OPINION-US VISA | IMMIGRATION CORNER – Why are there so many cases of TB?

According to the US embassy, “all immigrant visa applicants, regardless of age, require a medical examination prior to the issuance of a visa.” Applicants are required to schedule a medical exam with St. Luke’s Medical Center Extension Clinic two weeks before their visa interview. “The medical examination will include a medical history review, physical examination, chest X-ray and blood tests (for applicants 15 years of age or older). The United States also requires tuberculosis (TB) testing for all applicants two years of age and older. … You DO NOT need to bring the x-rays to your visa interview unless you suffer from tuberculosis (TB).”

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I have no problem or issue with visa applicants being required to undergo medical exams, x-rays or testing for TB. After all, it could create health issues to allow people into the US with contagious diseases or infections. However, I’m concerned that St. Luke’s seems to find an extraordinary number of Filipinos who are suspected of having TB, but in my experience, after undergoing sputum tests, etc., 98 percent of the time the tests turn out to be “negative.” Meanwhile, people are put through the time, expense and delays of undergoing sputum tests, which almost always turn out negative. When did the Philippines become such a hotbed and breeding ground of TB?

I’ve come across many questionable or head-scratching cases of St. Luke’s suspecting TB, only for the results to turn out negative:

In one case, a Filipino had been in the US for over 15 years. Because of his immigration situation, he was required to return to the Philippines for immigrant visa processing through an approved provisional waiver. Just before leaving for the Philippines, he had his annual physical exam, with no issues showing up in all of the tests. His wife was also a nurse and fully monitored his health condition, as any Filipino wife would. Still, when he went for his medicals at St. Luke’s, they said a spot appeared on his X-rays, and he had to undergo sputum tests for several weeks. Of course, the results turned out to be negative. But how could someone living in the US for 15 years and passing a US medical exam suddenly contract TB once he was tested at St. Luke’s? As a result, what should’ve been a relatively short trip required him to stay for many additional weeks.

In another case, a child was aging out (turning 21 years of age), but was not covered or protected by the Child Status Protection Act (CSPA) and therefore had to arrive in the US before midnight of her 21st birthday. Unfortunately, St. Luke’s thought her mother (the principal applicant) had a spot on her lungs and therefore showed signs of TB. The mother had to undergo sputum tests that took several weeks, by which time the child had aged out. The tests turned out negative, but because of the delay, the child had to be left behind, as she was no longer included under the petition.

In yet another case, a Filipina was being petitioned by her US citizen daughter and hoped to get into the US as soon as possible because her own mother was in critical condition and she wanted to arrive in the US to see her mother “one last time.” With the immigrant visa interview scheduled, she first went to St. Luke’s for her medical exams, but they saw spots and required her to undergo sputum tests. By the time the tests were completed, the mother had already died. Adding pain and insult to injury, the sputum tests were negative.

Does St. Luke’s x-ray machine need to be cleaned or recalibrated? Do the technicians need to be retrained on how to read or interpret test results?

It’s almost as though a person walks through a metal detector naked and yet sets off the metal detector because of the person’s fillings. True, they may have metal in their teeth, but it would seem the metal detector is set a bit too high and is far too sensitive in connection with detecting metal.

In the same way, are the machines or technicians at St. Luke’s overzealous in finding TB, which almost always turns out to be negative? I hope either the embassy or CDC (Center for Disease Control and Prevention) will check into this, as I still find it hard to believe that so much TB exists in the Philippines and yet, after the sputum tests, it almost always turns out negative.

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