About Minnesota Travelers: Guidance for Health Professionals
International Travel & Infectious Disease

Minnesota is home to over 5.7 million people, with many of these individuals traveling internationally each year. The Minneapolis-St. Paul International Airport serves almost a half million travelers annually, with numbers increasing yearly. To find the latest information, visit About MSP. Among those traveling are people who are visiting friends and relatives (VFRs).  

VFR travelers

Per the CDC Yellow Book: Visiting Friends & Relatives: VFR Travel, a “visiting friends and relatives (VFR) traveler” is a person who currently resides in a higher-income country who returns to their former home (in a lower-income country) for the purpose of visiting friends and/or relatives. Many of the VFRs in Minnesota are foreign-born immigrants traveling to countries in Latin America (e.g., Mexico, Ecuador), Africa (e.g., Ethiopia, Liberia), and Asia (e.g., India, Laos). 

VFR travelers have a higher risk of morbidity and mortality during and following travel because of factors such as: 

• Longer duration of travel
• Different dietary habits
• Travel to more remote areas
• Greater and closer interaction with people and animals in local communities
• Less access to knowledge and financial resources to support travelers’ health precautions 

An important disease that disproportionately affects VFR travelers is malaria. The risk of malaria is highest in the tropical and sub-tropical regions of the world, particularly sub-Saharan Africa. Minnesota typically reports between 50 and 70 cases of malaria in travelers every year and is consistently among the top states for travel-associated malaria cases. Over the past few years, a higher frequency of international travel has led to an increase in the number of cases reported, resulting in record numbers. Most of these cases occur in people that have traveled to Africa and Central America. For the latest malaria data in Minnesota, please visit Malaria Statistics. 

Prevent travel-related disease and death

International travel has become more common, and patients may not inform their health care providers about upcoming travel. It is important to ask all of your patients if they plan to travel internationally as there are important preventive interventions that should be offered to reduce travel associated morbidity and mortality (as outlined in the CDC Yellow Book). All patients traveling internationally should be advised that a pre-travel visit is important to help prevent illness during and after travel. This visit will include preventive health counseling, prescribing medications (if needed), and advice in case they become ill during travel.