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The Health Department said the two children — who now live in central Minnesota — two members of their new extended families and two people who came in contact with the relatives were infected after the children came to Minnesota in September.
International adoption agencies frequently encourage new parents to be vaccinated because children from developing countries come with higher risks of infections. However, extended relatives usually don’t get vaccinated.
Kris Ehresmann, who directs immunization efforts for the Minnesota Department of Health, said the state may formally recommend vaccinations for the extended families of the adoptees from areas where hepatitis A is endemic because cases like this have happened before.
She said that while the children can be tested for infectious diseases, relatives aren’t likely to wait for the results before embracing and interacting with them.
“Clearly, if you’re the grandparents or aunts and uncles, you don’t want to wait to hug these kids until you get the lab test back,” she said.
She said there was no timeline set for making such a recommendation, which would not be binding but would probably be passed along to adoptive parents by the international adoption agencies.
In the most recent case, health investigators checked out places where the family visited for new cases, including churches, worksites and other locations.
With people carrying infectious diseases, “Your hope is they are hermitlike and don’t socialize,” Ehresmann said. “But they always seem to be quite involved.”
Ehresmann said privacy rules limited how many details she could release about the case.
One person in the outbreak was hospitalized. Ehresmann said health officials have recommended preventive treatment for many people who have had contact with the family.
She said the public at large was not at risk.
Ehresmann said the children were not showing symptoms of hepatitis A upon arriving in the state in September, but one relative became ill several days later. The relative worked in a group home in Ramsey County, where a resident also became ill.
The adopted children made weekly visits to a church nursery in Dakota County, but Ehresmann said there is no evidence that other children at the nursery or their families have been infected.
The hepatitis A virus is spread through ingestion of fecal matter and is often associated with outbreaks at restaurants or group meals. It’s an inflammation of the liver that can cause jaundice, weakness and other symptoms but is rarely fatal.
