/when she goes she would be much less likely to catch either than if there is a mini outbreak.

Malaria is an issue. She should be able to take mtx with the higher quality anti malarial. I cant remember what it is. Plaquenil helps but isnt the total answer. I was allowed to take the stronger (expensive) one and plaquenil together when I was in Laos and Cambodia etc earlier last year.

Could take really strong sterilizing stuff and add to anything she drinks and remember to be careful when washing.

The dr doesnt make sense to me. Strong healthy people get the nasty diseases if careless or in wrong place at wrong time. And mtx builds up in the system so will still be there for that two week period. I had to wait three months of being clear of mtx before it was considered out of my system and could have vaccination.