Cases of malaria, hepatitis A, and typhoid fever among VFRs, Quebec (Canada)

J Travel Med. 2011 Nov-Dec;18(6):373-8. doi: 10.1111/j.1708-8305.2011.00556.x. Epub 2011 Oct 12.


Background: Visiting friends and relatives (VFRs), especially young VFRs, are increasingly recognized in the industrialized world as a high-risk group of travelers.

Methods: We performed a descriptive, cross-sectional design study of cases of malaria, hepatitis A, and typhoid reported to the Quebec registry of notifiable diseases between January 2004 and December 2007, occurring in VFRs and non-VFRs travelers.

Results: VFRs account for 52.9% of malaria cases, 56.9% of hepatitis A cases, and 94.4% of typhoid cases reported in Quebec travelers. Almost all (91.6%) of the malaria cases among VFRs were acquired in Africa, particularly in sub-Saharan Africa. An important proportion of malaria cases among VFRs (86.4%) were due to Plasmodium falciparum. The vast majority (76.6%) of typhoid fever cases among VFRs were reported by travelers who had visited the Indian subcontinent. Among VFRs, 40% of total cases were under 20 y of age, compared to less than 6% among non-VFRs. Those under 20 years of age also accounted for 16.9% of malaria cases, 50% of typhoid cases, and 65.2% of hepatitis A cases among VFRs.

Conclusion: Our study clearly shows that VFR children should be a primary target group for pre-travel preventive measures.

Publication types

  • Comparative Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Africa South of the Sahara / ethnology
  • Female
  • Follow-Up Studies
  • Hepatitis A / ethnology*
  • Humans
  • Incidence
  • Malaria / ethnology*
  • Male
  • Middle Aged
  • Quebec / epidemiology
  • Registries*
  • Retrospective Studies
  • Risk Factors
  • Travel*
  • Typhoid Fever / ethnology*
  • Young Adult