Updated: January 2020
All healthcare workers should have a documented baseline TB skin test. Staff/volunteers/students will be advised by their workplace/school program when they are required to complete TB screening.
Current clinical guidelines recommend TB screening for all persons less than 50 years old from TB endemic countries (>15 cases/100,000 annually). Refugees/claimants and newcomers within two years of arrival are at higher risk of TB.
All individuals who apply to come to Canada to live, work or visit for six months or more are required to complete an immigration medical exam (IME) by a designated Immigration, Refugees and Citizenship Canada (IRCC) panel physician. While the IME always includes an assessment for active TB, only limited latent TB infection (LTBI) screening is done. IRCC may also require individuals with chest x-ray scarring and other high-risk factors for TB to have a second TB assessment on arrival to Canada. More information is available on our TB Medical Surveillance page.
The Long-Term Care Homes Act, 2007 and Retirement Homes Act, 2010 require that all residents admitted to a long-term care or retirement home be screened for tuberculosis. For more information contact the TB program.
Every year about 300 people are diagnosed with active TB disease in Toronto. The major risk factor for all age groups is having lived in a TB endemic country.
All TB medication is free through Toronto Public Health (TPH) regardless of Ontario Hospital Insurance Plan (OHIP) status. For assistance with referrals, call TPH at 416-392-7457. TPH provides free supportive community care for those diagnosed with active TB disease.
Persons with active TB disease should be managed by a specialist with TB experience. If your patient is less than five years old, human immunodeficiency virus (HIV) positive and/or multi-drug resistant (MDR), refer to a TB clinic/respirologist/infectious disease physician/HIV clinic for treatment.
It is estimated that one in four persons worldwide has latent TB infection (LTBI). The major risk factor in Toronto for all age groups is having lived in a TB endemic country.
To report a positive TB skin test/IGRA, complete all four steps, whether you are ordering LTBI medication or not:
TB-UP is a Ministry of Health program that covers the cost of Ontario Hospital Insurance Plan (OHIP)-billable TB care, such as diagnostic tests (chest x-rays, sputum, other lab tests, TB skin tests, etc.) and physician care (outpatient and inpatient) for uninsured persons.
TB-UP will not cover non-OHIP-billable costs of inpatient TB care.
Contact Toronto Public Health at 416-392-7457 prior to providing service, and ask to speak with a TB nurse to register your patient.
The Ministry of Health will not issue retroactive payments for persons who receive TB diagnostic and/or treatment services prior to registration on TB-UP.
Individuals who apply to live, work or visit Canada for six months or more, are required to undergo an immigration medical exam (IME) by panel physicians designated by Immigration, Refugees and Citizenship Canada (IRCC). If the IME finds no active TB, but finds scarring on the chest x-ray the individual is required to complete a second TB assessment on arrival in Canada as a formal part of their immigration process. This is IRCC’s Post-landing TB Medical Surveillance program.
If you see an individual who requires TB medical surveillance, please follow the steps below.