Infectious Diseases

HISTORY OF INFECTIOUS ​DISEASES

Specifically inquire about any history of hepatitis, HIV, tuberculosis and malaria (especially recent malaria episodes).

 

PREVIOUS LATENT TUBERCULOSIS SCREENING

While most refugees and refugee claimants will have had a chest X-ray done as part of their routine Immigration Medical Examination, this is only done to screen for active tuberculosis and most patients will have never been tested for latent tuberculosis. It is still important to ask if a tuberculin skin test was already performed to prevent repeating the test needlessly. Patients who have gone through the USA or another Canadian province will often have been screened already. See Screening Recommendations for the indications of latent TB screening.

 

VACCINATION HISTORY

Even if patients remember being vaccinated, they should not be considered immunized unless they have appropriate immunization records. While some refugees have pre-departure immunization records from the International Organization for Migration (IOM), most refugees and refugee claimants do not possess proof of vaccination.

The CMAJ guidelines recommend adults to have had at least 1 MMR dose, a complete diphtheria/tetanus/pertussis/polio series (3 doses) and serologic proof of immunization against hepatitis B and varicella to be considered adequately immunized. Vaccination against human papillomavirus is also recommended for female patients between the age of 9 and 26 years old.

Adults who do not have records showing the above immunizations, and all pre-school age children should be referred to a local vaccination clinic for age-appropriate vaccination. In Canada, school-age children should be routinely vaccinated through school by a public health nurse (the immunization schedule may vary depending on the province).