Health Pre-arrival tuberculosis screening for long-term residents

Japan plans to introduce mandatory pre-arrival tuberculosis screening for people from some countries planning mid- to long-term stays starting next fiscal year. The targeted countries are expected to be China, Indonesia, Myanmar, Nepal, the Philippines and Vietnam, with most foreign nationals diagnosed with the infectious disease in Japan coming from those six nations.

The screening requirement will apply to those who hold citizenship of the countries and normally reside in them and who plan to stay longer than three months in Japan for such purposes as study or work. They will be obliged to provide evidence that they are not infected with tuberculosis prior to their arrival or will be denied entry. "We are making final arrangements to start the system in the next fiscal year," Health, Labor and Welfare Minister Takemi told a session of a House of Councillors committee. Japanese fiscal years begin in April. According to the source, the system is likely to be introduced starting with countries that have finished preparations for the tests. The Japanese government was previously considering introducing the mandatory tuberculosis screening system around the opening of the Tokyo Olympics and Paralympics, which took place in 2021, but the plan was postponed due to the coronavirus pandemic.

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That's interesting. I remember I had to take a chest x-ray before going to Japan (from the US) on a student visa in '99. The doctor specifically expressed his surprise that Japan was screening for tuberculosis (TB), which is why it stood out to me. But I never had to do a similar exam for any of the work visas I had. Strange.

At any rate, Japan's concern over TB is not new by any means. But it's interesting that they are increasing screening like that. I wonder why they're targeting TB specifically. There has to be a reason.

On a related note, one of my favorite Japanese authors, Endo Shusaku, had TB.

Mikawa Ossan said:

On a related note, one of my favorite Japanese authors, Endo Shusaku, had TB.

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I wasn't aware of that! He's one of my favourite Japanese authors, too. I read all of his books (that were translated into English ).

When we moved to the US my wife (who is Japanese) was required to get a chest x-ray to get her visa to the US as well. I thought it was odd the US screened Japanese for TB at the time but no real objection.

I was a "TB control worker" in the peace corps in Korea, from '74 to '76. I don't have statistics (was in a rural prefecture, but data was certainly forwarded on the the health ministry). TB was relatively common. Part of the job was giving PPD skin tests to 1st and 6th graders, and it was surprising how many were positive--which meant being exposed and having an immune reaction, and not that they had TB. Most everyone there (koreans) would at some point get a BCG, and most of the 6th graders did get one. BCGs are still common here in Japan, I think most are now on the bottom of a foot, to avoid the 'ugly' shoulder scar. (My wife's father had TB, cured, which during the war kept him out of it all and in a sanatorium.)

At that time, and since, Japan may have been only be a little ahead of Korea in the incidence of TB--they were probably on par during the war/occupation and even after.

One of the reasons to place foreigners as TB workers in korea was the difficulty in having patients continue the full course of their drug regimens. There were three drugs used: one was a daily shot in the buttocks of a gram of streptomycin (x 60days); another was PAS (para-amino-salycylic acid), which was something like 40 pills a day for six months; the third was INH, isoniazid, a small and easy pill to take, but it was supposed to be taken for two years.

Naturally, what would happen is someone was sick, would get the two months of shots (while also taking the other drugs), and about that time they'd be thinking, "hey, enough of this, I feel fine" and they'd stop taking their medicine. The 'foreign expert', the peace corps person, was there to lend credibility and emphasis to the m--keep taking your medicine. And yes, a fair percentage of patients would stop, get sick again, and then come back wondering why...

Drug resistance was certainly a problem even then, and at that time it was that regimen that was free from the govt, while secondary treatments (while they did work, if followed) were too expensive and out of reach for most anyone we dealt with.

Due partially to versions of that scenario playing out all over the developing and undeveloped world, today's multi-drug resistant strains of TB (MDR-TB) are extremely serious, and are hard to cure even with last resort antibiotics. Keeping these MDR strains of TB out of any country should be a no-brainer. Unfortunately, a chest X-ray, is only one small step in the process of discovering if that is the case.

In Nagasaki area anyway all the kids were getting it in the arm still. Saw it even in a three year old family member we played with this summer.