Medical Screening of U.S.-Bound Refugees

Central American Refugee Health Profile

Overseas Medical Examination

An overseas medical examination is mandatory for all refugees identified for resettlement to the United States and must be performed in accordance with CDC’s Technical Instructions. The overseas medical examination is performed by panel physicians selected by the U.S. Department of State. CDC provides the regulatory and technical oversight and training for all panel physicians. The purpose of the medical examination is to identify applicants with inadmissible health-related conditions.

Central American refugees and parolees admitted through the CAM program receive medical assessments from panel physicians before arrival in the United States (Figure 3). As this program is relatively new, additional components of the medical screening may be added as more individuals are approved for resettlement. Those entering under different mechanisms do not receive medical assessments by panel physicians before entry.

Information collected during the overseas medical examination is reported to the Electronic Disease Notification system (EDN) and is available to state refugee health programs in the states where the refugees are resettled. Refugees are not required to receive any vaccines before they are admitted into the United States.

Figure 3: Medical Assessment of United States-bound Central American Refugees

* Class B1 TB refers to tuberculosis fully treated by directly observed therapy, or abnormal chest x-ray with negative sputum smears and cultures, or extrapulmonary TB.
Figure 3: Medical Assessment of United States-bound Central American Refugees

* Class B1 TB refers to tuberculosis fully treated by directly observed therapy, or abnormal chest x-ray with negative sputum smears and cultures, or extrapulmonary TB.

Pre-departure Medical Screening

If previously diagnosed with Class B1 TB (tuberculosis fully treated using directly observed therapy, or abnormal chest x-ray with negative sputum smears and cultures, or extrapulmonary TB), Central American refugees receive a pre-departure medical screening approximately 3 weeks before leaving for the United States.

Post-Arrival Medical Screening

CDC recommends that refugees receive a post-arrival medical screening (domestic medical examination) within 30 days of arrival in the United States. The Department of Health and Human Services’ Office of Refugee Resettlement (ORR) supports medical screening for those who have been granted refugee status. The purpose of these comprehensive examinations is to identify conditions for which refugees may not have been screened during their overseas medical examinations and to introduce refugees to the U.S. healthcare system. CDC provides guidelines and recommendations for the domestic medical examination of newly arrived refugees, which state health departments oversee and administer. State refugee health programs determine who conducts the examinations within their jurisdictions; these may be performed by health department personnel, private physicians, or federally qualified health centers (FQHCs). Most state health departments collect data from the screenings.

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