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Travel Medicine and Adoptees
Infectious Diseases in Internationally Adopted Children

Global Prevalence of Infectious Diseases travel medicine, travelers, shots, vaccinations, adoption, international adoption

AIDS 10 million

 STD 130 million

Malaria 267 million

Hepatitis 280 million

Diarrhea 1.5 billion

Tuberculosis 1.7 billion

Intestinal parasites 3.0 billion travel medicine, travelers, shots, vaccinations, adoption, international adoption

Comparison of Refugees and Adoptees

International Adoption

Majority of children are from orphanages in Russia, Eastern Travel Medicine Travelers Shots vaccinations Europe, China

Screening Tests for International Adoptees

Hepatitis B profile, to include HBeAg, and anti-HBc. All patients who are positive for hepatitis B surface antigen are evaluated for the presence of hepatitis Bc antigen, delta agent, and elevated transaminases.

HIV-1 and HIV-2 testing

by ELSA in children >18 monthsof age

by ELISA and culture/PCR in children <18 months of age or in older children with recent injections

Mantoux (intradermal PPD) skin test with Candida control

Steel examination for ova and  parasites

Symptomatic children, especially  those from India, should be cultured for Salmonella, Shigella, Yersinia, and Campylobacter

· RPR or VDRL for syphilis

Complete blood count with erythrocyte indices

Dipstick uranalysis

Secondary Screening Tests

Antibodies to hepatitis C

Hepatic transaminases

Diphtheria and tetanus antibodies or children with >3 recorded DTP vaccines

TORCH titers for microcephaly

Not Recommended for Routine Screening

Thick/thin smears for malaria

Chest radiograph

Urine culture for cytomegalovirus

Utility of Screening Tests

57% of adoptees have at least one unsuspected medical diagnosis