I made a depressing discovery this weekend. While reading my National MS Society eNews, I came across some very valuable information on “exotic” travel vaccinations by accident. (I went looking for another article and came across this information totally by happenstance.)
It is the update regarding yellow fever vaccinations that caught my attention, due to a new study showing “significantly increased risk of MS relapse during the six weeks following the vaccination.” In this very small study, four of five patients “had a significant and persistent Expanded Disability Status Scale* score increase (≥2 points) on neurological evaluations conducted 12 months following the exacerbation.” That’s alarming. It’s life changing. It’s…debilitating. [I have included below the MS Society definition and explanation of the EDSS scale below.]
This is a huge deal to me as several of my preferred African destinations (Rwanda most especially) are potentially in the yellow fever zone and some countries require proof of yellow fever vaccination to enter the country. (The same is true for several South American countries.) Needless to say, I will not be getting the yellow fever vaccine ever again – unless and until they come up with a new vaccine proven to alleviate this risk to people like me.
Hoping to look on the positive side, I know I have been vaccinated for yellow fever in the past, and I know it is good for a long time (ten years) so off to the lock box I went looking for my yellow card. My thought was that I likely have another year or two, in which case I can squeeze in one or two trips before my old immunization tapers off. But no such luck. Ironically, or not, my yellow fever vaccination expires literally today 7/18/11. Even if I left at 11pm Saturday night when I discovered this, I’d barely be arriving in Kigali, Rwanda as I type. [Sigh.]
So what is a girl to do? I know my mother, who is reading this, will say “duh – you don’t go, darling.” Me, I’m investigating yellow fever. Whether it is treatable. What its survivability is. How significant outbreaks are in my preferred destinations. Whether there are ways to exempt out of the “required upon arrival from ALL countries if traveler is >=1 year of age” mandate by countries and listed on the CDC travel website.
The thought that I shall never see Rwanda again (or undertake new and amazing adventures to unexplored places) makes me profoundly sad…and has kept me up the last two nights (which is added insult as James has just figured out how to sleep through the night). If there is one thing I detest more than anything else in life, it is being told what I can not do. I shall now spend many hours trying to figure out how to defy the obvious. I guess that is what makes us human isn’t it?
“A part of the Minimal Record of Disability that summarizes the neurologic examination and provides a measure of overall disability. The EDSS is a 20-point scale, ranging from 0 (normal examination) to 10 (death due to MS) by half-points. A person with a score of 4.5 can walk three blocks without stopping; a score of 6.0 means that a cane or a leg brace is needed to walk one block; a score over 7.5 indicates that a person cannot take more than a few steps, even with crutches or help from another person. The EDSS is used for many reasons, including deciding future medical treatment, establishing rehabilitation goals, choosing subjects for participation in clinical trials, and measuring treatment outcomes. This is currently the most widely used scale in clinical trials.”