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Crohn's Disease Forum » Parents of Kids with IBD » Risks - Where do you draw the line?


 
03-16-2013, 10:34 AM   #31
crohnsinct
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Ha! Right Brians mom?! But honestly I think the incidence of IBD in those countries is much lower.

O's trip to Ecuador and Africa were stopped because she couldn't get the yellow fever vaccine and those countries wouldn't let her in without it. So the decision was completely out of our hands so yeah get those vaccines now while you can!

A trip to India was stopped by her G.I. and Infectious Disease doc because of the high incidence of TB and her Remicade use. Then two months later a small TB out break in her school because a child had travelled to visit family and brought it back!

Poor deprived child will just have to settle for Europe, Australia and such...not to mention heellllooo there are plenty of adventures and mission work to be done right here in the U.S.A.!
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03-16-2013, 10:42 AM   #32
Maree.
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Two factors to consider here:

1. There seems to be a fair bit of difference in prevalence of Crohn's by geographic region, there is some discussion of this and a map here. http://www.crohnsforum.com/showthread.php?t=40182
2. As most immune suppressant medications are very expensive they are probably not affordable to many 3rd world citizens.

There are more infectious disease in the 3rd world as a result more immunisations are required to visit some of these countries. Some of which are live vaccines. Yellow fever is one of these and international regulations require people to pove they've been vaccinated for yellow fever before they can travel to countries where it is endemic.
03-16-2013, 10:50 AM   #33
kiny
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There is an interesting inverse between TB and CD. Where TB is high, CD tends to be low, where CD is high TB is low, a number of people have noticed that. If it means anything or not I don't know, it might just be coincidence, but bacteria tend to compete between each other within the environment, whatever is causing crohn's disease might have too much competition in places where infectious diseases are high, like Africa.

CD rates are lower in Asia, but not *that* low anymore, it's half of what it is in the West in many urban areas, that's not that low anymore. It's still extremely low in Africa, they have no idea why.

It's not racial either, because first generation African immigrants tend to have crohn's disease rates that are as high as caucasians (in fact in my country they have slightly higher rates). It's likely that if we were born in Africa we wouldn't have had crohn's disease, whatever is the cause behind it, it's in the environment.
03-16-2013, 11:20 AM   #34
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OK, Cambodia!! That's where I'm drawing the line!! EJ can't go to Cambodia!!
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03-16-2013, 11:27 AM   #35
Tesscorm
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That's interesting Kiny. I'm curious, if people who immigrate as adults from Africa, for example, tend to have similar rates as the locals?? I'm wondering if the fact that they grew up (developed and matured) in Africa gives some protection??
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03-16-2013, 11:37 AM   #36
kiny
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That's interesting Kiny. I'm curious, if people who immigrate as adults from Africa, for example, tend to have similar rates as the locals?? I'm wondering if the fact that they grew up (developed and matured) in Africa gives some protection??
It doesn't here. Most immigrants in Germany and Belgium, where I live, are of Moroccan and Turkish origin (a few from central Africa) and they have higher rates than the caucasians, and many of them are first generation immigrants, meaning they have no parents who lived here and didn't grow up here, they immigrated and they got crohn's disease after immigration, at rates similar to locals.

This also makes me question the hygiene hypothesis, the hygiene hypothesis proposes that decreased contact with bacteria causes an expansion of Th cells and claim this is the reason for the increased crohn's disease rates in the West, but that doesn't match up with what happens here, those people who lived in Africa are not protected, they are only protected as long as they stay in their own environment, the minute you take them out of that environment their rates are just as high as locals.

Same thing happens in the UK with Indian immigrants btw, once those Indians immigrate, their rates go up even though the rates of their families back home are still the same.
03-16-2013, 11:47 AM   #37
Maree.
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Kiny do you happen to know is that true of people who migrate as adults or only those who spend their childhoods in Europe? I saw one thread that suggested it related to where you spend first 15 years of life, but no idea if there is any substance to that or not.
03-16-2013, 11:51 AM   #38
kiny
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I don't know, I would guess age has little to do with it since it's never mentioned. I only know that people of Africa and the Middle East, who immigrate to here have at least as high of crohn's disease as the locals, and in the case of Moroccans they have higher rates. But in morocco the rate of crohn's disease is much lower than here. The environment is the determining factor, not the individual.
03-16-2013, 12:00 PM   #39
kiny
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here are the specific rates for belgium, it's similar in germany but less pronounced



Locals have an incidence of 4 per 10^5 (per year), immigrants an incidence of 6 per 10^5. That's a lot higher, but in their home country the incidence is much lower. The fact they are from a country with a low incidence does not offer them any protection after they immigrate, in fact their rates are higher than the locals. Was confirmed by two studies, and Germany and Belgium are one of the few countries that have excellent records on crohn's disease populous.
03-16-2013, 02:22 PM   #40
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Talking about risks, how come we worry about swimming with dolphins (which I cant actually find any information about deaths caused by dolphin disease's, only one recorded death due to aggression), but dont even think about the travel there and back, which is far more riskier?

Personally if im feeling up to it I will try anything, yes read the warnings but come up with your own conclusion (I was told that you cannot wear contact lenses doing a bungee jump .. I think losing on of those was the least of my worries )

I would rather live a short fun filled, meaningful life then be old and never have done anything
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03-16-2013, 04:55 PM   #41
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^^^From the man who jumps out of perfectly good airplanes!! But I agree, wholeheartedly! I bet you drove your poor mother to drink though Rygon!
03-16-2013, 05:20 PM   #42
izzi'smom
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OK, Cambodia!! That's where I'm drawing the line!! EJ can't go to Cambodia!!
SOmething against Cambodia, Dex???
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03-16-2013, 07:00 PM   #43
Jennifer
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Talking about risks, how come we worry about swimming with dolphins (which I cant actually find any information about deaths caused by dolphin disease's, only one recorded death due to aggression), but dont even think about the travel there and back, which is far more riskier?
My guess is it may have something to do with fecal matter but instead of assuming and guessing I sent an email out to a place in Florida and asked them if swimming with dolphins is allowed with an impaired immune system from medication and if it isn't allowed I asked why.

If nothing else maybe we can find a place that doesn't mind if you swim with the dolphins and we can all just go there. :P I'm assuming there might not be any real danger and they are just protecting themselves from a possible lawsuit "just in case."
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03-16-2013, 09:24 PM   #44
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Mark, why isn't EJ taking 6MP any longer?
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03-17-2013, 09:35 PM   #45
Jennifer
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I contacted Discovery Cove in Orlando Florida about swimming with the dolphins and this was their response:

"Good Evening Jennifer,

Thank you for contacting Discovery Cove. We appreciate the opportunity to provide world-class customer service!

We do not ask guests to reveal their medical history before swimming with dolphins. However, you are required to sign a participation waiver before doing a dolphin interaction. By signing that waiver you are basically stating that you do not have a medical condition that would be aggravated by participating. Please consult your physician before your visit with us.

I hope this information has been helpful. Please donít hesitate to contact us if you have any questions, comments, or concerns.

Sincere Regards,
Liz | Guest Relations"

So basically if your doctor says its ok then you're free to swim with the dolphins at Discovery Cove.
03-18-2013, 10:58 AM   #46
Jmrogers4
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Thanks for taking the extra step and going to the horses mouth Jennifer. This is actually something Jack has always wanted to do.
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03-18-2013, 11:46 AM   #47
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03-18-2013, 04:44 PM   #48
positivemum
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Well my son is on Azathioprine and we are doing Discovery Cove in May. He could catch stuff just from school, the football pitch or swimming here in the Uk! We took him to Gran canaria last year and apart from worrying about germs through airplane air conditioning we didn't worry and he swam there every day. as someone else said he appears to have a stronger immune system as I can't remember his last cold/sore throat or sickness. and I was really ill in December with sinuses etc.

We have to live (within sensible precautions)
03-18-2013, 07:49 PM   #49
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My son Clark just got bitten by a dog. Of course we don't even own one it was my sister,s but while looking up everything possible about dog bites it states that if you are immune compromised your risk for infection goes up imensely. I am very glad we decided to try EEN before the drugs because I would be even more worried if he had been on them. As it is his hand is infected anyway and we have to start an antibiotic. Not thrilled about that as he is in remission and I don't want to risk setting off a flare but what else can I do? I think we all just need to weigh the risks and benefits and make the best decision we can to make our children as healthy and happy as possible. Swimming with dolphins would make me very happy
03-27-2013, 09:47 PM   #50
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Well, I took my step grand daughters to go swimming with dolphins thinking it would be a good experience. Only it was kind of last minute and there weren't any openings for the regular dolphin encounters. Only openings were for deep water snorkeling dophin swims. The girls were actually too young, but rather tall for their age and really wanted to go, and so we did.

When you are treading in 12 foot deep water, and dolphins start swimming up from underneath, to pop up within inches of your face, well, that's when you notice just how large their mouths actually are, and up close, their teeth are gigantic and look really sharp!

The girls were only 5 and 6 years old and they thought it was hysterical. I was scared to death and I think the dolphins knew it too, because they kept popping up in front of me over and over, as if they were having a good time terrifying me. The noises they made each time even sounded like they were laughing.

It wasn't at Discovery Cove though. Most people I know who have gone to Discovery Cove really enjoyed it. Maybe their dolphins are nicer?

But then we went on a river swim with manatees and that was a far more enjoyable experience (for me anyway). Peaceful and relaxing. Costs a lot less too.
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