Hepatitis A in International Adoptees

Hepatitis A is a virus that causes a liver disease that is common in most developing countries. The highest rates of the disease are located where immunizations are not available in Africa, South America (including Mexico) and much of Asia. Hepatitis A is spread from person-to-person contact, usually fecal-oral (such as at diaper changing, or from child to child in group care settings). Children typically contract the disease within the first ten years of life, overcome it, and gain lifelong immunity. In healthy people, the virus does not result in a long-term, chronic illness, but an infection can be easily spread. Children often do not show any symptoms, or they have non-specific symptoms that make hepatitis A can be difficult to diagnose. 

 Though usually not a serious problem for the child, the virus can be more serious for adult caretakers and for older children. Incubation periods can be 2-6 weeks before symptoms appear.  The illness can last from several weeks to six months, and can be very unpleasant--including fever, jaundice, nausea, diarrhea and general discomfort.  Not only will it be difficult to provide stable parenting when fighting the virus, but having an ill parent during the first months post-adoption can also interfere with the bonding process. For these reasons, our clinic recommends:

• Be aware of the risk of hepatitis A, and make sure to wash your hands thoroughly after interacting with the child, especially after diaper changes.
• If you are planning to travel overseas to pick up your child, make sure that all travelers are vaccinated prior to the trip.
• Anyone that will be in direct contact with the child upon his or her arrival home should be vaccinated to avoid spread of the disease, especially those who are of advanced age or have liver compromise.
• Have your child screened for hepatitis A exposure as soon as possible upon arrival in the U.S.

The hepatitis A vaccination comes in two doses with a one-month separation between the first and second dose, so you must plan ahead in order to be fully vaccinated when you travel.  Another short-term option that can be used if you do not have enough time to get vaccinated prior to travel is to receive a dose of immune globulin, which can be administered to anyone of any age and provides effective protection against hepatitis A virus for up to three months.  If there is concern that your child or family member has contracted hepatitis A, please seek medical help.  Talk with your primary care provider or international adoption medicine specialist about the possibility of hepatitis A infection and learn how to avoid the spread of the disease.