IMMIGRATION X-RAY FOR TUBERCULOSIS

Some estimate that tuberculosis (TB) has been around for millions of years, although it’s had many names over the years. In the 1800s, it was known as consumption, and was often still referred to this way despite being formally named tuberculosis in 1834.

TB is an acute or chronic bacterial infection that mostly affects the lungs, but can also affect the brain, kidneys, or spine. It can be caused by two types of bacteria:

1. Mycobacterium bovis – In the past, this was the more common bacteria which was passed to humans through dairy products. Stringent modern inspection and testing of dairy and cattle has made this strain less common in recent times.
2. Mycobacterium tuberculosis – Today this type of bacteria is the most common source of infection. It’s spread by airborne droplets breathed or coughed into the air by a person infected with active TB.

When Dr. Robert Koch discovered the bacteria that causes TB in 1882 the disease was killing one out of seven people living in the United States and Europe at that time. Centuries later the disease is still around, and World Tuberculosis Day on March 24 helps educate the public about the impact of TB.

HOW DOES TB AFFECT THE LUNGS?

TB bacteria can cause the formation of small tissue masses, called tubercles. When formed in the lungs, these tubercles can impair breathing and lead to coughing and release of sputum. Depending on the area of the body affected and the severity of the infection, symptoms of TB disease can also include feelings of weakness, weight loss, fever, night sweats, chest pain, and the coughing up of blood. If left untreated, TB can lead to death.

Tuberculosis can be inactive (latent) or active:

• Latent TB – You have TB bacteria in your body but are not sick because they are inactive. You don’t have symptoms and are unlikely to spread germs to others, although you are at risk of developing TB in the future.
• Active TB – You are sick and have symptoms. The bacteria are active and multiplying, destroying tissue in your body. If you have TB of the lungs or throat, you are infectious and capable of spreading germs to others.

X-ray imaging is used to look at the lungs to check for signs of active TB. X-rays use a type of electromagnetic ionizing radiation to create images of your lungs, heart, and the bones of your chest and spine. A small amount of radiation is sent into the chest and different areas of the chest absorb this radiation at different rates, creating an image with various shades of grey. When filled with air, the lungs show up as darker areas while the heart and lung vessels will appear as lighter areas.

Different lung and heart pathologies can be determined by the radiologist depending on their appearance within the lungs. For example, signs of infection, such as lesions, masses, or fluid, can show up as white patchy areas.

WHY ARE CHEST X-RAYS NEEDED DURING THE IMMIGRATION PROCESS?

A chest X-ray is a mandatory requirement from Immigration, Refugees, and Citizenship Canada (IRCC). It’s used to check for indications of tuberculosis for anyone looking to immigrate into Canada.

If someone applies to stay in Canada, or if they are emigrating to another country, there are usually a set of admission criteria that include meeting certain medical standards. Within Canada, applicants must not create a danger to public health or public safety.

The chest X-ray will be examined for:

• General radiological findings.
• Evidence of active or inactive TB disease.

Applicants must bring their immigration medical examination, unique medical identifier, or unique client identifier numbers with them to their X-ray exam. These numbers, or your name and passport numbers, can be used to retrieve your health case in eMedical – an online tool used by doctors, who are approved by IRCC to do medical exams, to record and send immigration medical exam results to IRCC.

HOW DO I GET AN IMMIGRATION CHEST X-RAY?

In Calgary, immigration chest X-rays for applicants trying to immigrate into Canada can only be requested by IRCC-approved doctors. One of these doctors will give you a requisition form and other paperwork outlining your need for this exam. You will then be directed to go to one of the clinics approved to perform these exams: Mayfair Place, South Calgary Health Centre, The CORE, and Westbrook. These X-rays are offered on a walk-in basis, appointments are not required; simply bring your forms with you.

For applicants trying to immigrate to New Zealand and Australia, these immigration chest X-rays can only be performed at Mayfair Place.

Your X-ray images will be reviewed by a specialized radiologist who will compile a report that is sent to your doctor and uploaded to eMedical. There is a cost for this exam, which can be paid with Visa, MasterCard, debit, or cash.

WHAT HAPPENS DURING A CHEST X-RAY?

During this exam, you will be asked to change into a gown and to remove any metal objects, such as jewelry, watches, hair clips, pins, and clothes with metal buttons, zippers, or snaps. We will also ask you to tie up any long hair that may obstruct a clear view of the chest.

For women between the ages of 11-55, you will be asked about the possibility of pregnancy prior to your exam, since X-rays use radiation. Lead shielding can also be provided to cover vulnerable areas. If you are pregnant, you will be asked to sign a consent form, explaining the radiation risks, before proceeding with the exam.

If you require assistance changing or moving, please bring someone to help you, if possible. You will be asked to apply two lead ball nipple markers to distinguish between nipple shadows and lesions in the chest. These are held on with adhesive and are easily removed after the exam.

One of our experienced technologists will help you move into different positions standing with your chest against an upright board. You will be asked to take a deep breath and hold it while the X-ray is being taken. Our state-of-the-art imaging technology will take views of the front and side of your chest. You will need to remain very still while the X-ray is being taken. You will also be required to take a deep breath and hold it for several seconds to help your heart and lungs show up more clearly. We need the lungs filled with air in order to assess them.

The X-ray itself is not painful but holding a particular position may be uncomfortable if you are experiencing pain. Overall, the exam may take about 15 minutes, although once in the X-ray room the process typically takes less than five minutes. Once the technologist has confirmed that the image is of good quality, you will be free to leave. For out-of-town patients, the radiologist will review the images before you leave the clinic.

REFERENCES

Centers for Disease Control and Prevention (2011) “Tuberculosis (TB).” www.cdc.gov. Accessed February 18, 2022.

Centers for Disease Control and Prevention (2016) “History of World TB Day.” www.cdc.gov. Accessed February 18, 2022.

Government of Canada (2020) “Canadian Panel Member Guide to Immigration Medical Examinations 2020.” www.canada.ca. Accessed February 18, 2022.

Healthwise Staff (2020) “Chest X-Ray.” www.myhealth.alberta.ca. Accessed February 18, 2022.

Nabili, S. N. (2020) “What Does a Chest X-Ray Show?” www.medicinenet.com. Accessed February 18, 2022.

National Organization for Rare Disorders (2021) “Tuberculosis.” www.rarediseases.org. Accessed February 18, 2022.