The available studies of long-term outcome concentrated on physical growth and intellectual achievement. Knowledge has advanced rapidly in the past decade but remains in a constantly evolving state as the demographics of adoptees change. The first and major concern for a newly adopting family is usually, the potential for 'exotic' infections. Thus, the infectious disease consultant often serves as a first stop in the comprehensive evaluation that these children require. Medical history Unlike refugee or immigrant children, adoptees most commonly arrive in the USA without any care giver who is familiar with their past medical or social environment.
Records are frequently, scanty, unavailable or, occasionally, even fraudulent.
Evaluation before adoption is highly variable, with excellent documentation from government-sanctioned adoption agencies in Korea to virtually none from poorer nations. Treatments used in other countries, such as quinghaosu or artemether for malaria, may also be unavailable. Immunization records Immunizations are frequently not given or are poorly documented . When in doubt, it is always best to repeat the series of vaccinations, as there is no harm in re-immunization, provided the HIV status is known. There are no international standards for medical evaluation before adoption.