TitleHealth Challenges of Young Travelers Visiting Friends and Relatives Compared With Those Traveling for Other Purposes
AuthorsPauline Han, MA, Emad Yanni, MD, Emily S. Jentes, PhD, Davidson H. Hamer, MD, Lin H. Chen, MD, Mary E. Wilson, MD, William B. MacLeod, ScD, Winnie W. Ooi, MD, Laura Kogelman, MD, Adolf W. Karchmer, MD, and Elizabeth D. Barnett, MD
PublicationThe Pediatric Infectious Disease Journal. 2012 Sep; 31(9):915-919.


The study objective was to assess differences in demographics and travel health challenges between youths ≤18 years old traveling internationally to visit friends and relatives (VFRs) compared with those traveling for other purposes (non-VFR).


The Boston Area Travel Medicine Network consists of 5 clinics collecting anonymous data from international pretravel consultations. Data on all travelers ≤18 years of age seen between January 2008 and July 2010 were used. VFRs were compared with non-VFRs on demographics, primary language, trip characteristics, travel vaccinations administered, malaria prophylaxis and antidiarrheal medications prescribed.


Thirty-five percent (610/1731) listed VFR as their purpose of travel. Almost half of VFRs were <5 (46%) years old compared with <5% of non-VFRs. Thirty percent of US-born VFRs with foreign-born parents were ≤2 years compared with 4% of foreign-born VFR children and 3% of US-born VFRs with US-born parents. More VFRs than non-VFRs planned travel to countries that were yellow fever holoendemic, had malaria risk and were high-risk for typhoid (44% versus 20%, 39% versus 12%, 25% versus 15%, P < 0.01). VFRs were less likely than non-VFRs to be prescribed atovaquone-proguanil (adjusted prevalence ratio = 0.57, confidence interval = 0.44–0.72) and to have had an antidiarrheal medication prescribed (adjusted prevalence ratio = 0.68, confidence interval = 0.60–0.75).


To reduce travel-related morbidity, healthcare providers should be prepared to give travel advice to parents of VFR infants and children, particularly those US-born VFRs with foreign-born parents, regarding antimalarial and antidiarrheal medications and preventing yellow fever, malaria and typhoid.