Restricted Travel

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?


*Expanded Disability Status Scale (EDSS)

“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.”

8 thoughts on “Restricted Travel

  1. Eileen July 18, 2011 / 12:35 pm

    Truth in advertising…after I wrote this I looked longingly at my yellow card again…and realized I can’t do math. Not even a little bit. Cause if I could do math, I’d know that if I was vaccinated on 7/18/00, my ten year yellow fever shot would’ve expired – a year ago! But it still pains me to know. It just makes me feel a tiny bit better to think that I couldn’t have gone on last weeks mission trip to Bolivia (another yellow fever required country) as my last hurrah.

  2. sprite July 18, 2011 / 12:39 pm

    I have faith that if an answer exists, you’ll find it. Good luck with the quest! And here’s hoping they’re already working on new and better vaccines!

  3. susan July 18, 2011 / 12:47 pm

    You’ll get there if its meant to be…go to Tunisia and travel south 🙂 You’ll just have to be far more creative. If you’re entering from an African nation I can’t imagine the requirements would be as stringent…you know from traveling there that following the letter of the law is not always the strong suit of the authorities. Having said that…if it’s not meant to be…you have a whole of host of memories that most people never experience and you can be grateful for that. You at least know what you’re missing…most people are clueless….

    • Eileen July 18, 2011 / 2:09 pm

      Excellent perspective. Thanks 🙂

  4. Common Loon July 18, 2011 / 2:04 pm

    As I recall, Tunisia happened before children, when there was much less to risk?

    I wouldn’t be as troubled about getting into a country as being able to return to this one w/o all of the checks in the block (which can be difficult even if all of the blocks are checked, as we learned last week!!!). Have you considered what specifically you are after: the adventures, the mission work, a specific culture, a certain climate, etc. ? There may be some stunning alternatives that won’t put you or your family at risk, if you are willing to contemplate specifically what you are seeking and your priorities (since one spot may not hold all that Rwanda holds for you). Also, places do change with time, and what made one destination so appropo at one point in life may evolve into something completely different and not as endearing over time. Eileen, you know that I certainly have a similar dislike for being told what to not do, and I also don’t particularly enjoy the delivery of such news by some folks! I support your research and sincerely hope you get what you’re after!

    • Eileen July 18, 2011 / 2:15 pm

      Good point on getting back in (I also sense a story…what gives?)

      As to what I am after…specifically pertaining to Rwanda, it is relationships with specific people and ministries, so not a transferable thing…and of course there is the place too, which is fairly unique. I’ll just have to wait and see on that one. But losing Rwanda forever would be a particularly hard pill to swallow.

      It will also mean I can not fix one of my biggest regrets, which was not being able to visit a child I sponsor through Compassion International when I was in Rwanda in 2005. They told her I was coming and then it didn’t work out. When I got her letter saying basically “you said you were coming and you did not come,” I felt like the worst person in the world, and I have vowed that on my next trip, I would for sure see Claudine. And now it looks like there may be no next trip…that totally sucks!

  5. susan July 18, 2011 / 2:41 pm

    urgh…tough with the compassion kid! Our little boy always asks and I feel like a loser basically saying…”umm…maybe never?” in a nice way…

    @getting back in….a six day quarantine is what most of the countries were requiring on the site I looked at. Extra vacation??

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