Dealing with malaria and mosquito's on holiday

Hi Everyone. My husband has CLL and finished FCR treatment 21/2 years ago. So far all is good - bloods normal WBC in normal range and stable. We are now considering a holiday in India (Goa) and I have maybe unwisely chosen a hotel with no aircon so I am worried about the risk of mosquito borne disease like malaria and Japanese encephalitis. The nurse says the risk of malaria is low and for normal people anti malaria drugs would not be needed but for people with compromised immune systems they are recommended. My husband does not want to take the pills as he says him blood counts are normal so his immune system should be OK . How do we know if he is immune compromised? Also the nurse advice is that inoculation is not needed against Japanese encephalitis for normal or immune compromised people. Has anyone else with CLL been to Goa and did you worry about mosquitos? Its the dry season so I feel OK ish about it but I am worried. What does everyone think?

Thanks tigerfox

[AussieNeil Administrator]

Hi Tigerfox,

While your 'husband does not want to take the pills as he says him blood counts are normal so his immune system should be OK'. I would be concerned with you that he is being blasé about his risk. If authorities are warning non-immune compromised people to take precautions, he should be doubly careful. With CLL, our immune system is always compromised. The degree of compromise varies from person to person but generally worsens over time and particularly during and after treatment.

Diseases spread by mosquitoes can be very difficult to treat for healthy people, with long lasting complications common - not the legacy you want from your holiday. Malaria is particularly hard to treat and for viral infections spread by mosquitoes, we rely on our immune systems to combat them; antibiotics can't help. Then there's the risk from a skin infection from insect bites. I spent over a week in hospital last year thanks to an insect bite and I haven't had treatment.

While your husband considers his blood tests show he is OK, blood counts are only an indication of how effective our immune system is. We can have 'good' blood counts and still be overly susceptible to infections that can take longer to clear. If his neutrophil count is good, that should reduce his risk of skin infections from bites - but healthy people can end up in hospital from insect bites too! Does he know how good his immunoglobulin counts are? These are generally low in CLL patients, particularly after treatments like FCR.

I hope your husband takes precautions against infection a bit more seriously and that you both have a good holiday.

Neil

[PE1234]

I wouldn't go to Goa without taking malaria tablets .As you know these little pesky things can have a nibble at us not only at night but also during the day .

We Havnt been to goa but have toured Sri Lanka Burma and Thailand .

Parts of Sri Lanka the hotels we stayed in didn't have air conditioning but there was always a coil burning in the room at night .

Also there isn't only Malaria out there but also Dengue fever and many other diseases .

These pests seem to be in parts of the world now that was once clear of malaria .

When we were in the Caribbean about three years ago there was an outbreak in St Martin and also Barbados .Never been known before .

Enjoy your holiday but stay safe and take the tablets .

🌞🌞🌞

[Hidden in reply to PE1234]

Thank you.

[SunnyCA]

I'm in my 8th year of CLL and was getting bad reactions to mosquito bites. They would blister and welt. My oncologist at Mayo Clinic said that 25 % of people with CLL have a worsening reaction to bites than others - as if developing a kind of allergy. I would cover up and use deet religiously. Mosquitoes are not to be taken lightly for people with CLL. If I had one bite on me my oncologist was always extremely concerned - so I would not minimize the risk as mosquitos carry awful diseases.