Prevention of travel-related infectious diseases in families of internationally adopted children
Prevention of travel-related infectious diseases in families of internationally adopted children
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DOI：
10.1016/j.pcl.2005.06.002
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发表时间：
2005-10-01
影响因子：
2.6
通讯作者：
Chen, LH
中科院分区：
文献类型：
--
作者：
Barnett, ED;Chen, LH
对收养家庭来说，预防与旅行有关的传染病从旅行之前开始，并延伸到旅行之后。许多国际收养家庭在将新家庭成员带回家之前至少会前往孩子的出生国一次。最常见的是，家庭前往前苏联，中国，危地马拉或亚洲，中美洲或南美洲或非洲的其他发展中国家的共和国。旅行的家庭成员和留在家中的儿童的家人和密切接触者都需要了解在旅行期间如何保护自己，以及如何预防国际收养儿童在抵达美国后可能传播的疾病。为收养而旅行所面临的风险不同于旅游或商务旅行者或探亲访友的旅行者所面临的风险（VFR旅客）。虽然申请国际收养通常需要至少一年或两年的准备，但家庭可能会在出发后2至3周内收到旅行通知。旅行家庭可能无法选择旅行目的地或行程、旅行时间或旅行期间的住宿。他们可能不会说当地语言，或无法经常获得口译服务，并可能对住宿，签证要求和海外程序感到担忧。他们可能是没有经验的第一次父母，或者可能是与其他需要照顾自己的孩子一起旅行。为收养而旅行可能会导致在该国长期和意外的停留，可能会在非旅游设施中住宿，例如当地的公寓，旅馆或他们孩子的孤儿院。因为想要取悦那些在收养过程中有权力的人（例如，调解人，翻译，法院和政府官员，机构和孤儿院人员），家庭可能会接受他们通常会避免的风险，如吃当地食物或饮用可能不安全的水，喝更多或不同类型的酒精，在农村卫生设施寻求医疗保健，或使用当地交通工具，不系安全带或汽车座椅。家庭可能会暴露在极端的空气污染、农场动物、二手烟或传染性病原体（如肺结核）中，如果没有收养过程，他们可能会避免这些。随着旅行医学领域的发展，具有特定风险的不同旅行者群体已经被确定，例如VFR旅行者。国际收养儿童的家庭和密切联系人可能就是这样一个群体。通过系统研究更好地描述这些风险可能会导致未来改善对这一人群的干预。本文介绍了目前的知识体系和预防这一群体旅行相关疾病的建议（见附录）。
Prevention of travel-related infectious diseases for adoptive families starts before and extends beyond the travel period. Many families adopting internationally travel to their child's birth country at least once before bringing their new family member home. Most commonly, families are traveling to the republics of the former Soviet Union, China, Guatemala, or other developing countries in Asia, Central or South America, or Africa. Family members who travel and family and close contacts of the child who remain at home all need information about protecting themselves during travel and preventing acquisition of diseases that could be transmitted by the internationally adopted child after arrival in the United States.Travel for adoption presents risks that are different from those encountered by the tourist or business traveler or those travelers who travel to visit friends and relatives (VFR travelers). Although the application to adopt internationally usually requires at least I or 2 years of preparation, families may be notified about travel within 2 to 3 weeks of departure. Adoptive families may not have a choice in their travel destination or itinerary, the time of travel, or accommodations during the trip. They may not speak the local language or have regular access to interpreters and may be apprehensive about accommodations, visa requirements, and overseas procedures. They may be inexperienced first-time parents or may be traveling with other children who require attention to their own needs.Travel for adoption may lead to prolonged and unexpected stays in the country, possibly with accommodation in nontourist facilities, such as local apartments, hostels, or their child's orphanage. Because of a desire to please the many individuals with power over the adoption process (eg, facilitators, interpreters, court and government officials, agency and orphanage personnel), families may accept risks they would ordinarily avoid, such as eating local foods or drinking potentially unsafe water, drinking more or different types of alcohol, seeking medical care in rural health facilities, or using local means of transport without seat belts or car seats. Families may be exposed to extreme air pollution, farm animals, second-hand cigarette smoke, or infectious agents, such as tuberculosis, that they might otherwise avoid were it not for the adoption process.As the field of travel medicine evolves, distinct groups of travelers with specific risks have been identified, such as VFR travelers. It is possible that the families and close contacts of internationally adopted children comprise such a group. Better description of these risks through systematic study may lead to improved interventions in this population in the future. This article addresses the current body of knowledge and recommendations for preventing travel-related illness in this group (see Appendix).