Advice for Those Visiting Friends and Relatives
This advice identifies a few key points you should consider in advance of your trip - it is not comprehensive. Although overseas trips should be planned in advance sometimes they are at short notice, for example, because a relative is ill.
Data collected on travellers who return to the UK from overseas consistently identifies that those who travel for the purpose of visiting friends and relatives have an increased risk of travel-related health problems including infections and are more likely to be hospitalized than tourist travellers.
Some of the reasons for this increased risk are thought to be:
- Pre travel advice is not always sought and therefore recommended vaccines are not taken.
- The risk of travel related illness may be under-estimated because of the familiarity of the trip.
- There is more likelihood of travelling last minute and for longer.
- There is more likelihood of mixing closely with the local community (so infections such as measles, influenza and meningitis can be spread).
- There may be a higher risks of exposure to infections such as malaria e.g. in rural areas, where it is more difficult to take sufficient preventive measures.
It is important to take out adequate health insurance to cover medical treatment and for repatriation particularly when visiting areas where access to adequate medical facilities is difficult. If going to an area of potential conflict or unrest advice should be sought from the Foreign and Commonwealth Office.
If staying with friends or relatives, you may have good control over food and water consumption. Water may need to be purified on a daily basis. These precautions are especially important if travelling with infants or children.
In addition, it is important to know how to treat stomach upsets and diarrhoea and when to seek advice.
Vaccinations take time. Consult your doctor or nurse as soon as possible. Late bookings can leave insufficient time for vaccinations to become fully effective. Even if you grew up abroad you may now have lost immunity to certain diseases.
- Tetanus and diphtheria vaccination is important for those likely to sustain injuries (tetanus) or mix closely with the local population (diphtheria). For countries where these diseases are still common you should to receive boosters every 10 years and everyone should have completed their normal British childhood schedule.
- There is an increasing risk from tuberculosis for those visiting many of the high-risk areas and mixing with the local population. Remember protection from BCG is only achieved after about 4-6 weeks. Boosters are not normally required.
- Meningococcal type ACWY vaccine is mainly a risk for those visiting risk areas in sub-Saharan Africa who will be mixing closely with the local population, as might be the case if you are returning home for a family gathering such as a wedding.
- Hepatitis A and typhoid vaccines are important for those who are not able to be careful about their food and water hygiene in risk areas. Eating with your relatives may be reasonably safe but accidents happen and eating out may be risky in poorer countries.
- Influenza vaccine can be considered for those who might get a more severe illness such as those with existing chest problems. Remember the 'flu' season in the Southern Hemisphere is from April to November.
- Rabies vaccination can be important if you are going to be more than a day or two from good medical facilities and especially if travelling with children who may be more inclined to approach animals.
- Yellow fever vaccination is recommended for some parts of Africa and South America. In addition a certificate may be necessary for entering certain countries and for crossing borders.
UK data on imported malaria cases shows that the number of cases of malaria in travellers who visit malaria areas for the purpose of visiting friends and relatives, is disproportionately high in comparison to travellers who go to malaria areas for other reasons. This higher risk might be partly explained for the reasons already outlined above.
The following advice should be followed for those visiting malaria areas:
- Seek professional advice in advance of your trip.
- Do not underestimate the risk of malaria which can be potentially life threatening.
- If you were born and lived in a country with malaria, any immunity that you may have previously had is quickly lost after you leave the malaria area.
- If you are advised to take antimalarial tablets it is important that you do so and that you take the tablets as directed and complete the whole course.
- Purchasing antimalarials overseas can be problematic and in some countries medication purchased can be sub-standard or counterfeit.
- All of the above is particularly important if travelling with infants or children.
- If you are pregnant or travelling with a child, you may be advised to avoid non essential travel to very high risk areas for malaria.
Female genital mutilation (FGM) is also known as female genital cutting and female circumcision. FGM is mostly carried out on young girls sometime between infancy and age 15 years and occasionally on adult women. Though not unique to VFRs, FGM takes place commonly in many country where UK VFRs travel to.
The practice is most common in the western, eastern, and north-eastern regions of Africa, in some countries in Asia (Indonesia and Malaysia) and the Middle East (see Risk Country List).
There is evidence of increasing global medicalisation of the procedure, with private clinics offering the operation in the Middle East and Far East.
Due to increasing international migration FGM is also practised amongst migrant communities from high FGM prevalence countries, including those living in the UK.
FGM is a human rights violation, a form of gender-based violence against females and when performed on girls under 18 years-of-age, it is child abuse.
- FGM is against the law in the UK.
- It is also against the law to take a girl overseas to have the procedure carried out.
For further information about FGM including what to do if you suspect someone may be at risks in the UK or overseas see: FGM.
Other aspects of advice that are relevant include: