TB Tests to be Mandated for Some Visitors from 6 Nations; Japan Aims to Maintain its Low Incidence of the Disease

Courtesy of Osaka Institute of Public Health
An electron micrograph of tubercle bacillus, a kind of bacteria that causes tuberculosis.

The government plans to require foreigners from six Asian countries coming to Japan for medium- to long-term stays to undergo tuberculosis tests before entering the country from fiscal 2024, it said Saturday.

Anyone attempting to enter Japan without documentation proving they are not infected with the disease will be denied entry. This is intended to prevent tuberculosis from entering Japan from overseas.

The requirement was originally scheduled to be implemented in July 2020, when the Tokyo Olympics and Paralympics were scheduled to be held, but was delayed due to the spread of COVID-19.

The six countries are the Philippines, Vietnam, Indonesia, Nepal, China and Myanmar, which account for about 80% of all foreign patients who have been diagnosed with tuberculosis while in Japan.

For those who plan to stay in Japan for more than three months, as they might pose a high risk of spreading the infection, the government will require them to undergo chest X-rays and other tests at a medical facility in each country designated by the Japanese government. They will also be required to obtain a certificate stating that they do not have the disease.

Without this certificate, the government will not issue a visa.

The number of new cases of tuberculosis in Japan was 10,235 in 2022, a decline to 8.2 cases per 100,000 people, falling below the World Health Organization’s standard for low tuberculosis incidence — 10 cases per 100,000 — for two consecutive years.

Although Japan has long been considered a country where tuberculosis is endemic, the number of cases has declined in recent years as a result of increased measures such as medical counseling by public health nurses and a decrease in the number of foreigners entering Japan amid the pandemic. The number of cases is now on par with Europe and the United States.

The government plans to tighten border controls, as foreigners account for about 10% of new tuberculosis cases.

These six countries still have a high number of tuberculosis cases, with 638 cases per 100,000 people in the Philippines, 475 in Myanmar and 385 in Indonesia.

Although the number of new arrivals of foreign students and technical trainees, among others who planned medium- to long-term stays in Japan, declined sharply amid the pandemic, the number is expected to continue to increase as they have again been allowed to enter Japan since March 2022.

Many of the foreign patients diagnosed with tuberculosis during their stay in Japan are young people.

“Given its high potential to infect a large number of people, it is necessary to ensure that the disease should not develop and spread in Japan,” said an official at the Health, Labor and Welfare Ministry.

The United States, Britain, Canada, Australia, South Korea and other countries have similar tuberculosis testing requirements prior to entry into their countries.

The government is working with the six Asian countries on the specific timing of the introduction of the measures. “We want to introduce the measures as early as possible in fiscal 2024 and increase precautions to curb the spread of the disease,” a government official said.