Hepatitis A infection in recent international adoptees and their contacts in Minnesota, 2007-2009.

OBJECTIVE The goal of this study was to describe hepatitis A-infected adoptees and the risk of transmission to their contacts. METHODS This was a retrospective review of adoptee-associated cases of hepatitis A and hepatitis A-infected adoptees identified in Minnesota from 2007 through 2009. RESULTS From 2007 through 2009 in Minnesota, 10 cases of hepatitis A, including 1 fulminant case, were associated with international adoptees. Eight cases were direct contacts of a hepatitis A-infected adoptee, and 2 other cases secondary contacts of an adoptee. During the same period, hepatitis A infection was identified in 21 recently arrived foreign-born adoptees; all were younger than 60 months of age, and only 6 were symptomatic. CONCLUSIONS Clinicians should be aware that transmission of hepatitis A may occur among both direct and secondary contacts of young children recently adopted from hepatitis A-endemic areas and that infected young children may be asymptomatic. Household members and other close contacts of international adoptees should be counseled about hepatitis A prevention, including vaccination. In addition, screening for hepatitis A should be considered for recently arrived adoptees from endemic areas.