New Clinic At Cedars-Sinai Medical Center Specializes In Diagnosing And Treating Infectious Diseases In Babies Adopted From Abroad

November 23, 1998

LOS ANGELES (November 23, 1998) - When Andrew and Allison Sievers adopted a baby from Vietnam at the end of October, they wanted to be sure he was healthy and that his vaccinations were current, accurate and complete. The couple, previously from Los Angeles and currently living in Tokyo, brought 5-month-old Evan to Cedars-Sinai Medical Center where the Division of Pediatric Infectious Diseases is developing a clinic specializing in internationally adopted babies.

"We had wanted to adopt internationally and we knew that we were getting a child from a third-world country where the medical care was not nearly what it is here," said Allison. "We also knew that whatever medical information we received from the country had to be considered suspect because we've heard that they often use outdated vaccinations or they out-and-out lie about certain things."

Moshe Arditi, M.D., director of the Division of Pediatric Infectious Diseases at Cedars-Sinai, said American families adopt about 10,000 children from abroad each year, with approximately 90 percent of those children coming from countries in Asia, Southeast Asia, and Central and South America. "Infectious disease considerations are very important in these patients because many infections are asymptomatic -- diagnosis can only be made through screenings. Also, a history and physical exam should be performed when the children arrive in the United States."

According to Dr. Arditi, some studies show that infectious diseases may be found in as many as 60 percent of adopted children, depending on their country of origin. Because of the prevalence of such infections as tuberculosis, hepatitis B, cytomegalovirus, syphilis and HIV, particular attention should be paid to those screenings, as well as tests to rule out a variety of intestinal parasites.

"Since international adoptees frequently are not immunized or they are under-immunized, they should receive necessary vaccinations based on the current recommendations in the United States," said Dr. Arditi.

Except for suffering from scabies, ringworm and eczema, little Evan -- whose legal name at the present time is Tran Van Loi -- was found to be in excellent health. Allison said she and her husband were committed to dealing with any diseases Evan might have, but they were relieved when they got the good news.

"I trust the results. It's not like the results from a foreign country whose medical care you don't understand," said Allison. "We live in Tokyo and the medical care in Tokyo is just different. Since we don't speak Japanese fluently at all, we wanted to make sure that we had him checked out by a doctor whose nuances we completely understood."

Because they expect to return to Los Angeles in a few years, they wanted to come back here for Evan's exam. Allison said that after trying to find "somebody who specialized in this kind of stuff" without success, she found out about the pediatric infectious disease specialists at Cedars-Sinai through a friend of a friend. Evan became the first baby seen in the clinic, which specializes in internationally adopted children but also includes a component for local children whose families plan to travel abroad.

"When we adopted Evan, there were two other families who were adopting at the same time," Allison said. "They had talked to their local pediatricians and were going home and going to their pediatricians. That was fine, but it never occurred to me to just go to a pediatrician because I assumed Evan would have something that a general pediatrician might not be able to identify. I didn't want to spend six months trying to figure out what the problem was."

While examination of children and the screening tests for infectious diseases are not necessary immediately after arrival in the United States, Dr. Arditi recommends they be performed within the first two weeks to help protect the baby, the family and the local community. However, parents should notify their physicians when the child arrives so that basic medical issues can be reviewed, and they can be alerted to potential infectious diseases such as scabies or lice.
For information about the clinic for internationally adopted children, parents may call Cedars-Sinai's Division of Pediatric Infectious Diseases at (310) 855-4471.

Moshe Arditi, M.D., director of the Division of Pediatric Infectious Disease, Cedars-Sinai Medical Center

For media information and to arrange an interview, please call 1-800-396-1002. (Editors, Reporters: Please do not publish this number in your story. It is exclusively for media use.)

Cedars-Sinai Medical Center

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