Thursday, February 01, 2007

Adopting from China and Health Risks

"My wife and I are considering adopting a girl from China. The main concern we have, which is probably not uncommon, is the health of the child. We are not so much concerned with things that can be controlled or cured with care and time (eg. scabies, parasites…etc). Our main concern is the handful of infectious diseases such as HIV, and Hepatitis B/C.

It appears as though HIV is quite rare in adoptive children from China. Hep C also appears to be somewhat rare. Hep B is obviously more prevalent, but there are vaccinations for that, so that is less of a concern. Given that though, we have not been able to find any statistics or studies any newer than one done in the year 2000 discussing the commonplace of these diseases among adoptive children. With news on the spreading of HIV in China, it would be nice to see some more recent statistics.

Are you aware of any more recent studies on the health of adopted children from China?"

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Blogger Think Tank Moderator said...

Todd Ochs, MD
Adoption Pediatrics
Chicago, IL


Physical health issues should be secondary to psychological and emotional health. Give me a child with a normal brain, and what we have left to deal with is plumbing (heart, kidneys), Carpentry (structural problems), and wiring (neurological). These are usually fixable. Chinese adoptees do well in their American families. Of the thousand-plus Chinese adoptees I have seen, less than one percent have persistent psychological/ developmental issues.

In terms of infectious diseases, HIV is prohibitively rare, because there is universal HIV screening. The caveat to this, is that the more sophisticated tests are not always available, and children are removed from the adoption pool, carrying antibodies from their mothers, and no virus. The maternal antibodies may remain for up to three years, so, a child at six months, who is HIV ELISA positive, may be unadoptable until she is three years old. There are surprise Hepatitis B cases, due to problems when drawing blood. Hepatitis C has not routinely been tested for, and has not been a problem. I am not aware of any surprise HIV cases from China, but do have a couple of children with Hepatitis B, in my pediatric practice.

I wrote an article for ADOPTION TODAY, on HIV in international adoption, and statistics from China are included. The problem is, that China is still secretive about potentially embarrassing problems. Clearly, with a rising middle class, the incidence of HIV and Hepatitis C will rise in China, And we will also start seeing Fetal Alcohol Spectrum Disorder. In Yunnan Province, which borders on the Golden Triangle, and is along the pathway for opium leaving Asia, has a significant problem with HIV, and I suspect, with Hepatitis C, as well. There is concern that Yunnan"s massive highway project could export HIV across China, as migrant workers head home at its conclusion.

7:24 AM  

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