Most doctors treating children have been trained to call social services if they discover a child with genital or anal warts to report the possibility of abuse. But new research, in the journal Pediatrics, shows that this symptom alone may not indicate that a child has been abused. The warts are caused by the human papillomavirus (HPV), explained Sara Sinal, a pediatrician at Brenner Children's Hospital and expert in child abuse cases. "However, we were seeing younger children with this virus and many times had no other signs that abuse was taking place. These children seemed different in many ways from the children we were seeing for suspected sexual abuse who did not have warts."
The researchers also noticed that a child would often go to an ear, nose and throat physician to be treated for oral or laryngeal warts (warts in the mouth or throat), however the physician treating the child never suspected or reported child abuse. "This is the same virus in a different location in the body and child abuse was never considered," Sinal said. "It made us look at these anal and genital warts so we could determine whether a child could contract the diseases from nonsexual contact. We did not want to call social services to report a child if there was no suspicion of abuse. Having been involved in many child abuse reports, I know how traumatic a report can be for a family."
HPV is the most common STD in the U.S. but it can also be spread from mother to child in the birth canal. It is also possible that warts can be transmitted by contact with a hand or contaminated object. But since the virus is a sexually-transmitted disease, many pediatricians often suspect sexual abuse when a child has symptoms.
Sinal urged caution on the actions taken when warts are detected. "Every child with warts needs a thorough evaluation for possible abuse. However, when there are no other signs a child is being abused, we no longer feel it is necessary to report the family to the department of social services for suspected abuse. We are encouraging our colleagues to keep an open mind when they discover HPV in a child," she explained.
