Summary of the Statement on International Travellers Who Intend to Visit Friends and Relatives

Abstract

Background: Travellers intending to visit friends and relatives (VFRs) are a specific group of travellers who have been identified as having an increased risk of travel-related morbidity.Objective: To provide recommendations for risk reduction in international VFRs. Methods:Recommendations regarding VFRs were developed based on available travel medicine literature and CATMAT expert opinion. Specific travel-related risks, including infectious disease epidemiology and burden in this population, were reviewed and recommendations were provided to attempt to mitigate these risks. Previous CATMAT statements related to VFRs were referred to and reiterated.Recommendations: Rates of travel-related illness in VFRs tend to be higher for many conditions. Diseasespecific risk factors and recommendations are discussed throughout this Statement. CATMAT recommends that VFRs' vaccinations be up-to-date and they be counselled on the importance of various risk reduction activities such as the use of malaria prophylaxis, safe sex practices and injury prevention. Pre-and/or post-travel tuberculosis testing is indicated in certain situations. Conclusion:The pre-travel health assessment is an important opportunity to address with VFRs issues regarding health beliefs, health behaviours, current health status and the possibility of pre-existing conditions. Discussions addressing the importance of adherence to health advice and potential challenges to achieving adherence may be necessary. PreambleThe Committee to Advise on Tropical Medicine and Travel (CATMAT) provides the Public Health Agency of Canada with ongoing and timely medical, scientific, and public health advice relating to tropical infectious disease and health risks associated with international travel. The Agency acknowledges that the advice and recommendations set out in this statement are based upon the best current available scientific knowledge and medical practices and is disseminating this document for information purposes to both travellers and the medical community caring for travellers.Persons administering or using drugs, vaccines or other products should also be aware of the contents of the product monograph(s) or other similarly approved standards or instructions for use. Recommendations for use and other information set out herein may differ from that set out in the product monograph(s) or other similarly approved standards or instructions for use by the licensed manufacturer(s). Manufacturers have sought approval and provided evidence as to the safety and efficacy of their products only when used in accordance with the product monographs or other similarly approved standards or instructions for use.

Tuberculosis infection in children visiting friends and relatives in countries with high incidence of tuberculosis

“…Awareness of travel-associated risk of disease in VFR remains low, which might explain the scarce use of pre-travel health-care services by the immigrant population. [ 29 ] Moreover, the diversity of recommendations for different regions and countries demonstrates the limited information available on this topic. [ 30 , 31 ] Knowledge about the effectiveness of LTBI screening or BCG vaccination strategies also remains poor.…”

Tuberculosis among children visiting friends & relatives

“…11 Travellers visiting friends and relatives (VFRs) account for up to 50% of international travellers from high-income countries. 12 Travellers to countries with a high-TB incidence are at risk of acquiring LTBI and TB during travel. 13 Travel-related factors, such as transmission intensity, stay duration, contact with the local population and individual characteristics, have been associated with TB transmission.…”