Travel to visit friends and relatives: migrant health guide

Main messages

PriorPeople to leaving the UK, people who travel to visit friends and relatives (VFR travellers) travellers) should visit the the Foreign and Commonwealth Office for overseas travel advice and  and National Travel Health Network and Centre (NaTHNaC) for country-specificfor travelcountry healthspecific travel advice onprior travel-relatedto risksleaving andthe disease, including vaccine recommendations.UK.

Many infections associated with travel predominantly affect affect VFR travellers travellers in their family’s country of origin.

VFR travellers travellers have a different risk profile to other types of travellers. They tend to travel for longer and live as part of the local community while abroad, which can increase their likelihood of exposure to infectious disease risks.

VFR travellers travellers might not seek health advice prior to travel because the destination is familiar to them or their family. They may underestimate risks to their health.

Healthcare professionals should:

• ask migrant patients opportunistically about any plans they may have to visit friends and relatives and advisearrange for them to receive travel health advice at least 6 to 8 weeks prior to their planned departure -– it’s never too late toin adviserelation them about to a planned trip

• ensure patients are up to dategive with immunisations as per the routine immunisation schedule, and advise on additional travel vaccinationsadvice

• consider possible infectious diseases in unwell travellers who return from trips to visit friends and relatives abroad – see the the communicable disease pages of of the migrant health guide for more information

• always include the travel history (that(the is, the places visited and the dates of travel) when requesting laboratory investigations for patients

• contact contact NaTHNaC’s specialist advice line for health professionals if if the patient has a complicated medical history or itinerary

• remind patients who intend to travel of the need for comprehensive travel insurance

Visiting

Migrants from countries with high rates of female genital mutilation (FGM) may return to visit friends and relatives (intending for their children to undergo FGM. It’s illegal to take girls who are British nationals or permanent residents of the UK abroad for FGM whether or not it’s lawful in that country.

Overseas travel advice during the COVID-19 pandemic

Information on overseas travel advice during the COVID-19 pandemic can be found on the COVID-19 guidance page.

VFR) travel travel

VFR travel travel is the second most common reason for international travel after holidays, overtaking business travel.

Much Much VFR travel travel is undertaken by migrants to the UK, or by their UK-bornUK born families.

VFR travel travel destinations often reflect the country of origin of migrant communities in the UK and include tropical or subtropical parts of the world where the risk of certain infectious disease is higher. HolidayBy travelcontrast, ismost moreholiday likelytravel tois be to destinations wherewhich travellershave tenda tosimilar stay in hotels or resorts, reducing their exposure to infectious disease risksprofile compared to VFRthe destinations.UK.

VFR travellers travellers often stay longer in their destination than holiday-makers and they are more likely to live as part of the local community during their stay. Their risk of acquiring disease is therefore quite different to most holiday-makers.

Health of of VFR travellers

travellers

Surveillance data showsshow that the majority of cases of malaria reported in the UK occur in people of African ethnicity or origin who have visited friends and relatives in Africa. Most have not taken adequate chemoprophylaxis, or taken none at all.

Similarly, the majority of cases of enteric fever (typhoid and paratyphoid) reported in the UK have been acquired in countries in Souththe AsiaIndian subcontinent by people of Souththese Asianethnicities ethnicity or origins. Most have not received typhoid vaccination prior to their trip.

While less data is available, there is some evidence to suggest that a number of other travel-associated illnesses also disproportionately affect affect VFR travellers, travellers, such as hepatitis A.

VFR travellers travellers may be less likely to seek health advice before their triptrip: due to factors such as familiarity with the destination,reasons afor perceptionthis that the risks are lowernot orwell beliefunderstood thatbut theymay doinclude notan needincorrect toperception takeof additionalrisk precautionsassociated becausewith offamiliarity theirwith connection to the area.destination.

Advice for healthcare professionals

Providing travel health advice to to VFR travellers travellers includes opportunistically asking migrant patients about travel plans when they consult for other reasons (such as new patient checks, childhood vaccination clinics and other consultations) and encouraging them to attend for further advice.

In addition to preventing the acquisition of travel-associated illness, the primary care practitioner has an important role in identifying travel-associated illness in unwell patients.

A travel history should form part of the assessment of any unwell patient, particularly those who are febrile. See assessing patients with symptoms.

Malaria can can present up to a year after leaving a malaria risk area. Anyone presenting in this time frame with a flu-like illness and a relevant travel history should have this diagnosis excluded as a matter of urgency. Malaria can be rapidly fatal.

When requesting laboratory investigations on an unwell returning traveller, always include the travel history with the places visited and the dates of travel. This helps the laboratory determine which tests can help in diagnosis.

ReportingIt travel history also contributes information to national surveillance of infectious disease and hence to the evidence base on which travel advice is formulated by the the National Travel Health Network and Centre (NaTHNaC).

Resources

NaTHNaC provides provides travel advice for health professionals and the public. ThisThese includes:include:

• health information for overseas travel
• web-based country-specificcountry specific advice
• a searchable database of outbreaks globally that may impact travellers
• yellow fever vaccination centre registration and training
• a a specialist advice line for health professionals advising advising travellers who have a complex medical history or itinerary

Additional resources for the public

The Foreign and Commonwealth Office (FCDO)has a range of information and services for peopletravellers, travellingincluding:

• visiting friends and family abroad

  UKHSA advice

• know forbefore visitingyou friendsgo: staying safe and familyhealthy abroad 
  including a travel checklist

Health Protection Scotland:Scotland Travelprovides travel advice on the following websites:

• TRAVAX for health andprofessionals
• Fit vaccinationsfor advicetravel for the public