The most important factor to consider is whether you have any symptoms of tuberculosis. The most common symptoms are coughs, night sweats, and fatigue. If you have these symptoms, you might have active tuberculosis disease. This is very serious and needs to be treated right away.

If you don’t have symptoms. it is still possible that you could have an active tuberculosis infection and not know it. For this reason, all people with a positive test need to have a chest xray to look for signs of infection. 99% of the ones I have tested have had a normal chest xray, so don’t worry about this unless you have symptoms.

If the chest xray is normal, you will be classified as having latent tuberculosis. This can be due to having had the tuberculosis vaccine (BCG) in your homeland or because you have been exposed to tuberculosis germs but they have not caused an actual active infection.

If you had the BCG vaccine, you do not need to be treated for tuberculosis unless your exam shows a change in condition that might indicate an infection.

If you were exposed to tuberculosis, then you need to take a medication to treat it. The most commonly used medication is Isoniazid. It is taken daily for six months. Most health departments will supply the medication for free or a small cost but you have to return monthly for refills.

You do not have to complete treatment for latent tuberculosis to send in your USCIS physical exam form. However, immigration will sometimes check for confirmation that the treatment was completed.

If you have active tuberculosis, you cannot continue with your USCIS process until you complete treatment. this may end up being a delay of six months to a year but it does not disqualify your USCIS application, it only delays it.

If you have had a positive reaction in the past, you MUST provide paperwork confirming that this is the case. It has to be included in your USCIS records. If you cannot provide this documentation, then you must undergo the skin test again or have the tuberculosis blood test done.

Once you provide the documentation, you must also have a chest xray done. The chest xray is a way to look for signs of the disease because the disease causes lesions in the lungs. The chest xray report must be within one year of when you send in your USCIS application or it will be rejected. The chest xray report must be mailed in along with your application.

The first question is whether you have ever had a tuberculosis skin test in the past? If so, did you have a reaction or was it negative?

If you have never had a positive reaction, then you have the option of having the tuberculosis skin test or the Quantiferon blood test. The government only recently approved the blood test as appropriate for tuberculosis testing.

The tuberculosis skin test involves injecting a small amount of a compound called purified protein derivative (ppd) into the skin. If you have been exposed to tuberculosis, it will respond by creating a welt at the injection site. If this welt is greater then 5mm, then further evaluation is required. (More on this later.) If you have HIV or a disease that can repress the immune system, then the test may be positive, even if it creates a welt smaller than 5mm.

The skin test requires that you return in 48 to 72 hours to have the site examined for a reaction. Most places charge around $20 for the tuberculosis exam. I charge this amount if I am only administering a tuberculosis test but I include it for free as part of the physical exam.

The second choice is the tuberculosis blood test. This only requires one visit for the blood draw. However, many of my patients have declined this option because it involves an extra $80 charge. That is the cheapest price I have been able to find for my patients- some labs charge as much as $250 for this test. Some students and military dependents many be able to get the blood test for free.

After the initial paperwork is done, then I will viisit with you to collect information about your health and medical background. I will also do a brief physical exam. (Don’t worry- it doesn’t include a pelvic or rectal exam.) Finally, I will administer the tuberculosis skin test, if you are having that done at my office. I will also draw blood for the required syphilis blood test and for the tuberculosis blood test, if you chose that option. I do not do vaccines in my office, so, if you need vaccines, I will give you instructions on where to go to obtain them.

The final portion of the visit involves making an appointment to follow up on the tunberculosis skin test, if neccessary. I also have people pay (we accept cash, check and credit card, but no insurance–I can give you a page to submit to you insurance company on your own). Our last step is to have you place a pin in our world map, showing where you are from. This last step is a special part of each immigration exam here at American Medical Exams PA because we enjoy finding out about where you’re from and learning more about you.

Please feel free to call me for an appointment. If I am busy, leave a message and someone will call you within a day.

I have started this blog to talk about what is involved in the medical exam for immigration and to offer my comments sbout the current debate surrounding immigration. In my opinion, a great deal of the debate focuses on the people who are here in the US illegally. Very few people are taking a look at the process that is already in place and the changes that need to be made to make becoming a citizen less burdensome for the people who want to do things legally.

One thing that surprises many Americans is when I tell them that the United States has people coming here from all over the world, not just from Mexico. When I opened my office, I put up a map of the world. I have had every immigrant place a pin in the map showing where they came from. Only about one third of my clients come from Mexico. I have large groups that have come from India, South Korea, Kenya, and the Philippines but my map shows people from all over the world, from every continent except Antarctica. Few people realize what a melting pot our country really is!