Travellers Visiting Friends and Relatives
A common misconceptionis that immigrants to Canada now returning home to a low or middle-income country to visit friends or family do not need vaccinations or travel health advice. While it is true that people living in certain countries build immunity to some diseases, that immunity is lost after moving away. These travellers, commonly known as those visiting friends and relatives (VFRs) are actually at higher risk of diseases including malaria, typhoid fever, tuberculosis, hepatitis A, and sexually transmitted infections. There are several reasons why VFRs are at higher risk of travel-related illnesses including:
- Misconception of health risks
- Financial barriers to pre-travel health care
- Cultural and language barriers
- Lack of trust in the medical system
- Last-minute travel plans and longer trips
- Travel to higher-risk destinations
- Highrisk travel behaviours such as staying in local homes, which often includes lack of access to safe food and water and not using door/window screens or bed nets
Did you know?…
- VFRs are 8 times more likely to be diagnosed with malaria than are tourist travellers.
- There is a high rate of VFRs who are not immune to measles, mumps, rubella and chicken pox.
- VFRs are 7 times more likely to be diagnosed with typhoid fever than are tourist travellers.
- The majority of typhoid fever cases in VFRs are associated with travel to South Asia (India, Afghanistan, Pakistan, Nepal, Bangladesh, Maldives, Sri Lanka and Bhutan).
- VFRs account for 28%-78% of travel-related hepatitis A cases.
- A study of Canadian-born VFR children found that typhoid, malaria, diarrheal diseases and hepatitis A accounted for 75% of travel related illness in this group, and only 26% of these travellers had received pre-travel health advice.
VFRs need travel health advice too!
VFRs have unique risks for travel-related diseases and can largely benefit from receiving pre-travel health advice. Health providers at TravelSafe Clinic are sensitive to the barriers and complexities of the pre-travel consultation in VFR travellers. It is an important opportunity for health promotion and risk reduction by providing travel related vaccines and medications, as well as tips to reduce risks, especially those related to insects and food and water bornediseases. If English is not the first language spoken it is helpful to bring a translator to ensure understanding.
Heading Home Healthy
The U.S. Center for Disease Control supports the Heading Home Healthy program which focuses on reducing travel-related illnesses in VFR travellers. The program contains videos, resources and health tools in multiple languages to assist VFRs and health care providers. This is a great tool for VFRs to learn more about different health risks and recommendations for travel.
TravelSafe Clinical Educator – Kristin Cain, RN, BSc, MSc(A)
