Interim Final Rule Revising Medical Examination of Aliens

Revision of 42 CFR Part 34 (Medical Examination of Aliens) Updated Screening for Communicable Disease of Public Health Significance – Interim Final Rule (IFR)

On October 6, 2008, HHS/CDC posted an Interim Final Rule (IFR) regarding these regulations.

• Interim Final Rule External
• Addendum to the Technical Instructions for Medical Examination of Aliens
• Interim Final Rule: Frequently Asked Questions
• Interim Final Rule: Fact Sheet [PDF – 2 pages]
• View Public comments

Key revisions include:

1. The definition of a “communicable disease of public health significance” remains as those diseases previously listed in the former regulation plus the addition of
   • Any quarantinable, communicable disease specified by current or future Presidential Executive Orders – current diseases:
     • pandemic flu
     • SARS
     • viral hemorrhagic fevers
     • cholera
     • diphtheria
     • infectious tuberculosis
     • plague
     • smallpox
     • yellow fever
   • Any communicable disease that is a public health emergency of international concern reported to the World Health Organization (under revised International Health Regulations of 2005), such as smallpox, poliomyelitis due to wild-type poliovirus, cholera, or viral hemorrhagic fevers (Ebola).
2. Addition of a risk-based approach for medical screening and testing based on medical and epidemiologic factors to determine where and for how long additional screening and testing should be conducted.
3. Updated screening and testing for tuberculosis using current medical knowledge and practice to screen for tuberculosis.

Note: The IFR does not currently affect the required medical examination performed by civil surgeons. Civil surgeons should continue to follow the procedures as provided in the current Technical Instructions for Civil Surgeons.