How Latent Tuberculosis and TB Disease Affect Immigration Medical Exam?

Tuberculosis or TB is caused by a germ called Mycobacterium tuberculosis, which usually affects the lungs but can also impact other body parts. According to WHO, the germ is highly contagious and is the second leading infectious killer after COVID-19.

TB most commonly manifests as a latent tuberculosis infection (LTBI), affecting 13 million people in the U.S . Those with LTBI are infected but not yet contagious. About 10% of the infected will progress to the deadly contagious or active version of the disease. In diabetics, about 30% progress. In the immunosuppressed, the conversion rate approaches 100%. Let us learn about the risk factors, diagnosis, and treatment of LTBI.

How Latent TB Infection (LTBI) Differs from Active TB

The main differences between Latent TB Infection and Active TB are

• A person with LTBI has no symptoms, but an active TB patient will show symptoms such as a bad cough that lasts longer than three weeks, blood or phlegm in the cough, severe weight loss, fatigue, chest pain, and fever.
• LTBI is non-contagious, i.e., a person with LTBI cannot pass it on to others, whereas active TB is highly contagious and is airborne. LTBI will not appear in a chest x-ray or a sputum smear test, but active TB can be diagnosed by an abnormal chest x-ray and a positive sputum smear test. However, LTBI cannot be ruled out by a chest x-ray alone.

Read more: How Testing Positive for Syphilis Affects the Immigration Medical Exam

Why Should You Care About Latent TB Infection?

Active TB can be fatal and cause permanent lung damage if left untreated, requiring immediate medical attention. People with LTBI may develop active TB in the future (see above).

Diagnosis of Latent TB Infection

The diagnosis of latent TB is performed when a person tests TB positive, and the medical evaluation does not indicate active TB. A blood test called the IGRA is used to screen for TB for immigration purposes. The highly inaccurate and user-dependent older tuberculosis skin test (TST) is no longer used for immigration purposes.

Risk Factors for Latent Tuberculosis Infection

Interacting with the people mentioned below may increase the chance of developing latent tuberculosis infection

• Person who currently has TB
• Person with medical conditions that affect the immunity of an individual.
• People who have been to the areas with high rates of TB, especially India and China.
• People in hospitals, prisons, nursing homes, homeless shelters, or refugee camps.
• Infants (children under 2 years old)
• Adults above the age of 60

Read more: How Hansen's Disease (Leprosy) Affects the Immigration Medical Exam

How Is TB Infection Becoming a Hurdle for Immigration?

To become a permanent resident or to get a work visa in the United States, you must undergo an immigration medical examination, and testing for TB is a required part of the process. You will need further tests and possible treatment if you are diagnosed with an active TB infection or LTBI during the screening. A positive TB test result will not affect your chances of getting a green card, as long as you follow the rules for additional testing and, if required, treatment.

If you need further information about TB and immigration medical examinations, you can contact Steven Wittenberg Gordon. With his decades of experience, Dr. Gordon is committed to helping you with the entire immigration medical examination process. Request an appointment for any questions related to immigration medical exams today.