Visiting Friends and Relatives
With travel of any kind, it is important to get pre-travel health advice to avoid illness, but this is especially true when visiting friends and relatives. More than half of international travelers to developing countries get sick during or after their trip, so the Centers for Disease Control and Prevention encourages travelers to be proactive, prepared, and protected before and during traveling.
Are you up-to-date on your medications and vaccinations? Are you too sick to travel? Traveling overseas can expose you to unfamiliar illnesses, so before traveling to India, make sure you are aware of the steps you can take to stay healthy.
Traveling to India to Visit Friends and Relatives
In 2010, more people traveled to visit friends and relatives than for any other reason; these travelers represented almost 30% of the total international travelers from the United States that year, which amounted to nearly 10,000,000 travelers.
All travelers face risks, but the risk of getting sick increases for travelers who are visiting friends and relatives in India. These illnesses can include malaria, typhoid, tuberculosis, hepatitis A, and sexually transmitted infections.
A primary reason for the increased risk is that less than 30% of travelers who are visiting friends and relatives seek pre-travel health care.
What are some reasons travelers who are visiting friends and relatives don’t take action toward prevention?
- They do not know the risk of local diseases.
- They believe that they are immune to local diseases.
- They have difficulty getting, or paying for, healthcare.
- Many clinicians do not recognize the unique needs of travelers who are visiting friends and relatives and treat them just like any other traveler.
Know the Risks!
Misconceptions About Immunity
Even if you grew up or have lived in India, you may not be protected from diseases such as typhoid or malaria. Immunity disappears quickly after a person moves away, causing that person to lose any protection he or she may have had. Travelers who are visiting friends and relatives likely do not have the same types of immunity to local germs as do their family and friends who live in India.
Risks Increase When Visiting Friends and Relatives
Travelers who are visiting friends and relatives are much more likely to develop travel-related illnesses because they are more deeply immersed in the local culture during their trips than are tourists. This group of travelers eats more local foods and stays longer than most other types of international travelers.
- 54% of imported malaria cases in the United States were in travelers who are visiting friends and relatives (8-10 times higher than in tourists or business travelers).
- 66% of typhoid cases occur in travelers who are visiting friends and relatives.
- 90% of paratyphoid A cases are imported from South Asia.
Lack of Pre-travel Care
Fewer than 30% of people traveling to India seek health care before their trip. Travelers should consult a physician before visiting India to get customized health advice. Pre-travel consultations can greatly decrease the likelihood and severity of travel-related illness.
Counterfeit and Substandard Medications
Medications and vaccines in India may not be as effective and could even be dangerous. Despite this risk, many travelers wait to purchase healthcare supplies in India rather than bring them from the United States.
- Studies in Southeast Asia have shown that up to 50% of the antimalarial drugs purchased locally were substandard.
- 88% of oral malaria medication sold was of poor quality.
In fact, the chance of buying counterfeit or substandard drugs in parts of Asia may be higher than 30%.
Cost of Sickness
Remember: it is much more expensive to treat an illness than to prevent one, so travelers can spend a little now to save a lot later.
Illness Treatment per person Prevention
Malaria $25,000 Less than $200
Hepatitis A $1,800 - $2,500 and 27 average number Less than$300 for both vaccine doses
of work days lost
Medical $25,000 - $250,000 Medical Evacuation Insurance is $15-$300 for a 1-3 week trip
- See a doctor at least 4-6 weeks before your travel date.
- Prevent illness by making sure your immune system is strong before travel.
- Get necessary vaccines and medicines before leaving the United States.
- Explore travel-health insurance options. Travelers who get sick while overseas may not be covered by their US health insurance.
- Check the CDC’s website for healthy trip tips.
- Unclean food and water can cause diseases like typhoid and hepatitis A. Enjoy time with your friends and family, but remember to keep safe eating and drinking tips in mind.
Things to Remember
Traveling can be fun but getting sick while traveling can ruin anyone’s trip. Travelers who are visiting friends and relatives in India are at greater risk of getting sick from a travel-related illness. This group of travelers are much more likely to get malaria, typhoid, hepatitis, and sexually transmitted infections than any other group of international travelers. Travelers to India should see a doctor at least 4-6 weeks before the departure date. Eight out of ten travelers who are visiting friends and relatives are unaware of pre-travel health recommendations.
- Baggett, H. C., Graham, S., Kozarsky, P. E., Gallagher, N., Blumensaadt, S., Bateman, J., Edelson, P. J., Arguin, P. M., Steele, S., Russell, M. and Reed, C. (2009), Pretravel Health Preparation Among US Residents Traveling to India to VFRs: Importance of Ethnicity in Defining VFRs. Journal of Travel Medicine, 16: 112–118. doi: 10.1111/j.1708-8305.2008.00284.x
- Bui, Y.-G., Trépanier, S., Milord, F., Blackburn, M., Provost, S. and Gagnon, S. (2011), Cases of Malaria, Hepatitis A, and Typhoid Fever Among VFRs, Quebec (Canada). Journal of Travel Medicine, 18: 373–378. doi: 10.1111/j.1708-8305.2011.00556.x
- Leder K, Torresi J, Brownstein JS, Wilson ME, Keystone JS, Barnett E, Schwartz E, Schlagenhauf P, Wilder-Smith A, Castelli F, von Sonnenburg F, Freedman DO, Cheng AC; GeoSentinel Surveillance Network. Travel-associated illness trends and clusters, 2000-2010. Emerg Infect Dis. 2013 Jul;19(7):1049-73. doi: 10.3201/eid1907.121573. PubMed PMID: 23763775; PubMed Central PMCID: PMC3713975.
- Gungabissoon U, Andrews N, Crowcroft NS. Hepatitis A virus infection in people of South Asian origin in England and Wales: analysis of laboratory reports between 1992 and 2004. Epidemiol Infect. 2007 May;135(4):549-54. Epub 2006 Sep 26. PubMed PMID: 16999877; PubMed Central PMCID: PMC2870611.