Adopting a Child from Another Country
Families adopting a child from another country may be at risk for infectious diseases, either from traveling overseas to unite with the child or from contact with the newly arrived child in the United States. Children being adopted in other countries are often at risk for infections because they are not vaccinated, live in crowded conditions, do not have access to clean water, or are malnourished or in poor health. If you are adopting a child from another country, plan for safe travel overseas and arrange for your child to have a medical exam with a pediatrician specializing in adoption health soon after you return home.
Preparing to Travel Overseas
At least 4–6 weeks before you depart to unite with your child, schedule a visit with a travel medicine specialist to discuss disease risks in the destination country and what you can do to avoid them. Your travel medicine specialist may recommend vaccines to protect against diseases in that country. Your travel medicine specialist can also give you advice on travel safety, food and water precautions, and preventing travelers’ diarrhea. General guidance for traveling internationally with children also applies to the adopted child you are bringing home.
People at home who will have close contact with your child (including extended family and caregivers) should be up-to-date on routine vaccines, as well as being vaccinated against hepatitis A and B. They should also have a booster of the vaccine that prevents pertussis (whooping cough) and, depending on the child’s country of origin, a booster of polio vaccine. It is important for everyone who has contact with the child to be vaccinated, even if they do not live in the same home; there have been cases of illnesses spread from internationally adopted children to grandparents, aunts, uncles, cousins, and other caregivers.
The Overseas Medical Exam
Children who are being adopted overseas by US citizens must have a medical exam in their country of origin, performed by a doctor specially designated by the US Department of State. This exam is designed to detect certain serious illnesses, such as tuberculosis, and should not be relied on to detect all possible health conditions. Additional information about the overseas medical exam is available from the Department of State: http://adoption.state.gov/adoption_process/how_to_adopt/health.php.
The Follow-Up Medical Exam in the United States
Within two weeks of arrival in the United States, your child should have another medical exam to assess his or her general health and screen for other infections, such as intestinal parasites, which are common in internationally adopted children. In some circumstances, screening for developmental delays can be considered.