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World J Gastroenterol. Jun 14, 2011; 17(22): 2708-2714
Published online Jun 14, 2011. doi: 10.3748/wjg.v17.i22.2708
Inflammatory bowel disease in travelers: Choosing the right vaccines and check-ups
Maria Esteve, Carme Loras, Ester García-Planella
Maria Esteve, Carme Loras, Department of Gastroenterology, Hospital Universitari Mútua de Terrassa, Fundació per la Recerca Mútua de Terrassa, University of Barcelona, Terrassa, Catalonia, 08221, Spain
Ester García-Planella, Department of Gastroenterology, Hospital de la Santa Creu i Sant Pau, Barcelona, Catalonia 08193, Spain
Author contributions: Esteve M, Loras C and García-Planella E wrote the manuscript; Esteve M and García-Planella E critically revised the manuscript for important intellectual content.
Correspondence to: Maria Esteve, MD, Department of Gastroenterology, Hospital Universitari Mútua de Terrassa, Fundació per la Recerca Mútua de Terrassa, University of Barcelona, Plaça Dr Robert nº 5, Terrassa, Barcelona, Catalonia 08221, Spain.
Telephone: +34-93-7365050-1215 Fax: +34-93-7365043
Received: April 27, 2010
Revised: June 14, 2010
Accepted: June 21, 2010
Published online: June 14, 2011

The majority of patients with inflammatory bowel disease (IBD) achieve good control of the inflammatory activity using available therapies. When remission is achieved and quality of life recovered, a considerable proportion of IBD patients express their desire to travel abroad, be it for business, academic or leisure purposes. Their physicians should help and encourage them whenever possible. However, preventive measures are warranted to minimize the risk, since IBD patients are exposed to the same infections affecting the general population, plus opportunistic infections (OI) related to the immunosuppression. There are a large number of potential OI that might affect patients with IBD. The true prevalence of these infections is unknown, and can vary from country to country. Therefore, reactivation or de novo acquisition of infections such as tuberculosis, malaria, and viral hepatitis will be much more frequent in endemic areas. Therefore, physicians should be aware of these aspects when planning specific preventive measures for patients traveling to a particular country. This includes good control of environmental exposure, chemoprophylaxis when indicated, and the use of a specific vaccination program to prevent endemic infections. In addition, it should be noted that, though the risk of acquiring an infectious disease is probably greater for IBD patients traveling from a developed to a developing country, the inverse situation can also occur; it depends on the previous acquired immunity of the host against infections in any particular environment.

Keywords: Inflammatory bowel disease, Vaccination, Opportunistic infections