According to the U.S. State Department, more than 11,000 children were adopted from other countries in 2010. Most of these children came from China, Ethiopia, Russia, South Korea and Ukraine. Almost 100% of children adopted abroad between 1998 and 2008 came from countries with high rates of the hepatitis A virus according to the American Academy of Pediatrics. 85 percent of those infections were in children under 5.
Why the concern? Hepatitis A is highly contagious. The symptoms include abdominal pain near the liver, dark urine and jaundice . But often people with it don't have symptoms, so it's hard to tell they are carrying the virus. As a result, it can easily spread it to others. In more serious cases, hepatitis A can cause an acute liver infection and in extreme cases, liver failure.
The recommendations come after a report in 2007 of a grandmother of a child from Ethiopia coming down with hepatitis A. A subsequent investigation found 20 additional cases of acute hepatitis A in people who had not traveled abroad but had close personal contact with children who had recently been adopted outside the United States.
So how do you know if you should get vaccinated? The AAP says you should get the vaccine if you anticipate having close contact with international adoptees during the two months after their arrival. It also recommends getting the first shot more than two weeks before the adopted child arrives and getting the second dose at least six months after the first one.