November is National Adoption Awareness Month

American parents adopt 12,000 children from abroad each year. International adoptees face unique health challenges. Find out about these health challenges, and make sure your child receives a medical exam upon arrival to the United States.

International Adoptions

Adopting a child is a wonderful and exciting event for families. Each year parents in the United States adopt more than 12,000 children from all over the world. These children are adopted from countries as diverse as China, Ethiopia, and Russia. The adoption process can sometimes be long and stressful. Parents must find reputable adoption agencies to work with, must deal with visa regulations for their new child, and must work through adoption paperwork. The health of their child is just one of many issues parents must consider, but it is extremely important.

Health Risks to International Adoptees

International adoptees may have been exposed to diseases that are not common in the United States, such as tuberculosis (TB). It is vital that adoptive parents and their family medical providers be well informed of the possible health risks for children adopted from overseas. If left undiagnosed, many infectious diseases can affect the long-term health of the child and could spread to other family members and close contacts. Therefore, parents should take their international adoptee for a physical exam and screening as soon as possible after arriving in the United States. Better informed adoptive parents and medical providers can help make sure adoptive children receive the care they need to live healthy lives in their new homes.

Medical Exams to Protect International Adoptees

International adoptees will complete a visa medical exam before coming to the United States. However, they should still get a medical exam right after they are brought to this country. The visa medical exam is not a full physical but rather focuses on screening for certain diseases; therefore, newly adopted children from other countries need a thorough medical exam. This exam should include a medical history and physical exam, as well as screening for infectious diseases.

Screening tests for international adoptees should include:

• tuberculosis (TB)
• hepatitis B
• congenital syphilis (syphilis passed from mother to baby)
• HIV/AIDS
• intestinal parasites

In addition to these infectious diseases, the adopted child should be examined for other medical and developmental issues, such as:

• hearing and vision
• growth and development
• nutrition
• blood lead levels

Photo courtesy Heidi Najdek, HLN Photography

All international adoptees should receive vaccines based on the Advisory Committee on Immunization Practices (ACIP) recommendations. Some children may get these vaccines prior to arrival in the United States; however, many children will still need vaccines or will need the next dose to complete a vaccine series.

Adopted children are not the only ones who should be up to date on vaccinations. Anyone who will have close contact with the adopted child should also be current on their vaccinations. Parents should be up to date on their routine vaccinations (as well as specific vaccinations for travel) before traveling to pick up their child. It is very important to make sure that any other children in the adopted child's new home are up to date on their vaccinations as well. The Travelers' Health website serves as a resource for information on staying healthy while traveling internationally. It also provides specific information on healthy travel for international adoptions.

CDC's Role in Protecting the Health of International Adoptees

CDC's Division of Global Migration and Quarantine provides guidance (called technical instructions) for physicians overseas who conduct visa medical exams. The visa medical exam is one of the steps all immigrants (including adoptees) must complete before obtaining a visa. This exam screens for infectious diseases specified by U.S. immigration law, including TB.

Additionally, the American Academy of Pediatrics (AAP) provides guidance for U.S. doctors or other medical providers to help them examine and screen international adoptees. This guidance is based on current medical knowledge and the advice of experts in the field of international adoption health. By producing useful guidance, CDC and AAP are helping parents and medical providers keep international adoptees healthy for their new lives in the United States.

Learn more about CDC's role in international adoption and the health of international adoptees.

More Information

• The Advisory Committee on Immunization Practices
• The United States Department of State adoption website
• The American Academy of Pediatrics
• The American Academy of Pediatrics Healthy Children Website: International Adoptions Recommended Testing