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Preventing Infectious Diseases during and after International Adoption

Lin H. Chen, MD; Elizabeth D. Barnett, MD; and Mary E. Wilson, MD
[+] Article and Author Information

From Mount Auburn Hospital, Cambridge, Massachusetts; Harvard Medical School, Boston, Massachusetts; and Maxwell Finland Laboratory for Infectious Diseases, Boston Medical Center, Boston, Massachusetts.


Acknowledgments: The authors thank Charles Hatem, MD; Stanley Sagov, MD; and Perri Klass, MD, for their thoughtful reviews of the manuscript and helpful suggestions.

Potential Financial Conflicts of Interest:Honoraria: M.E. Wilson (Merck & Co., GlaxoSmithKline).

Requests for Single Reprints: Lin H. Chen, MD, Mount Auburn Hospital, 330 Mount Auburn Street, Cambridge, MA 02238; e-mail, lchen@hms.harvard.edu.

Current Author Addresses: Drs. Chen and Wilson: Mount Auburn Hospital, 330 Mount Auburn Street, Cambridge, MA 02238.

Dr. Barnett: Maxwell Finland Lab for Infectious Diseases, Boston Medical Center, Room 503, 774 Albany Street, Boston, MA 02118.


Ann Intern Med. 2003;139(5_Part_1):371-378. doi:10.7326/0003-4819-139-5_Part_1-200309020-00013
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From 1989 to 2002, U.S. families adopted more than 167 000 children internationally (1). In 2002, U.S. citizens adopted 20 099 children from 20 countries; by comparison, 7093 foreign-born children were adopted in 1990 (1). During the past decade, the countries from which most children have been adopted have changed. In 1989, children were adopted most frequently from Korea, Colombia, India, the Philippines, and Chile (1). By 2002, only 1 of these countries (Korea) remained in the list of top 5 countries; China, Russia, Guatemala, and the Ukraine replaced the other 4 countries (Figure). This shift can be associated with a change in disease epidemiology in adopted children. The outbreaks of severe acute respiratory syndrome (SARS) illustrate the dynamic relationship of infectious diseases and travelers and the need to have up-to-date information.

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Grahic Jump Location
Figure. .
Trend in the number of adopted children from the most common countries of origin(1)
Grahic Jump Location

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