Travel to visit friends and relatives

Key messages for primary care practitioners

  • Many infections associated with travel predominantly affect people who travel to visit friends and relatives (VFR) 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 may not seek health advice prior to travel because the destination is familiar to them or their family; they may underestimate risks to their health. 
  • Ask your migrant patients opportunistically about any plans they may have to visit friends and relatives and arrange for them to receive travel health advice at least 6 to 8 weeks prior to their planned departure. [Note however that it is never too late in relation to a planned trip to give travel advice.]
  • See NaTHNaC [external link] for country specific travel advice, and the 'Yellow Book' (Health Information for Overseas Travel [external link]). NaTHNaC also provides a specialist advice line for health professionals where the patient has a complicated medical history or itinerary: 0845 602 6712 (local call rate) Monday - Friday, 9am - 12pm; 2 - 4.30pm.
  • Always remind patients who intend to travel of the need for comprehensive travel insurance and direct them to the Foreign and Commonwealth Office [external link] for general and security information associated with their planned destination. Travellers may also wish to register with their LOCATE [external link] service, which can help to find them while travelling in the event of an emergency.
  • Be alert to the possibility of infectious diseases in unwell travellers who have returned from trips to visit friends and relatives abroad. See assessing patients with symptoms.
  • When requesting laboratory investigations on patients always include the travel history (i.e. the places visited and the dates of travel). 
  • Be aware that migrants from countries with high rates of female genital mutilation (FGM) may return to visit friends and relatives intending their children to undergo FGM. It is illegal to take girls who are British nationals or permanent residents of the UK abroad for FGM whether or not it is lawful in that country. If you are concerned that a girl may be taken overseas for the purpose of FGM please call the Foreign and Commonwealth Office on 0207 008 1500 or email fgm@fco.gov.uk

Background information

Patient information (English only)

Patient information (English and other languages)

Other useful resources

Background information

  • In recent years in the UK, VFR travel has overtaken business travel as the second most common reason for travel after holiday travel.
  • Much VFR travel is undertaken by migrants to the UK, or by their UK born families.
  • VFR travel destinations reflect the country of origin of migrant communities in the UK, and include more tropical parts of the world where the risk of infectious disease is higher. By contrast most holiday travel is to destinations which have a similar infectious disease profile to the UK.
  • 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.
  • Surveillance data show 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 any/adequate chemoprophylaxis.
  • Similarly the majority of cases of enteric fever (typhoid and paratyphoid) reported in the UK have been acquired in countries in the Indian subcontinent by people of these ethnicities or origins. Most have not received typhoid vaccination prior to their trip.
  • While less data are available, there is some evidence to suggest that a number of other travel associated illnesses also disproportionately affect VFR travellers e.g. hepatitis A.
  • It appears that VFR travellers may be less likely to seek health advice before their trip; the reasons for this are not well understood but may include an incorrect perception of risk associated with familiarity with the destination.
  • Targeting VFR travellers for travel health advice includes opportunistically asking migrant patients about travel plans when they consult for other reasons (e.g. 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.
  • Remember that 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, remember to always include the travel history with the places visited and the dates of travel. This helps the laboratory determine which tests may be helpful in diagnosis. It also contributes information to national surveillance of infectious disease and hence to the evidence base on which travel advice is formulated by the National Travel Health Network and Centre (NaTHNaC [external link]).
  • NaTHNaC has a range of services to support health professionals who advise travellers. These include: 
    • the 'Yellow Book' (Health Information for Overseas Travel [external link])
    • web-based country specific advice
    • a searchable database of outbreaks globally that may impact on 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

Back to top

Patient information (English only)

HPA patient leaflets on malaria and typhoid fever

Travel safe - reducing the risk of getting a bloodborne infection when you're abroad [external link] (Department of Health information leaflet)

NaTHNaC advice for pilgrims going to Hajj or Umrah [external link]

Visiting Friends and Family in South Asia [external link] (Foreign & Commonwealth OfficeTravel Advisory leaflet)

Staying safe and healthy [external link] advice from the Foreign & Commonwealth Office including a travel checklist

Visiting friends and family abroad [external link] advice from the Foreign & Commonwealth Office

Back to top

Patient information (English and other languages)

Going to Hajj or Umrah? [external link] (Department of Health information leaflet) Available in English, Arabic, Bengali, Gujarati, Urdu 

Back to top

Other useful resources

Travel health - visiting friends and relatives [external link] training video from HPA migrant health event 12 November 2012

A video describing health risks relevant to travellers visiting friends and relatives abroad.

HPA travel health page  

HPA report: Foreign travel-associated illness – a focus on those visiting friends and relatives: 2008

For travel advice for health professionals, or the public, please see NaTHNaC [external link]

NHS travel advice for health professionals is also available from TRAVAX [external link] (this site requires registration)

For travel advice for the public please see the Health Protection Scotland web resource: Fit for Travel [external link]

The Foreign and Commonwealth Office [external link] provides a range of information and services to travellers

Know Before You Go Campaign [external link] (Foreign & Commonwealth Office)

Back to top

© Crown Copyright