Infection Control on Immunosuppressants

[RosieStarr]

I’ve recently been diagnosed with RA, and therefore placed on immunosuppressants. Have been warned to be careful about infection control - eg. Wash hands regularly, avoid conact with non-vaccinated people, be careful with young kids (colds etc)

Was just wondering if anyone who is on immunosuppressants has any general advice or tips? I’ve made sure I’ve always got antibacterial wipes and gel on me, just in case!

There's not much more you can do than that tbh. I would learn the hospital handwash and get your family to also. Handwashing is really one of the best ways to avoid infection. Change towels regularly. Avoid obviously infected people and busy crowded places (pubs,public transport etc at certain times) Some food considerations (depending on how immunocompromised you are) Avoid "bio" products e.g. Yakult or any product with added bacteria. Avoid foods from deli counters that has been open for hours. Also pepper can have fungal spores so stay away from that. Also maybe avoid mould based cheese, ie Brie, blue cheese. But that's advice we give very compromised patients so you may not have to go that far.

I don’t really do anything different now. Just normal hygiene and I will avoid someone if I know they have flu or vomiting (but I’d probably do that anyway )

When I was first diagnosed with RA and started on Methotrexate I was a bit paranoid but as time has moved on and with the monthly blood tests I’m pretty relaxed. I’m having the flu jab this year though.

It’s scary when you’re first diagnosed but it definitely gets easier.

Immunosuppressants have played havoc with my (already on the low end of normal) white blood count but I really don't feel I've picked up any more bugs than I did before I was diagnosed. I'm reasonably careful with handwashing and avoiding obviously ill people but I get the tube to work every day so am sure I come into contact with more than my fair share of germs, and I've been largely fine.

You should be offered a free flu jab and pneumonia vaccine by your GP and get regular blood tests, so anything untoward going on should be picked up and dealt with quickly.

Thanks for your replies - I’m going to do my best to avoid people who are ill, will look into the flu vaccination though. I’ve paid to have it for the past few years so would like to continue to have it.

methotrexate makes it hard for me to heal small cuts or spots. i got taken off it for 3 months due to recurrent chest infections, had to take lots of antibiotics and am on week 3 of taking the meth again. i can definitely tell the difference.

i had a free flu jab last year and this, and last year had a free pneumonia jab as well, that i didn’t even know was a thing! it’s not Boy in the Bubble stuff, but i am careful.

i hope the meds help you. i am not in any less pain on the meth, but i am more mobile, if that makes sense. so, i am still fidgety with pain by bedtime, but i don’t need to crawl upstairs like a reverse Exorcist. so, swings and roundabouts...

Yes, that’s my thinking - it might be annoying having to be careful all the time, but at least I can function!

I second Fancypuffin, when I first went on methotrexate I was paranoid about all the side effects I read and being near anyone with an infectious disease, but I've relaxed now.

We had a case of meningitis confirmed at school a few months ago and I was immediately on the phone to my consultant in sheer panic. There was no need. As she said, how do I know the person standing next to me in Sainsburys hasn't got typhoid?

I also had to go to the gp last week, because I had an unusual pain in my leg and I was concerned it had something to do with the methotrexate. She asked me if I'd actually read the side effects on a box of paracetamol or ibuprofen? They're pretty scary too, but very rare. You have regular blood tests for a reason. If there is any problems, they'll take you off it immediately.

So, I'm much more chilled about it now. Ultimately, the drugs are working. I feel so much better and that's good. I've had the flu jab, just because I can, but the rest of my life is as normal as possible. Oh and by the way, I'm the senior first aider at a school of 1500 pupils and I've yet to pick anything nasty up from them!

I’m not really bothered about the side effects, I’m more bothered because in my line of work I am more at risk of contracting infections. Lots of safety measures in place but ultimately still greater risk. Personally I think it’s just better to reduce the risk where possible. Also using it as a fantastic excuse to refuse to see awful SIL who isn’t vaccinated- bonus! 😂

I'm on mtx but I have a one year old so I can only do so much to avoid illness! Lots of handwashing and making sure DC have all vaccinations Inc chickenpox.

I also remind people that it might just be a sniffle to them but I can end up pretty poorly.

I find keeping a healthy lifestyle helps-plenty of veg, sleep and gentle exercise. I am more likely to get ill if I'm rundown and tired.

DD is on immunos.

Family and friends know to stay away from DD if ill.

If I heard of chicken pox/shingles in close mixing, I would contact OOH immediately - this is the most important thing I think.2

I'm immunocompromised - neutropenic and take GCSF to stimulate my neutrophils
I avoid obviously ill people, chicken pox and kids who have just had flu nasal spray
Apart from that I'm a very bad neutropenic and eat fruit and veg without washing it, kiss my horse and spend my life covered in mud

But I know from the 8 years I spent undiagnosed that my "weak spot" is chest infections/tonsillitis. I have a stomach of steel so food isn't an issue but I run away from anyone mentioning a sore throat/cough!

I try to avoid people who are obviously ill but it is impossible really. I am religious about hand washing when I've been out and before eating anywhere but I don't overly worry.