Selected infectious disease risks in international adoptees

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Abstract
In 1985 there were approximately 8500 international adoptions in the United States, a phenomenon that has doubled in the past 5 years. The majority of these children originate from areas of the world where the hepatitis B virus is hyperendemic and where the prevalence of numerous other infectious diseases is higher than it is domestically. We consecutively screened 360 adopted Korean children for hepatitis B virus markes, syphilis serology, tuberculin status and the presence of parasitic infection. Ten hepatitis B virus carriers were identified (prevalence, 2.8%) as were two children with congenital syphilis and two with reactive tuberculin skin tests. Intestinal parasitosis was not evident but four cases of scabies were detected and were associated with prior residence in an orphanage. We conclude that even though the seroprevalence rate was lower than expected, providers responsible for the care of Korean adoptees should screen for the hepatitis B surface antigen carrier state, that susceptible household contacts of hepatitis B surface antigen-positive children should be protected with hepatitis B vaccine and that children treated abroad for congenital syphilis should be assessed for the adequacy of therapy.