Infectious Diseases and Immunizations in International Adoption

Abstract

Children who are adopted internationally have an increased risk of infectious diseases due to endemic conditions and variable access to preventive health care, such as vaccines, in their country of origin. Pediatricians and other providers who care for children should be familiar with the recommended screening for newly arrived international adoptees. Testing for gastrointestinal pathogens, tuberculosis, hepatitis, syphilis, and HIV should be routinely performed. Other endemic diseases and common skin infections may need to be assessed. Evaluation of the child's immunization record is also important, as nearly all international adoptees will require catch-up vaccines. The provider may also be asked to review medical records prior to adoption, provide travel advice, and ensure that parents and other close contacts are up-to-date on immunizations prior to the arrival of the newest family member. The pediatrician serves a unique role in facilitating the evaluation, treatment, and prevention of infectious diseases in international adoptees. [Pediatr Ann. 2017;46(2):e56-e60.].

Comprehensive Health Evaluation of the Newly Adopted Child

“…25 Therefore, all internationally adopted children need to undergo screening evaluations based on the risks presented by their previous life circumstances, including health risks specific to country of origin. 18,[43][44][45][46]…”

“…For those adopted domestically, testing is recommended for children with definite or unknown exposure to and/or risk for tuberculosis, HIV, HBV, and sexually transmitted infections. 18,45,46,56,58 Other tests can be considered on an individual basis. 18,45,46,56,58 Children, whether domestically or internationally adopted, may be at risk for iron, calcium, and vitamin D deficiency secondary to past dietary inadequacies.…”

“…18,45,46,56,58 Other tests can be considered on an individual basis. 18,45,46,56,58 Children, whether domestically or internationally adopted, may be at risk for iron, calcium, and vitamin D deficiency secondary to past dietary inadequacies. 25,54,56,60,61 Therefore, screening for anemia and rickets is suggested.…”

Infectious Diseases in Internationally Adopted Children and Intercountry Discrepancies Among Screening Protocols, A Narrative Review

“…Infectious diseases are commonly reported in internationally adopted children (IAC) (1), and their need for rapid, cautious, and thorough screenings has been underlined by several authors (1–5). A recent Italian study indicated that clinical conditions affecting IAC, ranging from congenital malformations, to complex infectious diseases, such as tuberculosis infection (observed in 15% of children included) and parasitosis (in more than 20%), to non-severe and easily treatable infections, such as Molluscum contagiosum and fungal skin infections, have been frequently reported.…”

“…Early diagnosis of infectious diseases is crucial both for the optimal management of IAC and to reduce risk of transmission to the community (1, 6, 7). Cases of transmission of the Hepatitis A and Hepatitis B viruses, scabies, tuberculosis, Tinea capitis / corporis , and measles to adoptive families have been reported in the literature (1, 6, 7).…”