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Visiting Friends and Relatives

Abstract Visiting friends and relatives (VFRs) comprise over a quarter of all international travelers, and nearly half of all visits to low-income or lower middle-income, disease-endemic countries. They are more likely to travel to areas with higher risk for many infections, often undertake last-minute travel, may stay for longer periods than other groups of visitors, and often live in close proximity to local populations. These factors, combined with lower uptake of pretravel health care visits and vaccines, increase their risk of acquiring a range of diseases. In particular, VFRs have the highest morbidity from typhoid, hepatitis A, malaria, tuberculosis, and sexually transmitted infections. VFR children seem particularly at risk of severe infections. While the pattern of morbidity among VFRs is now well recognized, a lack of data on the ways to address the problem remains, requiring increased effort and innovative approaches.