International adoption - travel health

International adoption presents a number of unique travel health considerations.

Like other travellers, parents travelling to their child’s country of origin should receive pre-travel health advice and take health precautions while travelling.

Other family members who are not travelling may require certain vaccinations before the adopted child arrives in Canada.

Children who are adopted internationally may receive medical care that differs from what is available in Canada, or may have been exposed to diseases that are uncommon in Canada. They may require vaccinations or medical tests after arriving in Canada.

Parents planning an international adoption

Consult a health care provider to discuss:

• the health information you have about your child. If the adoption agency has informed you that your child has a health issue, ask your health care provider if any specialized care is needed and if so, whether or not this care is available in your area.
• developmental and health issues that may be more common in internationally adopted children.
• an appointment upon returning to Canada for the health care provider to see the child.

Consider making an appointment with adoption medicine specialist for a ‘pre-adoption consultation’ to discuss your child’s file.

Before travelling

If you are travelling to your child’s country of origin, you should consult a health care provider or visit a travel health clinic preferably six weeks before you travel to:

• be sure that your routine vaccines are up to date, regardless of your travel destination.
• find out if any other vaccines, like the yellow fever vaccine, are required or recommended for travel.
• discuss whether or not you need anti-malaria pills or any other medications for travel. If so, request that your prescription last for more than the length of your trip, as delays in the adoption process may occur while you are abroad.
• discuss travel health measures like safe food and water precautions and insect bite prevention.

Before you leave, there are other steps you can take to plan a safe and healthy trip:

• check the Travel Advice and Advisories for up-to-date information on your destination
• sign up for the Registry of Canadians Abroad 
• make sure your passport is valid until well after you expect to return to Canada in case there are delays
• verify in advance whether you need a visa to enter your destination country.
• pack a travel health kit
• purchase travel health insurance

Family members staying at home

Sometimes internationally adopted children may have illnesses that are not properly diagnosed, or have yet to be diagnosed, which can be spread to family members and other close contacts. It is recommended that, anyone, including other family members, who will be in close contact with the adopted child, schedule an appointment with a health care provider, preferably six weeks before the adopted child arrives in Canada to:

• make sure that their routine vaccinations are up to date.
• find out if they require additional vaccinations against certain diseases that may be more common in the adopted child’s country of origin, like hepatitis A and hepatitis B.

While travelling

The pre-adoption care that children receive and the quality of their records vary widely among countries. Try to collect as much information about your child’s medical history and care as you can, recognizing that even if the information is available, it might not be accurate. Some questions to ask include:  

• Pregnancy and birth
  • Birth date?
  • Birth weight?
  • Gestational age (length of the pregnancy)?
  • Were there any complications during the pregnancy or birth?
  • Where was the child born?
• Housing and type of care
  • Where did the child live (e.g. foster parents’ home, orphanage/institution, hospital)?
  • What type of care did he or she receive there?

• Medical care
  • Has the child received any vaccinations? If so, which ones and when?  Try to get the written records.
  • Has the child been ill, hospitalized, or required surgery? If so, why?  Record the names of the medications and procedures the child received, including test results, if available.
  • Is the child currently taking any medications?
• Biological parents
  • Ages, if known?
  • Medical histories, including if they were known to have abused drugs or alcohol?

After returning home

Citizenship and Immigration Canada requires an immigration medical exam for all children immigrating to Canada. For children under five, this will include a history and physical exam.

You should also visit your own health care provider within two to three weeks of returning home with your child. The visit will allow your health care provider to assess available documents and: 

• determine whether or not your child is adequately immunized. 
  • Many vaccines that are routinely given in Canada, like the vaccines for mumps, rubella, chicken pox (varicella), and meningococcal disease, are in limited use in other countries.
  • Your health care provider will review your child’s immunization record, if he or she has one. Sometimes vaccine records of adopted children from other countries may not be similar to the recommended schedule of immunizations in Canada. Your health care provider may suggest re-vaccination to bring your child’s vaccinations up to date, if needed.

• assess your child’s growth, development, and any attachment (or bonding) difficulties.
• conduct a physical exam.
• perform certain tests to screen for health issues based on your child’s risk factors, country of origin, or physical exam. These might include:
  • tests for diseases that may be more common in your child’s country of origin, like tuberculosis, hepatitis,  HIV or other infectious diseases.
  • tests for diseases that are more common in people with the same ethnic background as your child, like certain blood disorders.
  • hearing and vision tests.
  • tests to check how different parts of the body, like the thyroid, kidneys, or liver, are functioning.

Seek medical care quickly if the child has a fever, diarrhea, vomiting, or loss of appetite after you return home.

 Related links

• International adoption
• Children and travel
• Tips for healthy travel with children
• Taking children on a plane
• Well on your way: a Canadian’s guide to healthy travel abroad

Other resources

• Intercountry Adoption, Immigration, Refugees and Citizenship Canada