Lymphoma and some lymphoma treatments can affect your immune system. This makes it harder for you to fight infections. This might be the case even if you are in remission (no evidence of lymphoma). For these reasons, you need to take extra care when visiting parts of the world where you could come into contact with new infections.
If you have had your spleen removed (splenectomy), you have a higher risk of developing infections. Even if you are on long-term antibiotics, it’s still important to take steps to help lower your risk of infection.
Give some thought to your trip before you go, to help make your travel plans as safe as possible. Ask your hospital consultant, nurse specialist or GP for advice.
Keep in mind that some treatments for lymphoma, including radiotherapy and some types of chemotherapy, can make your skin more sensitive to sunlight (photosensitive). If you are planning to travel to a very sunny or cold country, speak to a member of medical team for advice about this.
- Seek medical advice about the safety of your plans, including how you’ll travel, where you’ll stay and what you’ll do while you’re away. Find out if there are any places or activities you should avoid.
- Find out what medical services are available where you’re going and how to access them if you need them. If you are using a travel company, you could ask them for this information.
- If you are taking medication, pack some extra. You could split it between your flight and hand luggage, in case any luggage is lost. You might need to take a medical letter explaining why you have this medication, particularly if you have any of it by injection. Your clinical nurse specialist can provide this for you. If you have a mobile phone, you could take a photo of the letter so that you have a copy on it when you travel.
- Choose clean accommodation. Recent reviews from other people who have stayed there could be helpful. If the accommodation has a restaurant, it might have a hygiene rating you could check.
- Keep good personal hygiene. Wash your hands thoroughly before meals, after using the toilet and after using public facilities. Keep some sanitising gel with you in case soap and water isn’t available.
- Get suitable travel insurance in place before you go.
There are steps you can take to help lower your risk of infection while you are travelling outside the UK.
- Stay away from people with infections such as colds, chickenpox, diarrhoea and vomiting.
- Protect yourself from mosquito bites, which can cause diseases such as malaria.
- Sterilise your drinking water and the water you use to brush your teeth. The easiest way is to boil it. Note that bottled water can contain bacteria, which could be harmful to you if you have a lowered immune system. Avoid having ice in your drink, unless you are sure it’s made from sterilised water.
- Don’t eat salads or unpeeled fruit, unless you are sure they’ve been washed well in sterilised water. If you have a low white blood cell count (neutropenia), your medical team might give you further advice about food and drink.
- Be careful with food storage, particularly with meat and fish. The NHS website has information about how to store food safely.
We have more information about risk of infection, including ways to help prevent it.
You might need vaccinations before you travel to some parts of the world. These protect you from serious infections that are not found in the UK.
Ask your GP for advice about whether you need travel vaccinations and, if so, what vaccines are suitable for you. If you have lowered immunity, you might need other vaccines, including those against influenza, meningococcal meningitis and pneumococcal infections.
Seek medical advice at least 8 weeks before your trip. Some travel vaccinations need to be given well before you travel to be effective. You might also need to allow time for them to be ordered in for you.
Where can I get travel vaccinations?
Some vaccinations are available on the NHS at GP surgeries. These usually include vaccines against: hepatitis A, typhoid and cholera and polio. The polio vaccine is usually given as a combined diphtheria/tetanus/polio vaccine).
Some vaccinations are not available on the NHS (for example yellow fever, Japanese encephalitis and rabies vaccines). You have to pay for these vaccines at a pharmacy that offers travel health services or, in some cases, at a specialist licensed centre. Note that the yellow fever vaccine is a live vaccine, so it might be unsuitable for people who have lymphoma.
Are travel vaccinations safe for people who have lymphoma?
Many vaccinations are safe and recommended for people who have lymphoma. Check with your GP before you have any vaccinations. If it’s unsafe for you to have a vaccination, think carefully about the possible risks and benefits of making the trip.
These are made using killed bacteria or viruses and, in general, shouldn’t cause any problems. Examples include vaccines against:
- flu (injectable version)
- hepatitis A and B
- Japanese encephalitis
- tick-borne encephalitis
Live vaccines are made using bacteria or viruses that are weakened but still alive. These vaccines might not be suitable people who have lymphoma because they could cause an infection.
Examples of live vaccines include those against:
- measles, mumps and rubella (MMR vaccine)
- polio (oral vaccine)
- tuberculosis (BCG vaccine)
- typhoid (oral vaccine)
- yellow fever.
The Department of Health Guidelines say that you should not have live vaccines for at least:
- 3 months after finishing a course of high-dose steroids
- 6 months after finishing treatment with chemotherapy or radiotherapy.
- 12 months after finishing treatment to dampen your immune system after a stem cell transplant
- 24 months if you had graft-versus-host disease (GvHD).
Malaria is a serious tropical disease carried by some types of mosquito. They spread it when they bite. The risk of developing malaria is higher in tropical and subtropical parts of the world, including Africa, parts of Asia and South America. The Travel Health Pro website has information about travel safety when visiting particular countries, including about the risk of malaria.
If you have lymphoma, you should be particularly cautious about travelling to areas where malaria is widespread. If you have had your spleen removed (splenectomy), you are more at risk of becoming very unwell if you develop malaria.
To help prevent being bitten by mosquitoes:
- Use an insect repellent. Products containing the active ingredient DEET
(N,N-Diethyl-m-tolumide) are generally considered to be most effective.
- Sleep under a mosquito net. The Malaria Consortium recommends using a net that has been treated with a long-lasting insecticidal (LLIN).
- Use air conditioning if it’s available. This helps to cool the room without opening windows, which can prevent mosquitoes from getting in. Mosquitoes are generally less active in lower temperatures too. A fan might also help to keep mosquitoes away if you sleep directly under the air movement.
- Wear clothes that cover as much skin as possible – mosquitoes cannot bite through material.
Anti-malarial tablets can significantly lower your risk of getting malaria.
Your GP can advise you on if and when you need anti-malaria tablets and which type is most suitable for you. They consider factors such as your age, medical history, whether you’re currently having treatment for your lymphoma and where you are travelling to. Some tablets need to be taken for a few weeks before you travel, so make sure you seek medical advice in plenty of time.
Anti-malaria tablets are not available on the NHS. Your GP can give you a prescription for them but you need to pay for them in full.
You can read the full Malaria prevention guidelines for travellers from the UK document on the GOV.UK website.