Our approach to infectious disease screening for internationally adopted children

Infectious disease	Test
Hepatitis A virus (acute infection)	Hepatitis A IgM antibody
Hepatitis B virus	Hepatitis B surface antigen, surface antibody, core antibody
Hepatitis C virus	Hepatitis C antibody
Syphilis	Nontreponemal (RPR or VDRL) and Treponemal tests (TPPA or FTA-ABS)
HIV	Combined antigen/antibody HIV test*
Tuberculosis	TST^¶ or Interferon-gamma release assay (≥2 years of age)
Intestinal parasites	Stool ova and parasites examination (3 specimens) and Giardia intestinalis and Cryptosporidium antigen (1 specimen)
Bacterial enteric infection (children with bloody diarrhea or diarrhea and fever)	Bacterial stool culture
Tissue parasites (for adopted children from endemic areas)^Δ	Strongyloides serologic testing Schistosoma serologic testing
Lymphatic filariasis (for children >2 years of age adopted from endemic areas)^Δ	Filarial serologic testing (≥2 years of age)
Chagas (endemic areas)	Trypanosoma cruzi serologic testing

Refer to UpToDate content on infectious disease considerations in international adoptees for additional information.

IgM: immunoglobulin M; RPR: rapid plasma reagin; VDRL: Venereal Disease Research Laboratory; TPPA: treponema pallidum particle agglutination; FTA-ABS: fluorescent treponemal antibody absorption; TST: tuberculin skin test; HIV: human immunodeficiency virus.
* Some experts suggest reassessing six months after arrival.
¶ Repeat TST testing ≥3 months after the initial test is suggested if the initial TST is negative.
Δ Some experts perform serologic testing only if absolute eosinophil count is ≥450 cell/microL and stool ova and parasite examination is negative.

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Our approach to infectious disease screening for internationally adopted children