Brenner Children's Hospital pediatrician says one symptom no longer a clear sign of child abuse

October 03, 2005

WINSTON-SALEM, N.C. - Children who come to a pediatrician's office with genital or anal warts may not be the victims of child abuse as once thought, according to pediatricians at Brenner Children's Hospital, part of Wake Forest University Baptist Medical Center.

Most pediatricians have been trained to call social services if they discover a child with genital or anal warts to report a possible allegation that child abuse may have taken place. However, new research published in the October issue of Pediatrics, shows that this symptom alone may not indicate that a child has been abused.

"We have seen over the past few years an increase in the number of Human papillomavirus (HPV) cases (the virus which causes anal and genital warts) in adults and in children," said Sara Sinal, M.D., a pediatrician at Brenner Children's Hospital and expert in child abuse cases. "However, we were seeing younger children with this virus and many times had no other signs that abuse was taking place. These children seemed different in many ways from the children we were seeing for suspected sexual abuse who did not have warts."

Sinal and her colleagues also noticed that a child would often go to an ear, nose and throat physician to be treated for oral or laryngeal warts (warts found in the mouth or throat), however the physician treating the child never suspected or reported child abuse.

"This is the same virus in a different location in the body and child abuse was never considered," Sinal said. "It made us look at these anal and genital warts so we could determine whether a child could contract the diseases from nonsexual contact. We did not want to call social services to report a child if there was no suspicion of abuse. Having been involved in many child abuse reports, I know how traumatic a report can be for a family."

HPV is a virus which can affect mucous membranes, causing warts to grow in the anal, genital, oral cavities or respiratory locations of the body. It is the most common sexually-transmitted disease in North America. However, it can be spread from mother to child in the birth canal. A person can get warts in their mouth and throat after having oral sex with someone who is infected. It is possible that warts can be transmitted by contact with a hand or contaminated object. The virus can lay dormant for many months and perhaps years before warts appear and some infected patients have no symptoms. Since the virus is a sexually-transmitted disease, many pediatricians often suspect sexual abuse when a child has symptoms.

"We are not ruling child abuse out as a possible cause for the infection in children under the age of four," Sinal said. "Every child with warts needs a thorough evaluation for possible abuse. However, when there are no other signs a child is being abused, we no longer feel it is necessary to report the family to the department of social services for suspected abuse. We are encouraging our colleagues to keep an open mind when they discover HPV in a child."

Treatment for HPV can take months and require surgery. Despite treatment, the warts often reoccur, Sinal said.

"There is a vaccine that is being developed to prevent this virus," Sinal said. "Once it is approved then many of these cases can be prevented."
-end-
Sinal and her colleagues analyzed 124 children over an 18-year period and compared them to children who were known to have suffered abuse for the study. Sinal worked with the following specialists at Brenner Children's Hospital to complete the research: Charles Woods, M.D., an infectious disease specialist; Dan Kirse, M.D., a pediatric otolaryngologist; and Kelly Sinclair, M.D., a former pediatric resident at Brenner Children's Hospital.

Media Contacts: Rae Bush, rbush@wfubmc.edu, or Ann Hopkins, prtemp@wfubmc.edu, at 336-716-4587.

Wake Forest University Baptist Medical Center is an academic health system comprised of North Carolina Baptist Hospital, Wake Forest University Health Sciences and Brenner Children's Hospital. The system comprises 1,187 acute care, rehabilitation, psychiatry and long-term care beds and is consistently ranked as one of "America's Best Hospitals" by U.S. News & World Report. Brenner Children's was named one of the top children's hospitals in the nation by Child magazine.

Wake Forest Baptist Medical Center

Related Child Abuse Articles from Brightsurf:

Screening may bypass one-quarter of child abuse cases
Up to one-quarter of people who suffer child sexual abuse might be passed over for treatment because of current screening procedures, according to UC Riverside psychology researchers.

Molecular stress indicator not observed in survivors of child sexual abuse
Researchers and medical experts have long known that child sexual abuse has profoundly negative effects on the health of survivors; however, an international team of researchers was not able to find a link between the abuse and telomere length, considered an indicator of cellular aging and health.

Research shows child abuse and neglect results in increased hospitalizations over time
In a new study published in the leading international journal, Child Abuse and Neglect, University of South Australia researchers have found that by their mid-teens, children who were the subject of child protective services contact, are up to 52 per cent more likely to be hospitalised, for a range of problems, the most frequent being mental illness, toxic effects of drugs and physical injuries.

Research helps police understand child to parent abuse more than ever before
Researchers have provided detailed insights and recommendations to help one of the UK's largest police forces recognise, report and analyse instances of violence from children towards parents.

Drug reduces the risk of child sexual abuse
A drug that lowers levels of the male hormone testosterone in the body reduces the risk of men with pedophilic disorder sexually abusing children, a study from Karolinska Institutet published today in the journal JAMA Psychiatry shows.

Child abuse awareness month during COVID-19 pandemic
This Patient Page calls attention to risk factors for child abuse during the COVID-19 pandemic and discusses ways to reduce stress and risk of child abuse during social isolation.

Infant home visiting program linked to less child abuse
Family Connects, a nurse home visiting program for newborns and their parents, is linked to substantial reductions in child maltreatment investigations in children's earliest years, according to new research from Duke University.

Child abuse associated with physiologically detected hot flashes
Childhood abuse has been shown to lead to an array of health problems later in life.

Injury more likely due to abuse when child was with male caregiver
The odds of child physical abuse vs. accidental injury increased substantially when the caregiver at the time of injury was male, according to a new study published in The Journal of Pediatrics.

Child abuse linked to risk of suicide in later life
Children who experience physical, sexual, and emotional abuse or neglect are at least two to three times more likely to attempt suicide in later life, according to the largest research review carried out of the topic.

Read More: Child Abuse News and Child Abuse Current Events
Brightsurf.com is a participant in the Amazon Services LLC Associates Program, an affiliate advertising program designed to provide a means for sites to earn advertising fees by advertising and linking to Amazon.com.