CANADA FIRST IMMIGRATION REFORM COMMITTEE
P.O. Box 332, Rexdale, Ontario, M9W 5L3
PH: 905-897-7221; FAX: 905-277-3914
Webpage: http://www.canadafirst.net
cfirc@canadafirst.net

Sept. 5, 1999

IMMIGRATION: CANADA'S SILENT HEALTH THREAT

Dear Member of Parliament;

After Reform's September 3rd, 1999 press conference on Vancouver Island, where Leon Benoit sounded the alarms for tighter health check of immigrants, we would like to forward you some more information on the major health threat immigration poses to Canadians.

All this information is available in more expanded version at: http://www.canadafirst.net

The health effects of Canada's dilapidated immigration system are one of the scariest, most shocking, and disgusting parts of the immigration fiasco.

TUBERCULOSIS

Tuberculosis, thought to be an eradicated disease in Canada is making a considerable comebake thanks to immigration. Take Canada's largest city as an example. "The City of Toronto has 450-500 cases of TB per year with an incidence rate three times the provincial and Canadian average. ... In 1996 the foreign-born accounted for 92% of Toronto's TB cases." (TB in Toronto - Information for Physicians - Ontario Medical Association - March 11, 1999)

This threat of Tuberculosis reaches far and wide in Canada. From the front line immigration officers, who have a great risk of catching the disease, to court judges requiring anyone in the court to wear a surgical mask, to medical doctors like Vancouver's, Dr. Maria Hugi who caught TB while resuscitating a Burmese refugee. She said in the CMA-J that "If I was so easily infected with 30 minutes or less exposure, then almost anyone he was in contact with could have had it with no idea that they had been exposed. This is truly a public health nightmare," Canadian Medical Association Journal (April 20, 1999)

Dr. Maria Hugi, has been sounding the alarm bells for mandatory and immediate medical screening of immigrants and refugees. During an exclusive interview with her published in the Canadian Immigration Hotline, she noted that "'The best thing ever to happen to TB is AIDS. We've let down our guard. TB is the number one killer in the world,' and, thanks to lax screening and an indifferent government, it's heading our way." And in a big way! Health Canada reports a shocking increase in the percentage of foreigners bringing the disease into Canada. In 1996, 63 per cent of the 1,849 TB cases reported were in the foreign born, up from just 35 per cent in 1980. (Health Canada, Health Protection Branch, Laboratory Centre for Disease Control, Tuberculosis in Canada)

Dr. Maria Hugi goes on to say that "All immigrants, including overseas refugees selected abroad, and certain visitors are required to undergo an immigration medical examination prior to entering Canada. ... All in-Canada refugee claimants [illegals who designate themselves are 'refugees' once they're here] are required to undergo an immigration medical examination and requested to do so within sixty days of such a claim."

So TB carrying "refugees" can then flow freely into society without as much as a medical exam before being released!

And as for this idea of Immigrants who are tested abroad. Dr. Lee Ford-Jones, a paediatrician and infectious-disease specialist at Toronto's Hospital for Sick Children writes in the April edition of Paediatrics and Child Health that immigrants who "arrive sick or unvaccinated, [are] slipping through the medical screening process abroad ... [or who] do not see a doctor when they get here. ... People who apply from abroad to immigrate to Canada go through an IME -- short for Immigration Medical Examination, done world-wide by about 1,400 doctors vetted by Citizenship and Immigration Canada. ... Screening abroad is so unreliable that a Canadian doctor whose patient is a new immigrant or refugee 'does well to assume that nothing has been undertaken and evaluate accordingly."

"More than 1,800 people will have to undergo tuberculosis testing next week after a Scarborough high school [Agincourt Collegiate] student was diagnosed with the potentially fatal disease." (Toronto Sun, January 13, 1998).

"Tuberculosis tests will be carried out on 200 Revenue Canada employees next week after a co-worker at a Town Centre Ct. office tower contracted the disease." (Toronto Sun, February 11, 1998)

"More than 20 people who attend St. Patrick's Adult Day School in Ottawa are being monitored for signs of tuberculosis after the highly contagious infection was discovered in a student. ... The woman, who had emigrated from the Philippines several years ago ... is being monitored daily by a homecare worker. [Let us hope the admitting immigration officer has offered to pick up the tab] ... The disease, normally found in lungs or lymph nodes, has become so rare in North America that doctors no longer vaccinate children against it." (Ottawa Citizen, January 30, 1998)

TB is a reportable disease. When students or co-workers are advised to report, it may come as a rude shock, but how were concerns over an emerging AIDS epidemic and tainted blood scandals handled by Canadian authorities? Well the crucial thing was to save their bacon, ensure that the gay community was not "scape-goated" and - until the lawsuits started rolling in - deny that there WAS a problem. During the 1950s and 60s, emigrants were subject to rigorous and recurring medical examinations before they qualified for admission to Canada.

The question of "DPs and Disease" occupied pride of place in newspapers at a time when Canadians actually believed that fit and healthy immigrants were in some way, superior. This instinct for self preservation came to be seen as "not quite nice" and fell into disrepute about the time the immigration axis shifted to precisely those areas of the world most crippled by debilitating, wasting diseases. One wonders in vain why the Government of Canada would neither alert Canadians, nor recommend BCG vaccinations, confronted as we are by the double-barrelled threat of a global TB epidemic, and a collapsing domestic health care system. Canada's public health strategy consists of maintaining the same indictable silence, while presumably waiting for infection rates among the Canadian-born to match those of newcomers -- and they almost certainly will -- to do otherwise could very well hurt someone's feelings. Nor has the threat posed by tuberculosis gone unnoticed.

Last September, Toronto's medical officer of health, Dr. David McKeown warned, "the conditions for such resurgence already exist in Toronto. These include: high levels of immigration from countries where TB is prevalent (78% of cases are foreign born), increasing prevalence of HIV infection, [AIDS is the leading cause of premature death among men in Toronto] crowding in drops-ins and shelters for the homeless who are at increased risk, and increasing poverty. Currently 15 per cent of TB cases are resistant to commonly used antibiotics, 9 percent are known to be infected with HIV, and nine percent are homeless. ... Based on the combined 1997 budgets of the seven current municipalities, public health represents 1.7% of the expenditures of the new Toronto." (Threats to Health in the Changing City: Choices for the Future, September 9, 1997)

What's wrong with this picture? High immigration was supposed to eliminate poverty and homelessness. Aren't we equally assured that robust immigrants are far healthier than doddering old Canadians? Perhaps 'tuberculosis management opportunities' will eventually rival ESL as a growth sector in Canada's mighty immigration industry!

The identical trend has been noted in Australia, where MP Pauline Hanson, "accused successive governments of letting people infected with hepatitis B and tuberculosis migrate to Australia over the past two decades. 'I put it to you that rather than discriminate against seriously infected foreigners, our governments chose to discriminate against its own citizens and endanger all Australians,' she told a meeting in Brisbane. 'To add insult to injury, they further endangered us by not embarking on a drive for immunisation to protect us because to do so would have meant disclosing what they exposed us to.' ... 'We must keep our young people, especially students sharing school equipment and things like musical instruments, from being exposed to diseases imported from overseas.'" (South China Morning Post, March 23, 1998)

"A sudden rise in new tuberculosis cases has prompted fears of a resurgence of the killer disease in Hong Kong. The rate of increase has doubled over the past year." (South China Morning Post, March 23, 1998) Australia (population 18,031,000 in 1995) "has an immigration quota for the fiscal year to June 30, 1998, of 68,000." (Toronto Star, March 20, 1998) Compare Canada (population 29,600,000 in 1995) which (again) plans to make room for 200,000 - 225,000 immigrants during 1999.

"The infection rate among foreign-born residents under the age of 30 is 20 times that of Canadian-born residents. ... People born outside of Canada accounted for 77 per cent of TB cases in Montreal, although only 23 per cent of the population is foreign-born. ... [Montreal public health researcher, Dr. Terry Tannenbaum, ventures,] 'It's important to treat every case of tuberculosis, so we need programs that are adapted to cultural diversity and which ensure that drugs are free.'" (Globe and Mail, March 21, 1998)

The drugs aren't really "free" though - are they? One might as well say that ESL programs adapted to cultural diversity are "free" too.

"During the past decade, rates of TB among Canadian-born residents have continued to decline. ... On the basis of the population in the midpoint census year of 1991, [there was] a decline in annual incidence from 5.4 to 3.3 per 100,000. During the same period, the number of cases among foreign-born residents rose from ... 18.8 to 24.4 per 100,000. ... [Globally,] estimates for 1990 of TB incidence, which takes into account under-reporting, were 237 per 100,000 in Southeast Asia, 191 in Africa and 127 in Latin America. About 95% of the 8 million cases reported annually occur in the developing world. ... Over the past 12 years the number of immigrants to Canada has more than doubled, from 84,302 in 1985 to the current level of about 250,000. At the same time, the predominant places of birth of these new Canadians has shifted substantially. Europe was the major source in the 1960s, whereas Asia and increasingly Africa and Latin America, regions with high rates of TB, have been the major sources in the 1990s.

... It is therefore not surprising that the epidemiology of TB in Canada increasingly reflects patterns of immigration in terms of not only the countries of origin of the immigrants, but also their chosen destinations. ... The chest radiography screening of applicants required by Immigration Canada eliminates people with currently active pulmonary TB. [As was stressed in the November newsletter, this "technology" is widely viewed as clownishly outmoded -- the sputum test is preferred by nations that are serious about eradicating the disease. The chest X-ray identifies only about 70% of lungs ravaged by advanced pulmonary - and extremely contagious - tuberculosis.

The thoroughly discredited X-ray is unable to detect infected, but currently inactive cases, nor will it identify non-respiratory strains like adenitis, genitourinary, abdominal or bone and joint varieties. About the best that can be said for the chest X-ray, is that countries which rely upon such an ineffectual method will never have to officially admit to hosting an epidemic - because they will never really know exactly how many people are actually infected.] ... In southern Alberta the mean period between arrival in Canada and diagnosis was 11.2 years ... in Montreal 33.2% of the foreign-born residents with TB presented within 2 years of their arrival in Canada and 56.3% within the first 5 years. These data suggest an earlier onset of disease in Montreal than in southern Alberta." (Globalization of tuberculosis, E. Anne Fanning, MD, CMAJ, March 10, 1998)

It is tempting to speculate whether an infectious person manages to come into contact with the same number of people during 2 busy years in densely populated Montreal as his counterpart might do over the course of 11 years in sparsely populated southern Alberta.

In Montreal, it is people supposedly in their most productive years who suffer "the highest age-specific rate for foreign-born residents (62.8 per 100,000) occurred among those aged 15-29 years. For Canadian-born residents, the highest age-specific rate (10.0 per 100,000) occurred among those aged 65 and over. ... Among the patients born outside Canada 24.0% were from Haiti (mean annual rate 133.5 per 100,000) and 14.3% from Vietnam (mean annual rate 137.0 per 100,000)." (Epidemiology of tuberculosis in Montreal, Paul Rivest MD, MSc; Terry Tannenbaum, MD, MPH; Lucie Bedard, MSc, MPH, CMAJ, March 10, 1998)

During a five year study of new TB cases in southern Alberta, "immigrants to Canada accounted for 70.6% of the cases. On the basis of a mid-study estimate that foreign-born residents accounted for 16% of the population of southern Alberta, the annual incidence of TB in this group was 25.8 per 100,000, which is more than 21 times greater than the annual incidence among Canadian-born non-aboriginal residents (1.2 per 100,000). ... Of the [infected] immigrants ... 73.4% were born in Asia ... China, Hong Kong, Vietnam, the Philippines and the Indian subcontinent. [By 1996, these countries represented five of our top immigration sources.]

A 1990 survey "estimates that up to 600 people per 100,000 in China had some form of tuberculosis ... in India today, every second adult is infected with the tuberculosis bacterium." (World Health Organization Annual Report, 1997)] ... Compliance with preventative therapy may also be particularly poor among Asian immigrants. ... The mean interval between arrival in Canada and diagnosis of disease was shorter for those from Asia (9.1 years) ... than those born in other regions (17.2 years). ... This study has shown that the increased risk of TB among immigrants persists for many years after their arrival in Canada. ... There was a trend for a longer period to diagnosis among younger immigrants. [Hardly encouraging news for Canadian schoolchildren who might attend day-care and graduate from high school alongside classmates who may or may not become infectious at any time] ... The risk of TB for immigrants is the same as prevails in their countries of origin. ... It can therefore be anticipated that the expected increase in the proportion of foreign-born residents in the Canadian population will be associated with an increase in the incidence of TB." (Tuberculosis among immigrants: interval from arrival in Canada to diagnosis - a 5-year study in southern Alberta, Robert L. Cowie, MD; Jill W. Sharpe, BN, CMAJ, March 10, 1998)

"Citizenship and Immigration Canada protects the safety and public health of Canadians through the medical examination of all immigrants." (CIC Report on Plans and Priorities 1998-99, March 26, 1998)

"22 countries account for 80 per cent of the world's tuberculosis cases ... Afghanistan, Bangladesh, Brazil, China, Democratic Republic of Congo, Ethiopia, India, Indonesia, Iran , Mexico, Myanmar [Burma], Nigeria, Pakistan, Peru, Philippines, Russia, South Africa, Sudan, Tanzania, Thailand, Uganda and Vietnam." (Vancouver Sun, March 19, 1998)

Canada's top ten source countries for immigration in 1996 were: Hong Kong, India, China, Taiwan, Philippines, Pakistan, Sri Lanka, U.S., Iran, U.K........... (Citizenship and Immigration Canada)

"A study released by the World Health Organization last October said that eruptions of antibiotic-resistant TB in "hot zones" on at least four continents threatened the global spread of virulent new strains of the disease. Hot zones ... were found in India, Russia, Latvia, Estonia, Argentina, Dominican Republic and Ivory Coast." (Edmonton Journal, March 25, 1998)

"Multi-resistant TB drugs can cost up to $250,000 U.S.. per patient to treat, with a cure rate of only 50%." (Toronto Sun, October 23, 1997) "Russia has the dubious distinction of harbouring the most TB cases in the developed world and openly resisting WHO recommendations for diagnosis and treatment. ... Russian health officials, for example, insist on requiring costly chest X-rays to diagnose TB, rather than sputum samples. ... The rising number of TB infections in previously low incidence countries to which Russians have been emigrating has made health official's worst fears a reality -- the epidemic can and will transcend borders and social classes. [This ought to please the Marxists, they've been looking for an equalizing tool to eliminate distinctions for some considerable time] ... The rate in this country of 148 million is 75 per 100,000." (Toronto Star, March 25, 1998) It's unlikely that Russia's example -- allowing a health care system to crumble -- will serve as a cautionary tale for Canadian officials; it's been a very long while since Canada troubled itself with the health and well being of Canadians.


Protect yourself and your family!

Read the Center for Disease Control's flyer and find out how tuberculosis is spread


Vancouver Doctor warns: Poor Screening of Immigrants Poses Serious Health Hazard

A powerful immigration lobby and weak, rudderless government officials are endangering the health of Canadians, a Vancouver doctor charges. "Immigrant and refugee lawyers are fuelling this corrupt system. All they want to do is line their pockets. They think nothing of protecting the health of Canadians," she says.

"We out here in the Vancouver emergency departments, are still reeling from the social toll taken by your recent tragic lack of screening of the Honduran refugees who entered the country in August, 1998," Dr. Maria Hugi told Immigration Minister Lucienne Robillard in a February 4 letter.

The Swiss-born, Vancouver-raised doctor knows what she's talking about. She herself caught TB while resuscitating a Burmese refugee. "If I was so easily infected with 30 minutes or less exposure, then almost anyone he was in contact with could have had it with no idea that they had been exposed. This is truly a public health nightmare," she told the Canadian Medical Association Journal (April 20, 1999) Unlike the all-too-typical Canadian who takes his lumps from an uncaring system and slinks away silently, Dr. Hugi chose to speak up.

In her letter, the spirited 40-ish doctor explained the health chaos caused by allowing in a horde of self-styled Honduran "refugees." "The other day, one of my colleagues treated a Canadian woman whose jaw had been broken by a Honduran refugee. Last week, I treated a young 19-year old Honduran refugee, 36 weeks pregnant who would have been admitted to Canada on August 5, 1998 and who had received no prenatal care until I saw her. Needless to say, she had to be admitted to hospital (her blood count was dangerously low) and, after calling three hospitals, I finally managed to find her a bed. Through an interpreter, she kept insisting that she was 20 weeks pregnant and that her last menstrual period occurred after she entered Canada. In addition to screening refugees for communicable diseases, pregnancy screening might be warranted for young refugees so that we can offer them good prenatal care, so vital to the well-being of the mother and baby."

This Honduran peasant girl who spoke no English, thus, got a scarce bed and some lady who was a third generation Canadian, with an injured back, was sent home. In an interview with the Canadian Immigration Hotline, Dr. Hugi charged: "People who've paid into the system are turned aside in this irrational system in favour of people who've never paid a dime."

Dr. Angus Rae is a neurologist at St. Paul's Hospital in Vancouver, Dr. Hugi explains. He has complained about desperately ill foreigners being put on dialysis which is "hideously expensive." Because of the urgency of their need, "they jump the queue, even though they've never paid taxes here."

"When they let in drug-running gangsters from Honduras, there's a social cost," Dr. Hugi emphasizes. "If I need my hip replaced, I mightn't get it because some drug addict needs his valves replaced."

Dr. Hugi tells of an immigrant student at Simon Fraser University with full-blown tuberculosis. The costs of this lapse of government screening was that "they had to check 450 people the student had come into contact with." Foreign "students are not screened very well," she observes.

"The best thing ever to happen to TB is AIDS. We've let down our guard. TB is the number one killer in the world," and, thanks to lax screening and an indifferent government, it's heading our way.

The doctor illustrates the problem of the lax screening of immigrant students with the story of a doctor friend of hers who treated an infant from sub-Saharan Africa who had rampant AIDS. "The parents refused to be HIV-tested," says Dr.Hugi. "They were visa students."

"When we think of AIDS, we think of TB," says Dr. Hugi. the indiscriminate use of antibiotics in Third World countries has led to drug resistant TB. "Southeast Asia and the Philippines is where TB became drug resistant."

Russia is another medical timebomb. "They're not immunizing people for diphtheria anymore in Russia. They really need to screen those Russian immigrants," she warns. Health Checks Penalize First World Immigrants

Ironically, says Dr. Hugi, health checks penalize First World would-be immigrants. "If you're an immigrant from Sweden, the U.S., or Switzerland and you have hypertension or high blood pressure, your detailed medical history will document it. Forget about getting in here."

On the other hand, in Third World lands, she explains,. "there's a black market in chest x-rays and clean bills of health. We should send Canadian doctors who can't be bought to test would-be immigrants," she advises.

"There are just no teeth to refugee health checks in Canada," she charged. "Those who come without documents to the U.S. are put into holding tanks and sent back!"

Those Who Take In Refugees Put Their Own Families At Risk

"Magnanimous Canadians who take refugees into their homes aren't told that many refugees have contagious diseases. These people are putting their families at risk," Dr. Hugi warns.

"I'm looking at this in a very practical, scientific way. The only reason we don't have Gypsy Moth infestation here is we have very strict screening of plants and fruit." It's the same with heartworm in pets. There's a very strict regime of quarantine of pets coming in, she explains. "We're ruthless with trees, livestock, or pets, but we're muddled when it comes to humans."

"Mother Nature is ruthless. She'll infect you with TB, if you get in the way," she warns. "AIDS has set us back 100 years in terms of good public health practices. Do you think Mother Nature gives a damn about the AIDS lobby?" she asks.

The situation of the Honduran "refugees" is a farce. Dr. Hugi explains that since 1996, when the U.S. began detaining illegal refugees, the numbers of Hondurans dropped from 100,000 a year to 25,000. When the Hondurans started pouring across the Texas border, the Americans set up detention tents, and the influx stopped. Now illegals are detained for 10 days, If their claim seems credible, they're released on bond. In Canada, in most cases, they're just released until their hearings.

Other dread diseases are making a comeback in part, thanks to lax immigration screening. "Syphilis is coming in from Southeast Asia," says Dr. Hugi, "carried by people coming back from Southeast Asian sex trips. The Thais really sell their young -- sacrificing their kids to the sex trade." Little Sympathy from the Government

Dr. Hugi has had to submit to an intense regime of drug treatment for the TB she contracted. She counts herself lucky that it was not the drug-resistant strain.

However, she received scant sympathy from officials at Citizenship and Immigration Canada. She sent two letters about her concerns on June 20 and October 1, 1998 to the Immigration Department. Not until December 2, nearly six months after the first letter, did Joan Atkinson Director General of the Selection Branch of the department bestir herself to reply.

Clearing away the tangled verbiage, Atkinson essentially said that emergency room work is a high risk profession: 'them's the breaks' and, anyway, refugees and immigrants are not to blame. "Health risks ... are an essential element of such work and are not posed by one particular client group."

"Canada is, I believe, justifiably proud of its stance with regards to providing a safe haven for persons at risk of persecution. All immigrants, including overseas refugees selected abroad, and certain visitors are required to undergo an immigration medical examination prior to entering Canada. ... All in-Canada refugee claimants [illegals who designate themselves are 'refugees' once they're here] are required to undergo an immigration medical examination and requested to do so within sixty days of such a claim. Furthermore, there are provisions for not only the immigration medical examination fees to be paid by this department, but also any required emergency and essential health care for those in-Canada claimants who lack the financial resources to pay for same."

Atkinson used the obfuscating dodge of "privacy" to thwart Dr. Hugi's inquiries into the exact status of the Burmese AIDS patient who had infected her with TB and subsequently died. "If your patient was an in-Canada refugee claimant, then he would have been referred for medical examination after making his refugee claim. If, as a result of this medical examination, tuberculosis was suspected, appropriate referral for investigation and treatment would have followed. ... Medical confidentiality prevents the identification of the individual about whom you write. Without specific knowledge of this person it is impossible to determine his immigration status." [Other than the fact that he is currently dead, and, presumably, no longer entitled to privacy!]

The letter illustrates Dr. Hugi's complaints about Canada's toothless policies. A self-proclaimed refugee may be asked and advised to go for a health check, but failure to do so does not result in removal. A desperately ill person may be "referred" for treatment, which the Canadian taxpayers pay for, but this costly and often contagious person is not removed and no consequences follow his not taking the treatment that is advised.

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CANADA FIRST IMMIGRATION REFORM COMMITTEE
P.O. Box 332, Rexdale, Ontario, M9W 5L3
PH: 905-897-7221; FAX: 905-277-3914
Webpage: http://www.canadafirst.net
cfirc@canadafirst.net

September 5, 1999

Press Release:

TAKE TB SERIOUSLY CFIRC WARNS MPS

Tuberculosis Cases by Origin - Canada: 1980 and 1996
HEALTH CANADA
Laboratory Centre for Disease Control
.
Tuberculosis Cases by Age Group and Origin - Canada: 1996
HEALTH CANADA

Laboratory Centre for Disease Control

"Tuberculosis, not the Y2K may be the real millennium bug, and Canada is an open target because of lax immigration screening," warned Paul Fromm, Director of the Canada First Immigration Reform Committee, said today. Canadian immigration authorities are failing spectacularly in protecting Canadians from the scourge of tuberculosis, Fromm charged, following up on Reform's September 3, 1999 press conference on Vancouver Island, where Leon Benoit sounded the alarms about the health threat immigration poses to Canadians.

An especially virulent and drug resistant form of tuberculosis is exploding in poverty stricken Russia. Paul Fromm, Director of the Canada First Immigration Reform Committee, said today.

According to comments by Dr. Hans Kluge, director of Medecins Sans Frontieres' tuberculosis programmes in Russia, 10 per cent -- that is, 100,000 to 110,000 people -- of Russia's prison population in infected with TB and, of those, at least one third carry the multi-drug resistant superbug. According to the South China Morning Post (March 24, 1999): "When multi-drug-resistant TB appeared in New York in the early 1990s, it cost authorities US$250,000 to effectively treat each patient. Between 1991 and 1993 the American health services spent US$1 billion on controlling it."

Health Canada reports a shocking increase in the percentage of foreigners bringing the disease into Canada. In 1996, 63 per cent of the 1,849 TB cases reported were in the foreign born, up from just 35 per cent in 1980. (Health Canada, Health Protection Branch, Laboratory Centre for Disease Control, Tuberculosis in Canada)

In November 1997, Toronto was reporting 140 - 170 cases of tuberculosis a year. Now there are 450 to 500 new cases recorded in Toronto (a three-fold increase in less than a year and a half).

The major source of new TB cases in Canada are immigrants and Canada's medical establishment has been sounding the alarm for several years, Fromm explains. "The City of Toronto has 450-500 cases of TB per year with an incidence rate three times the provincial and Canadian average. ... In 1996 the foreign-born accounted for 92% of Toronto's TB cases." (TB in Toronto - Information for Physicians - Ontario Medical Association - March 11, 1999)

According to the World Health Organization Annual Report (1997), in 1990 "up to 600 people per 100,000 in China had some form of tuberculosis; ... in India today, every second adult is infected with the tuberculosis bacterium." Distressingly, India and China rank high among the top ten sources of immigration to Canada. In 1996, according to Facts and Figures, 1996: Immigration Overview, published by Citizenship and Immigration Canada, India and Mainland China were our second and third largest source of immigrants. Hong Kong placed first, said Fromm.

"Canada must screen newcomers before they enter the general population," said Fromm. "Those with active tuberculosis must be excluded. This is especially important with the more than 25,000 persons who show up at our airports and claim 'refugee' status. Almost all are immediately released into the general population and it takes months before their claims are assessed," said Fromm.

"Among these unscreened people, we may well have far worse than Typhoid Mary!" he warned.

Transport Canada should also consider demanding proof of a recent TB test from travellers from tuberculosis hotspots, like Russia, China, India, and Southeast Asia boarding Canadian carriers. "We fussily deny people the right to smoke on planes, although the harm caused by secondary smoke is largely unproven,": Fromm said. "However, we take no precautions to screen out those infected with tuberculosis. Yet, we have a number of recent examples of several people contracting TB after just a few hours of exposure on a plane to someone carrying this blight."

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