Medical Issues

Medical Tests for New Intercountry Arrivals

Take this list of tests to your doctor upon the arrival of your internationally adopted child

Children entering Canada from overseas may not have been tested for hepatitis, tuberculosis, syphilis or parasitic infections. As well, some children may not have been immunized, children have arrived in Canada with the above conditions.

Medical Disease Screening

It is recommended that all children have age-appropriate screening test, including an evaluation for anemia, visual and hearing impairments and assessment of growth and development.

Families should provide the family doctor with as much information as is known about their child.


Unless there is clear, written documentation of prior immunization, it is sensible to begin a routine immunization schedule for children not immunized in early infancy (Health Canada: Canadian Immunization Guide, 4th Edition, 1993). There is little risk in inadvertently repeating immunizations.

Internationally adopted children should receive these tests:

  • Complete blood count and red cell indices
  • Blood lead level
  • Serology for Syphilis
  • Hepatitis B profile to include hepatitis B surface antigen and antibodies to hepatitis B surface and antigen**
  • Hepatitis C
  • HIV-1
  • Stool sample for ova and parasites***
  • PPD (mantoux) &chest X ray (if not already done)
  • Urinalysis

** If your child is found to be a carrier of hepatitis B, you and your family should be immunized.

*** Intestinal parasites are common in many parts of the world. They may not be causing your child symptoms, but knowing their presence will help prevent transmission to others. If your child has loose stools, other tests may be appropriate.

Hepatitis B

Please review the informative letter to parents developed by Dr. Margaret Lawson, volunteer medical consultant with The Children’s Bridge adoption agency. The letter was written to assist adoptive parents to understand the issues around Hepatitis B. Dr. Lawson is a paediatrician at the Children’s Hospital of Eastern Ontario (CHEO) in Ottawa, specializing in pediatric endocrinology (hormone problems in children). In writing this letter, Dr. Lawson obtained assistance from the infectious disease department at CHEO.

Although the likelihood of Hepatitis B infection is relatively remote, this letter sets out preventive precautions that families should consider and discuss with their doctor. For further information, you may also want to read the article on Hepatitis B published in the March 2002 Children’s Bridge Newsletter.


Thank you to the following people for their assistance with this information:

  • Dr. Dana Johnson, Prof. Of Pediatrics, International Adoption Clinic, University of Minnesota
  • Dr. Simon Dobson, Pediatric Specialist in Infectious Diseases, Children’s Hospital in Vancouver, B.C
  • Dr. Elinor Ames, Prof. Psychology Dept. Simon Fraser University