Hepatitis a screening for internationally adopted children from hepatitis A endemic countries
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Vanessa N Raabe1, Casey Sautter, Mary Chesney
11University of Minnesota Medical School, Minneapolis, MN, USA.
Insights
Routine screening for hepatitis A virus (HAV) infection in internationally adopted children is crucial. This study found a 4.6% infection rate, highlighting the need for universal screening upon arrival.
Area of Science:
- * Infectious Diseases
- * Pediatrics
- * Public Health
Background:
- * Hepatitis A virus (HAV) infection screening is not standard practice for internationally adopted children.
- * International adoption clinics serve as key points for assessing the health of newly arrived children.
- * Previous research has not established routine screening protocols for HAV in this population.
Observation:
- * A study at the University of Minnesota International Adoption Clinic screened 656 children from 2006-2010.
- * Acute HAV infection was identified in 30 children (4.6%) via positive HAV immunoglobulin M tests.
- * Infection rates were highest in children under two years old and varied by country of origin.
Findings:
- * Hepatitis A virus (HAV) infection was detected in 4.6% of internationally adopted children screened.
- * Children from Ethiopia, Guatemala, China, Colombia, Haiti, Philippines, Liberia, and Nepal showed varying infection rates.
- * No specific symptoms differentiated infected children from uninfected ones, complicating clinical identification.
Implications:
- * Universal screening for HAV infection in international adoptees is recommended upon arrival in the U.S.
- * Early detection and management of HAV can prevent social disruption and facilitate post-adoption adjustment.
- * Implementing screening protocols can mitigate the spread of HAV within the U.S. and protect vulnerable children.
Abstract:
Screening for hepatitis A virus (HAV) infection is not currently routinely recommended in internationally adopted children. International adoptees seen at the University of Minnesota International Adoption Clinic from 2006 to 2010 were assessed for acute HAV infection (positive HAV immunoglobulin M). Thirty of the 656 children screened (4.6%) were acutely HAV infected. HAV-infected children emigrated from Ethiopia (16), Guatemala (4), China (2), Colombia (2), Haiti (2), Philippines (2), Liberia (1), and Nepal (1). Infection was most frequent among children younger than 2 years (6.7%). No symptoms distinguished children with acute HAV infection from uninfected children. HAV infection caused significant social disruption, including separation of children from their ill adoptive parents during the initial weeks postarrival, a period important for postadoption adjustment and attachment. All international adoptees arriving from countries with high or intermediate HAV endemicity should be screened for HAV infection on arrival to the United States.
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