title: Travelers visiting friends and relatives (VFR) and imported infectious disease: travelers, immigrants or both? A comparative analysis.
abstract: BACKGROUND
  Immigrants are increasingly traveling back to their countries of origin to visit friends and relatives (VFRs). They account for an important proportion of all international travelers and have a high risk for certain travel-related infectious diseases.
  
  
  METHODS
  We describe the spectrum of infectious diseases diagnosed in a cohort of 351 VFRs and compare them with two previously published cohorts: of immigrants and travelers attended at our centre.
  
  
  RESULTS
  The most frequent diagnoses observed among VFRs were typical travel-associated infections such as malaria (75 [21.4%]), traveler's diarrhea 17 [4.8%]), intestinal parasites (16 [4.6%]) and dengue (11 [3.1%]). Asymptomatic chronic infectious diseases, such as latent tuberculosis (56 [16%]), chronic viral hepatitis (18 [5.1%]) and filariasis (18 [5.1%]), probably acquired before migration, were also observed.
  
  
  CONCLUSIONS
  VFRs should thus be approached from two perspectives as concerns imported infectious diseases: as travelers and as immigrants. Etiological studies focusing on the presenting complaint as well as systematic screening for other latent infectious diseases should be performed.
authors.affiliation: Tropical Medicine & Clinical Parasitology, Infectious Diseases Department, Ramón y Cajal Hospital, Carretera de Colmenar Km 9.1, Madrid 28034, Spain.
authors.forename: B
authors.initials: B
authors.lastname: Monge-Maillo
authors.affiliation: Tropical Medicine & Clinical Parasitology, Infectious Diseases Department, Ramón y Cajal Hospital, Carretera de Colmenar Km 9.1, Madrid 28034, Spain.
authors.forename: F F
authors.initials: FF
authors.lastname: Norman
authors.affiliation: Tropical Medicine & Clinical Parasitology, Infectious Diseases Department, Ramón y Cajal Hospital, Carretera de Colmenar Km 9.1, Madrid 28034, Spain.
authors.forename: J A
authors.initials: JA
authors.lastname: Pérez-Molina
authors.affiliation: Tropical Medicine & Clinical Parasitology, Infectious Diseases Department, Ramón y Cajal Hospital, Carretera de Colmenar Km 9.1, Madrid 28034, Spain.
authors.forename: M
authors.initials: M
authors.lastname: Navarro
authors.affiliation: Tropical Medicine & Clinical Parasitology, Infectious Diseases Department, Ramón y Cajal Hospital, Carretera de Colmenar Km 9.1, Madrid 28034, Spain.
authors.forename: M
authors.initials: M
authors.lastname: Díaz-Menéndez
authors.affiliation: Tropical Medicine & Clinical Parasitology, Infectious Diseases Department, Ramón y Cajal Hospital, Carretera de Colmenar Km 9.1, Madrid 28034, Spain. Electronic address: rlopezvelez.hrc@salud.madrid.org.
authors.forename: R
authors.initials: R
authors.lastname: López-Vélez
mesh_terms: D000293:Adolescent; D000328:Adult; D002648:Child; D015331:Cohort Studies; D003141:Communicable Diseases / Q000453:epidemiology*; D054242:Emigrants and Immigrants / Q000706:statistics & numerical data*; D006801:Humans; D008875:Middle Aged; D011634:Public Health; D012189:Retrospective Studies; D014195:Travel / Q000706:statistics & numerical data*; D057236:Travel Medicine; D055815:Young Adult
keywords: Immigrants; Infectious diseases; Public health; Travel medicine