Dr Chris Davenport , TMA Boronia
It’s Monday morning, another busy day in General Practice filled with the usual interesting patients - for blood pressure reviews, medication repeats, women’s health discussions and children with the latest coughs and colds.
7-year-old Alice has come with her mother for a review of her eczema. It’s the school holidays and I ask what the holidays will hold for her.
“We are going on a holiday to see my Grandma,” she replies, “ She lives in Vietnam, where Mum and Dad came from and we are taking our new baby to see her”
They are leaving in a few days, travelling to stay with their grandparents and catch up with the extended family. The children had been born in Australia and this was to be their first trip “back home”. They were up to date with the Australian childhood vaccinations but no thought had been given to obtaining travel advice or vaccinations. “As they were just going home.”
This is a common scenario, where families return to their country of origin to visit friends and relatives without seeking travel advice. Or some families present asking for vaccines for the children while assuming that they (the adults) will be OK. They feel they know the risks, grew up in that environment, feel comfortable and assume all will be well.
However, Immigrants and their children who return to their country of origin to visit friends and relatives (VFR) are at increased risk of acquiring infectious diseases compared with other travellers. (Heywood, et al., 2016)Several studies have shown that of all Australians returning from overseas with an infectious illness 65% are from the VFR group, whereas the VFR group only makes up 23% of Australians travelling.
VFR travellers are a large and important group as one-quarter of Australia’s population were born overseas and do travel “home” to visit family.
Their risk is higher due to several reasons.
They have a lower perception of risk as they are familiar with the destination. There is a perception of protection from prior immunity developed in childhood – an immunity that may have waned since leaving their home country. Their children have not been exposed to the diseases and infections common in their parents’ place of origin. They are more likely to travel to resource-poor settings and have a longer duration of travel than those travelling for tourism or business. VFR travellers are more likely to have closer contact with the local population e.g. while catching up or living with extended family, close contact with large groups, the children playing and in close contact with family members. They are more likely to consume local water and less likely to be concerned with Malaria prevention. As a group, they are less likely to be vaccinated prior to travel compared with holiday traveller for the reasons mentioned above.
It is important to discuss travel and prevention of infectious disease when opportunities like this present themselves, and important too, to discuss with the adults that they may also be at risk.
Bibliography
Heywood, A. E., Zwar, N., Forssman, B. L., Seale, H., Stephens, N., Musto, J., . . . MacIntyre, C. (2016). The contribution of travellers visiting friends and relatives to notified infectious diseases in Australia: state-based enhanced surveillance. Epidemiology and Infection, 144(16), 3554-3563. Retrieved 1 30, 2020, from https://ncbi.nlm.nih.gov/pmc/articles/pmc5111124