Travelling and CF

Question

My girlfriend has a mild form of CF. We would like to go live abroad for a year. We have a full list of CF hospitals worldwide where CF specialists are available. But now my question is: which countries are OK to go to and which are not good, with regards to temperature, air humidity etc.

Answer

Dear questioner,
Your question is very relevant for people with cystic fibrosis, however not so easy to answer. The first step in preparing and organizing a stay abroad safely is indeed to verify that the country you want to travel to has a CF centre with adequate medical infrastructure and up to date hygienic standard. You have indeed solved that problem, congratulations. This leaves us with your question: which countries are more or less safe to travel to for CF patients. As you know, patients with CF are prone to lung infection by specific germs. If germs that can cause severe lung infection in CF patients are more common in certain areas, these cannot be considered really safe to travel to for a holiday or well chosen to go and live for a longer time. The real problem is that infection with some germs is very difficult to treat and/or can even cause life threatening infections. For this reason “inland regions” (we mean regions far away from the coast) with a tropical climate are contra-indicated, like for example these regions in Southern and Middle America, Africa and South-East-Asia. Relatively contra-indicated are regions with a hot climate and a high humidity like for example the South-West of the United States. In Georgia, Florida and Texas Mycobacterium abscessus is more prevalent. Infections with this ‘atypical mycobacteria’ are extremely difficult to treat and often life threatening. This is why patients with CF are advised against visiting these regions. Another dangerous bacteria is Burkholderia pseudomallei and this bacteria is endemic in Mexico, South-East-Asia and the Northern part of Australia. This list may look like a restriction on your travel plans, however there are many parts of the world where you can travel to without important risks. Examples are : non-EU countries in Eastern Europe, Russia, Northern African countries like Tunisia and Marocco, Namibia, South-East America, Caribbean Islands, the parts of Southern America with temperate or subtropical climate and islands in the Indian or Atlantic Ocean. Countries without any specific risks are EU-countries, Turkey, Israel, Northern America (with exclusion of the South-West),the far East (Japan, Taiwan), Australia (except for the northern part) and New Zealand.
This topic concerning travelling for patients with CF is of such importance that the Ecorn project is planning a consensus document on this subject. As soon as this consensus document is available, it will be accessible on the Ecorn website. Prof. Tummler from Hanover, a CF expert with special interest in microbiology (science on disease causing germs) helped us to prepare the answer on this question.
K. De Boeck, M. Proesmans

29.01.2009