Thalassemia Major, Rituximab and traveling

Andy,
As you know, my son was on prednisone from fall/06 to fall/08, and then he had his rituximab treatment this summer and he receives IVIG to give him immunoglobulin G to fight the common pathogens and illnesses. 

I have avoided travel with him to other countries because of his thalassemia, now that he has also been on prednisone and has had rituximab I am even more weary about traveling with him outside of North America because his immune system is not accustomed to countries outside of NA.  Is this caution warranted?  Is there any risk taking him to Mexico?  or some place like India?  Do you recommend that I wait a few years until his immune system fully recovers? 

Thanks,
Sharmin

Sharmin,

I think this depends on how much his immune system has recovered. Are his white cells back to a normal level? India and Mexico both have areas where the water is not safe so it may be wise to avoid these areas until his immune system is back to normal. He may also need a hepatitis A vaccination before going. I would suggest asking your doctor for approval before any trips.

Thank you Andy,  his white cells have been normal (other than that one drop in neutrophils which lasted one day).  His IgA and IgM are still below normal due to the rituximab, and his IgG is being maintained.  We have considered going to Mexico a few times - but as you have said it may not be the safest thing for us.  We have also been told to avoid immunizations while the antiCD20 is still in his system, therefore he can't get the Hep shot.  All of this, coupled with his prednisone treatment - is a suggestion that we should probably avoid exposing him to anything right now - thanks Andy - you are right we should stick to North America for the next couple of years. 

Andy, is it a risk for any thal major residing in North America to travel to countries like India and Mexico - just because they have grown up here? 

Sharmin