ARCHIVED – Operational Bulletin 340 - August 19, 2011

Mandatory Referral to Canadian Public Health Authorities for Complex Pulmonary Tuberculosis-Inactive and other Non-infectious Communicable Diseases Cases

Summary

Foreign nationals who had an immigration medical exam (IME) abroad may have been assessed as having complex pulmonary tuberculosis-inactive (PTI) /other non-infectious communicable disease. Upon their arrival in Canada, a procedure exists for the mandatory referral to the provincial/territorial public health authority.

Issue

Currently, complex PTI and urgent non-infectious communicable disease cases are not referred to the Canadian public health authorities in a timely manner when instructions provided by the overseas medical officers are not consistently entered into the Field Operations Support System (FOSS)/Global Case Management System (GCMS) and/or followed by Canada Border Services Agency (CBSA) officers. Consequently, these cases are missed at the ports of entry (POE), resulting in increased public health risks to Canadians.

Background

Medical surveillance is required for applicants who were previously identified with a reportable communicable disease. Currently, these conditions include pulmonary tuberculosis inactive (PTI-2.02) and adequately treated syphilis (2.04). These two conditions require surveillance by a provincial/territorial public health authority and contact with these authorities must be made within 30 days of entry in Canada. Additionally, a sub-group of the PTI, namely complex PTI-non infectious communicable disease cases (2.02U) requires that the applicants report themselves to the public health authorities within 7 days of arrival in Canada.

It is of paramount importance that Citizenship and Immigration Canada (CIC) and CBSA officers apply with due diligence the procedure in place to ascertain the integrity of CIC medical surveillance notification program to provincial/territorial public health authorities.

Processing Instructions (shared responsibility between CIC visa officers and CBSA POE officers):

Upon decision by the medical officer that the applicant’s immigration medical exam meets the definition of complex PTI or other non-infectious communicable disease, it is the responsibility of the CIC visa officers to do the following steps:

• Complete the Medical Surveillance Undertaking Form (IMM 0535 B);
• Clearly indicate “URGENT” in red on the IMM 0535 B;
• Check/ ADD the code 2.02U in box 8 of the IMM 0535 B form (note: this new code 2.02U-Complex PTI will  soon be available in GCMS);
• When feasible, provide the medical officer and the Public Health Liaison Unit (formerly the medical surveillance notification unit) (IRCC.MHBSurveillance-SurveillanceDGMS.IRCC@cic.gc.ca) with the applicant’s date of departure and intended Canadian address;
• Request/insert a stand-alone Non-Computer Based Entry (NCB) 36 (for /Computer-Assisted Immigration Processing System (CAIPS)/FOSS and GCMS) with the following narrative: “Complex PTI and/or other non-infectious tuberculosis case requiring mandatory assessment within 7 days of arrival by a Canadian public health authority. Upon entry to Canada, the completed IMM 0535 B identified as URGENT must be faxed to the Public Health Liaison Unit at (613-952-3891)”.
• Issue the “Medical Surveillance Handout of Inactive Tuberculosis or other Urgent Complex Non-Infectious Tuberculosis (PDF, 124.43KB)” and check-off the “seven (7) days of entering Canada”; and
• Instruct the applicant to provide the IMM 0535 B at the port of entry.

The responsibilities of the CBSA POE officers are:

• Request the IMM 0535 B to the applicant; if none available, write a new completed one following the above instructions;
• Obtain a Canadian address;
• Insure the form is signed by the applicant;
• Fax the IMM 0535 B to the Public Health Liaison Unit (formerly the medical surveillance notification unit) at 613-952-3891 the same day as stated in the NCB 36 note;
• Give one copy back to the applicant;
• Issue the “Medical Surveillance Handout of Inactive Tuberculosis or other Urgent Complex Non-Infectious Tuberculosis (PDF, 124.43KB)” and check-off the “seven (7) days of entering Canada; and
• Send the original one to the Public Health Liaison Unit (formerly the medical surveillance notification unit) within the next 24 hours via the prepaid envelopes.