Free Services to Protect You from TB

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by Nancy Hayahara

The TB Immigration Medical surveillance process is designed to rule out active TB and to prevent active TB disease from developing. One out of 3 people in the world has the TB germ. Ninety percent will not get sick and cannot spread TB to others – this is latent TB infection. Only 10% may get sick and spread TB to others – this is TB disease.

In Canada, the rate of TB is low compared to other countries around the world. Yearly, about 1,600 people get sick with TB. Many come from countries with high TB rates. Newcomers face many stressors which may weaken their immune systems and increase their risk of getting sick with TB disease. Highest risk for TB disease is therefore during the first 5 years in Canada.

Persons applying for permanent residency, refugee claimants, and certain applicants for temporary residency are required by CIC to have an immigration medical exam (IME). This IME includes a chest x-ray to look for TB disease. People found to have TB disease are treated before being allowed entry into Canada.  People that have a chest x-ray suggesting latent TB infection will be asked by CIC to contact their local public health unit within 30 days of entry to Canada. These individuals will have medical surveillance as a condition of entry.

Medicine to prevent and cure TB is available free from Public Health. Any information obtained by Public Health will not be shared other than with the health care professionals responsible for the TB medical follow-up.

Persons on medical surveillance must see a doctor for a medical exam which includes a history, physical check-up, and other tests as needed (e.g. tuberculin skin test, chest x-ray, sputum). Treatment may also be recommended for those with TB infection or past TB that has not been treated or treated inadequately. Persons who do not take medicine for TB infection must seek medical care if they have TB symptoms in the future.

In Ontario, the cost of TB medical care is covered by the Ontario Health Insurance Plan (OHIP).  Although most newcomers have to wait 3 months for an OHIP card, those individuals who are uninsured during this time are eligible for free TB medical assessment and care through the Tuberculosis Diagnosis and Treatment Service for Uninsured Persons (TB-UP) program.

For more information on TB or TB medical surveillance, call your local public health unit. In Toronto, call 416-338-7600 or visit

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