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Ann Arbor, MI 48109-1050
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International Mandatory Tuberculosis Screening

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Requirement in brief  The University of Michigan (UM) requires certain entering international students to be screened for tuberculosis (TB). All UM campuses (Ann Arbor, Dearborn and Flint) participate.

Am I required to be screened?  You must be screened for TB if you answer Yes to ALL of the following three questions.

  1. Are you an entering UM international student with an F-1 or J-1 visa type?
  2. Did the UM issue your Form I-20 or DS-2019?
  3. Are you a citizen of one of the following countries (identified by the World Health Organization) according to your I-20 or DS-2019?

Afghanistan Indonesia South Africa
Bangladesh Kenya Taiwan
Brazil Mozambique Thailand
Cambodia Myanmar United Republic of Tanzania
China (includes Hong Kong) Nigeria Uganda
Democratic Republic of the Congo Pakistan Vietnam
Ethiopia Philippines Zimbabwe
India Russian Federation  

How can I be screened?  First, be sure you need to be screened. Not all international students need to be screened. See Am I required to be screened?

If you are a student starting at UM in Spring/Summer 2008, follow instructions sent via email to your umich email account (Subject: Mandatory TB Screening), or send an email with questions to tbscreen@umich.edu.

If you are a student starting at UM in Fall 2008, you can schedule your TB screening online at Scheduling.

If you have documentation of prior TB screening, you still need to schedule an appointment for TB screening. Please bring documentation with you when you come for that appointment. A health care provider will check your documentation to make sure it is acceptable. See more on documentation.

Why do I need to be screened for TB? The US Centers for Disease Control and Prevention (CDC) and the Michigan Advisory Committee for Elimination of Tuberculosis recommend screening individuals from countries where TB is relatively common. The UM Executive Officers approved this policy in 2004 (see Tuberculosis Screening Mandate). A TB test can detect whether you have TB infection and if so, you can get treatment.

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Who identified the countries? The World Health Organization (WHO) identified the countries, which together account for 80% of the world's TB cases. See the Stop TB Partnership website for a summary.

What if I don't comply with the screening requirement? You will not be allowed to register for your second semester until you are screened for TB, which will also affect your ability to stay in the US on an F-1 or J-1 visa sponsored by the UM. Please be screened as soon as possible during your first semester so that you can register for your second semester classes, certainly before the busy finals period.

What if I have dual or multiple citizenships/nationalities? Whether you must be screened for TB will be determined by your citizenship/nationality stated on your Form I-20 for F-1 students, and Form DS-2019 for J-1 students.

I already had a TB test (or treatment). Can I meet the requirement by bringing documentation? You still need to make an appointment for screening. You can meet the requirement by providing the following documentation IN ENGLISH, and including your COMPLETE NAME:

  • Negative TB skin test, reaction size in millimeters, done within a year of starting UM classes OR
  • Positive skin test, reaction size in millimeters AND normal chest x-ray (report preferred) OR
  • Negative QuantiFERON-TB Gold test done within a year of starting UM classes OR
  • Positive QuantiFERON-TB Gold test with normal chest x-ray (report preferred) OR
  • Completed treatment for active or inactive TB.

The following types of documentation are not acceptable:

  • Tine test
  • QuantiFERON test
  • Chest x-ray only
  • T-SPOT test

Do you have a form for documentation? Yes, Documentation for International Mandatory Tuberculosis (TB) Screening (PDF) can be used by a health care provider to document prior testing. If desired, please bring documentation using this form (or another form in English) to your screening appointment.

What is the process for screening? You will meet with a health care provider, who will review your screening requirement and any documentation you bring. (Specific dates/times for screening clinics will be announced later.) If needed, you will have a TB blood test (QuantiFERON-TB Gold) or TB skin test.

What is the TB blood test (QuantiFERON-TB Gold)? It's a new test to identify TB bacteria. If the test result is positive, a person is infected with TB. This test is especially appropriate for people who had BCG vaccine because the vaccine does not affect this test result.

What is the process for the TB blood test (QuantiFERON-TB Gold)? First your blood will be drawn at the UHS Laboratory. Later you will be notified of your test result.

  • If the result is negative, you do not have TB infection.
  • If the result is positive, you have TB infection. A chest x-ray will be required to check for active TB in the lungs.
  • If the result is indeterminate, you will need a TB skin test.

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What is the process for TB skin testing? First, you will meet with a health care provider to be injected with a small amount of fluid called PPD under the top layer of skin on your lower arm.

Next, you will need to return in person 48-72 hours later for the test reaction on your arm to be examined.

  • If the reaction is not significant, or there is no reaction (negative), then you have no TB infection.
  • If the reaction of your arm is significant (positive), a chest x-ray will be required to check for active TB in the lungs.

What if my TB test is positive? A chest x-ray will be required to check for active TB in the lungs.

  • If the chest x-ray is normal and you have no symptoms of active TB, you most likely have inactive TB.
  • If you have an abnormal chest x-ray or symptoms of active TB, you may be required to have additional tests.

What are the side effects of these tests?

  • The blood test has no side effects.
  • The skin test will not make you sick. It may cause swelling, itching or tenderness at the injection site, which usually disappears within a week. You can continue normal activities including washing your arm after the test.

What if I am diagnosed with TB infection?

  • Most people have inactive (latent) TB, which cannot be transmitted and does not cause symptoms. Treatment with antibiotics is recommended in order to prevent active TB. You can attend school normally.
  • Active TB can be transmitted and is very serious, sometimes causing permanent damage and even death. It is curable with appropriate medicine, and treatment with antibiotics is required.

Will TB test results affect my visa or student status? Having TB will NOT affect your visa or student status. Students who have TB infection are not discriminated against in any way. UHS must report cases of active TB (not inactive TB) to county health departments for investigation of possible transmission of others. Otherwise, health records at UHS are confidential and cannot be released without patient consent. Your TB test result will not appear on your academic documents.

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How much would treatment cost? For currently enrolled students on the Ann Arbor campus, UHS will provide most health care at no additional cost. Insurance helps to pay for any services outside of UHS or on other campuses. Cost for medication for individuals with inactive TB is minimal (less than $3 per month for students with the UM International Student/Visiting Scholar Health Insurance Plan). If you have been previously diagnosed with TB (active or inactive), there may be some restrictions on health insurance coverage outside of UHS.

I got BCG vaccine in my country. Do I still need to test? Yes, you do. Please follow instructions at How can I be screened?.

Does BCG vaccine affect the test result? The blood test is not affected by BCG vaccine. The skin test is usually not affected by BCG vaccine if the vaccine was done more than 10 years ago. BCG vaccine does not cause inactive TB.

Do others (e.g. international scholars, family members, travelers to the countries listed by WHO) have to be screened for TB? TB screening is encouraged for others at risk but not required by the University of Michigan. TB skin testing is available at minimal cost on the UM Ann Arbor campus as follows:

UHS Allergy, Immunization and Travel Health Clinic
(for individuals 10 years and older)
207 Fletcher Street
734-764-8304
See also Tuberculosis and Testing and Location and Parking

North Campus Family Health Service
2364 Bishop
734-647-1636

For more information including Flint and Dearborn campuses, please contact the following UM offices.

Ann Arbor campus:
Email University Health Service at tbscreen@umich.edu

Erika Kido
Coordinator, International Mandatory Tuberculosis Screening
Ann Arbor campus

Dearborn campus:
Suzette Crandell
UM Dearborn Counseling and Support Services
Phone 313-593-5430
Email counseling@umd.umich.edu

Flint campus:
Ree Ann Slagor, RN, MSN, APRN-BC
UM Flint Health Services
Phone 810-424-5269
Email rslagor@umflint.edu

 


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