Adopting children from Ethiopia, China, may be delayed months due to TB testing rules

By Kristin Collins

McClatchy Newspapers

(MCT)

The family is caught up in new rules designed to halt the spread of drug-resistant TB, a growing worldwide problem. TB is a bacterial infection in the lungs that can be fatal if left untreated.

Adoptive parents and advocates say the new rules are draconian, delaying the adoptions of orphaned children while providing few public health benefits.

Even in the most active stage of the disease, children very rarely transmit TB to others, health experts agree. And the government testing process causes months-long delays for some children, even those who are not sick with TB.

"We don't have any reason to believe our child is ill, so it's just so frustrating," said Marily Nixon , a lawyer. "We can't bring her home because of a policy, and not really because of a health condition."

Nixon and Rigotti, a professor at Duke's Fuqua School of Business, began the process of adopting nearly two years ago. In February, they were assigned a child, Tsehaynesh.

Instead, they were told she had a positive skin test, which means that a person has been exposed to the disease at some point but does not mean they are sick with it. Then, a chest X-ray found a "suspicious" area in her lung. That triggered the new rule requiring that Tsehaynesh have a sputum test, the results of which take about 10 weeks because lab workers must wait for cultures to grow.

"The uncertainty and the fear about what's going to happen in the bureaucratic blender really takes its toll," Nixon said this week.

Officials with the CDC say the new rules, which are being rolled out gradually in several countries, ensure that immigrants who have TB get proper treatment and do not infect others. They say the wait for test results is necessary to ensure accuracy.

Pearson said the CDC has convened a working group and is considering whether changes are needed to reduce delays in adoptions.

"They just don't transmit tuberculosis," said Benjamin, the adoptive father of four children from Korea. "But a lot of damage can be done to kids in 2 or 4 or 6 months in an orphanage."

Advocates say the CDC needs to make changes quickly.

The daughter, Marta, was orphaned at 13 after her mother died of TB. When she arrived at the orphanage, she had active pulmonary TB, for which she received eight months of daily multi-drug therapy. Several tests afterward proved that she was cured.

But when she had the CDC-required testing, a skin test showed she had been exposed to the disease and a chest X-ray showed scarring. The government refused to accept medical records showing she was cured. Instead, it made the family wait three months for the results of a government-approved test.

During the wait, Marta, now 14, remained in a fly-infested Ethiopian orphanage, where she went to the bathroom in a hole in the ground and did not have enough to eat, Gautsch said.

"We're not talking about leaving them at the Ritz Hotel," Gautsch said. "They're deplorable conditions. I cannot understand the idea that it's better for U.S. public health to keep them institutionalized."