Individuals who have applied to enter, extend their stay or become a permanent resident in Canada, are required to undergo an immigration medical exam (IME) by panel physicians as designated by the Immigration Refugees and Citizenship Canada (IRCC). Through their IME with an IRCC authorized panel physician, they may have had an abnormal chest x-ray, a positive tuberculin skin test (TST) or Interferon Gamma Release Assay (IGRA), previous history of tuberculosis (TB) or been in close contact with an active TB case. As such, this patient may be at high risk for developing active TB and a medical assessment is required as part of this process.
If you see an individual who requires TB medical surveillance, please follow these steps:
- Conduct a physical exam and assess for symptoms of pulmonary and extra-pulmonary (e.g., lymph node) TB.
- Send the patient for a chest x-ray – anterior/posterior and lateral views.
- Collect three spontaneous sputum specimens (at least one hour apart), for TB testing if symptomatic and/or if they have an abnormal chest x-ray.
- If active TB disease is suspected, call Halton Region Public Health immediately at 905-825-6000 ext. 7341 and instruct client to isolate at home and refer to an ID specialist and/or respirologist.
- Consider doing a TST or an IGRA if active TB is ruled out, and discuss treatment for latent tuberculosis infection (LTBI) as appropriate.
Note: LTBI management is not an IRCC requirement for TB medical surveillance.
- Complete the medical assessment form that the patient will provide and return it to Halton Region Public Health by fax to 905-825-8797. A referral to an ID specialist and/or respirologist or pending lab results (sputum results) should not delay the return of the completed form(s).
- Halton Region Public Health will advise IRCC that the medical surveillance requirement has been met.