Travel to visit friends and relatives: migrant health guide
Advice and guidance on the health needs of migrant patients for healthcare practitioners.
Main messages
Prior to leaving the UK, people who travel to visit friends and relatives (VFR travellers) should visit the Foreign and Commonwealth Office for overseas travel advice and National Travel Health Network and Centre (NaTHNaC) for country-specific travel health advice on travel-related risks and disease, including vaccine recommendations.
Many infections associated with travel predominantly affect VFR travellers in their family’s country of origin.
VFR 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 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 advise them to receive travel health advice at least 6 to 8 weeks prior to their planned departure - it’s never too late to advise them about to a planned trip
-
ensure patients are up to date with immunisations as per the routine immunisation schedule, and advise on additional travel vaccinations
-
consider possible infectious diseases in unwell travellers who return from trips to visit friends and relatives abroad – see the communicable disease pages of the migrant health guide for more information
-
always include the travel history (that is, the places visited and the dates of travel) when requesting laboratory investigations for patients
-
contact NaTHNaC’s specialist advice line for health professionals if the patient has a complicated medical history or itinerary
-
remind patients who intend to travel of the need for comprehensive travel insurance
Visiting friends and relatives (VFR) travel
VFR travel is the second most common reason for international travel after holidays, overtaking business travel.
Much VFR travel is undertaken by migrants to the UK, or by their UK-born families.
VFR 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. Holiday travel is more likely to be to destinations where travellers tend to stay in hotels or resorts, reducing their exposure to infectious disease risks compared to VFR destinations.
VFR 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 VFR travellers
Surveillance data shows 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 South Asia by people of South Asian 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 VFR travellers, such as hepatitis A.
VFR travellers may be less likely to seek health advice before their trip due to factors such as familiarity with the destination, a perception that the risks are lower or belief that they do not need to take additional precautions because of their connection to the area.
Advice for healthcare professionals
Providing travel health advice to VFR 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.
Malaria 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.
Reporting travel history also contributes information to national surveillance of infectious disease and the evidence base on which travel advice is formulated by the National Travel Health Network and Centre (NaTHNaC).
Resources
NaTHNaC provides travel advice for health professionals and the public. This includes:
- health information for overseas travel
- web-based country-specific advice
- a searchable database of outbreaks globally that may impact travellers
- yellow fever vaccination centre registration and training
- a specialist advice line for health professionals advising travellers who have a complex medical history or itinerary
Additional resources for the public
Foreign and Commonwealth Office (FCDO) information for people travelling abroad
UKHSA advice for visiting friends and family abroad
Health Protection Scotland: Travel health and vaccinations advice for the public
Updates to this page
-
Removed link to COVID-19. Updates to wording and links.
-
Rebranded page to UKHSA. No change to content.
-
Added link to COVID-19 migrant health guidance and updated advice for healthcare professionals.
-
Updated and made editorial changes to meet GOV.UK style.
-
First published.