Visiting family back home is a different trip from a week at a resort. Canada's Committee to Advise on Tropical Medicine and Travel (CATMAT) says people who visit friends and relatives abroad, often called VFR travellers, tend to have higher rates of many travel-related illnesses.
Why family visits carry more risk
CATMAT links the higher risk to how these trips happen:
- Longer stays, often in rural areas.
- Eating what your hosts eat, and drinking untreated water.
- Homes without window screens or bed nets.
- Close contact with many people, raising the risk of tuberculosis (TB).
- Last-minute trips for a sick relative or a funeral.
- Less advice before the trip, and a belief that you're already immune.
Children born in Canada are likely at greater risk than their parents, partly because they lack immunity to local infections. In a Canadian study of children who fell ill after visiting family abroad, 71% needed hospital care, and only 26% had received advice before the trip.
Malaria: growing up there doesn't protect you now
The Government of Canada is clear: people born in or who lived in a country with malaria lose their immunity once they move away, and are as much at risk as any other visitor. CATMAT adds that severe malaria is more likely once that partial immunity is gone. Take your medicine as prescribed, even if your relatives don't.
Canada recommends malaria pills for most travellers to Pakistan, Nigeria and Ghana. In India, Bangladesh and the Philippines, it depends on the area and time of year. Sri Lanka and Jamaica have no malaria transmission.
- Buy them in Canada to ensure their safety and quality, and keep taking them after you leave the malaria area, as prescribed.
- Prevent bites with repellent, screens or closed windows, and an insecticide-treated bed net if mosquitoes can get in.
Your physician chooses the medicine and dose (see our malaria pills guide).
Vaccines that matter most
Typhoid
Canada recommends typhoid vaccine for most travellers aged 2 and older going to South Asia, including India, Pakistan, Bangladesh, Sri Lanka and Nepal. In a Quebec study, more than 90% of typhoid cases in travellers were people visiting family or friends. Extensively drug-resistant (XDR) typhoid, which doesn't respond to most antibiotics, has been reported in Pakistan. Elsewhere the vaccine isn't routine, but CATMAT says it may be considered for higher-risk family visits, such as long stays or travel with children. It's about 50% effective, so food and water care still matters.
Hepatitis A
Adults born where hepatitis A is common are more likely to be immune; a blood test can check. Their Canadian-born children may be at higher risk. Canada recommends the vaccine for all travellers to areas with hepatitis A.
Measles, and an early dose for babies
Measles is rising in many parts of the world, and travellers can catch it visiting family during outbreaks. Without proof of immunity, people born in 1970 or later need 2 doses of MMR vaccine; those born earlier need 1. Babies 6 to 11 months old can get an early dose before travelling where measles is a concern. That dose doesn't count toward the routine schedule, so 2 more doses follow after the first birthday. Younger babies aren't given the vaccine; ask their doctor how to protect them. MMR is generally not given in pregnancy.
Rabies
Most human rabies comes from dog bites, and CATMAT counts visiting family among activities with more animal contact. The pre-exposure vaccine is a choice you make with your provider. CATMAT suggests offering it where dog rabies circulates and rabies immune globulin, part of the usual treatment after a bite, may be hard to get; its list includes Pakistan and Sri Lanka. For India, Canada says it may be recommended for higher-risk people, including children. Watch children closely around animals. After any bite or scratch, wash it with soap and water for about 15 minutes and get care right away, without waiting to return to Canada.
Routine vaccines and boosters
- Tetanus and diphtheria: a booster every 10 years. Also ask about hepatitis B if you aren't protected.
- Polio: a one-time adult booster where polio circulates. Stay over 4 weeks in Pakistan and you must show proof of a polio dose from the 12 months before you leave, on the yellow International Certificate of Vaccination or Prophylaxis (ICVP). A WHO recommendation covers Nigeria too.
- Yellow fever: Ghana requires proof of vaccination. In Canada, only designated yellow fever vaccination centres give the vaccine and the ICVP; our physician can refer you.
Tuberculosis on long stays
TB is far more common in parts of Asia and sub-Saharan Africa than in Canada, and risk rises with longer stays. Avoid close contact with anyone who has TB or a lasting cough, and skip unpasteurized dairy.
Testing after the trip isn't routine for healthy adults. CATMAT's 2026 guidance suggests one skin test, at least 8 weeks after return, for some adults born in a higher-TB country: those not tested since moving to Canada who have a condition that makes active TB much more likely, such as HIV, kidney disease, cancer or immune-suppressing medicines. Ask about testing a child under 5 after a long stay, since young children are more likely to develop severe TB.
Children, grandparents and pregnancy
Children. Malaria can be particularly severe in children. Pill doses are based on weight; keep tablets in childproof containers. Children dehydrate faster with diarrhea, so pack oral rehydration salts.
Grandparents. Older travellers may face a higher risk of severe malaria and of complications from hepatitis A and typhoid, and more side effects from some vaccines, especially yellow fever. A full medicine list lets the physician check interactions, such as atovaquone-proguanil with warfarin, a blood thinner.
Pregnancy. Canada suggests pregnant travellers consider avoiding malaria areas, and some malaria medicines may not be safe in pregnancy. Zika, which can cause serious birth defects, is a risk in India, Bangladesh, Sri Lanka, the Philippines, Nigeria and Jamaica. Most travel insurance doesn't automatically cover pregnancy-related care.
Medicines abroad and travel insurance
Canada advises against buying medicines abroad unless a health care professional tells you to: counterfeits may not work and can contain harmful ingredients. Counterfeit rabies vaccine has been reported in major cities in India. Bring enough of your regular medicines for the whole trip, in original labelled containers, in your carry-on.
For emergency care outside Canada, OHIP pays hospitals at most $50 a day for outpatient care and $200 to $400 a day for a hospital stay. It pays nothing to move you to an Ontario hospital. Buy travel health insurance that covers pre-existing conditions and medical evacuation. Away more than 7 months in a 12-month period? Check with ServiceOntario before you leave about keeping OHIP.
When to see a doctor after your trip
- Fever up to a year after a malaria area, even if you took your pills: get care as soon as possible, within 24 hours, and ask for a malaria test. Over 90% of falciparum malaria, which can be rapidly fatal, appears within 3 months.
- A bite or scratch abroad: see a doctor as soon as you're back, with your treatment records.
- Measles symptoms (fever, cough, runny nose and red eyes, then a rash): stay home and call ahead.
- Any illness: say where you travelled.
Your timeline before you go
Canada suggests seeing a health care provider about 6 weeks before you leave. The typhoid shot is given at least 2 weeks before travel, oral typhoid is finished at least a week before, and the 2 rabies doses are at least 7 days apart. Leaving sooner? Still book: some vaccines have faster schedules, and some malaria pills start 1 to 2 days before arrival.
Book a $110 virtual consultation with a physician licensed in Ontario. You need to be in Ontario during the video call. Prescriptions go to our Toronto pharmacy, Cloud Pharmacy at 55 Dundas St E, where pharmacists give travel vaccines. If cost is a worry, say so: CATMAT notes advice can be prioritized by risk. Prices are on our pricing page.
Frequently asked questions
I had malaria as a child in Nigeria. Do I still need malaria pills?
Very likely. That immunity fades once you move away, and Canada recommends malaria pills for most travellers to Nigeria.
Can my baby get the measles vaccine before we travel?
Yes, from 6 months, if you're going where measles is a concern. Two more doses are still needed after the first birthday.
Does OHIP cover me while I'm visiting family abroad?
Only partly. It pays limited daily amounts for emergency care and nothing to bring you home, so buy travel health insurance.
Sources: CATMAT — Statement on travellers visiting friends and relatives | Government of Canada — Visiting friends and relatives abroad | CATMAT — Prevention and treatment of malaria | Canadian Immunization Guide — Immunization of travellers | Canadian Immunization Guide — Typhoid vaccines | CATMAT — Rabies pre-exposure vaccination in travellers | CATMAT — TB screening among returned travellers | Government of Canada — Travel advice for Pakistan | Ontario — OHIP coverage while outside Canada
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