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Immigrants aged 2 and older applying for permanent residence in the US must get a medical screening for tuberculosis. Minimizing the spread of tuberculosis has been a significant task for the United States, and this has been achieved by aggressive screening, surveillance, and treatment protocols. However, TB is still challenging due to the difficulty in diagnosing and treating it. According to the CDC, it is estimated that up to 13 million people in the United States are living with a latent TB infection. The immigration medical exam for TB enables civil surgeons to detect individuals infected with tuberculosis to have proper treatment, reducing the risk of spreading the disease.
It is common to suffer from fever and coughing; however, these might be symptoms of tuberculosis. Immigrants coming to the US pose a health risk of spreading TB and must be checked for infection through a medical screening. India, China, Indonesia, the Philippines, Pakistan, Nigeria, Bangladesh, and South Africa, account for two-thirds of TB cases worldwide.
It is vital to understand that the medical screening for TB is a part of the medical examination. A civil surgeon's responsibility is to evaluate an applicant's conditions that restrict the applicant from entering the US. It will ensure that the immigrant is in good health. There are specific instructions for civil surgeons issued by CDC. The focus is on individuals traveling to reside, study, or seek refuge.
Also read: How Is Tuberculosis Linked to Immigrants
Every immigrant above age 2 must be tested for TB by an IGRA blood test unless the applicant can present written proof of a previously positive IGRA. Applicants with proof of a previously positive IGRA must undergo a chest x-ray to prove they are not contagious.
BCG vaccination is used in countries where TB is prevalent. It leaves a permanent scar or mark, usually in the upper left arm. It reduces the chance of contracting TB in children. BCG is not used in the US. BCG is notorious for throwing off the results of the tuberculosis skin test (TST), a test that is no longer in use for immigration purposes. The current TB test used for immigration purposes is a blood test called an IGRA. BCG does not at all influence IGRA results. The IGRA is an extremely accurate and sophisticated test. If your IGRA is positive, you are without any doubt infected with TB, regardless of any prior vaccination with BCG.
If available, previous chest x-rays are sometimes useful for comparison purposes and can allow the civil surgeon to clear an applicant with an abnormal chest x-ray. In the absence of comparison films, applicants with abnormal chest x-rays must be evaluated by the local health department. The health department screening protocol involves examining sputum samples by microscope and by special culture and usually takes about two months to complete. At the end of the screening period, the health department will advise the civil surgeon whether the applicant must be treated immediately or if treatment may be safely performed outside the immigration process.
Bottom line - applicants will not be deported or kept from adjusting their status due to TB infection, as long as they comply with the required testing protocols. If your interview with USCIS is scheduled before your screening for TB has been completed, keep your appointment--USCIS understands! You will simply be issued a further Request for Evidence (RFE) when your TB screening (and treatment if required immediately) is completed.
Steven Wittenberg Gordon, MD, will assist you with the immigration medical exam, including the mandatory screening for TB. Please visit his website for details, or call us at 913-787-5805 to schedule an appointment.