Citizenship and Immigration committee  Yes.

Citizenship and Immigration committee  I don't think we're able to answer that question.

Citizenship and Immigration committee  I'm sorry, that's outside our....

Citizenship and Immigration committee  That's a huge topic. It might be something you might like to ask colleagues at the Centre for Addiction and Mental Health to talk about because there are specialists there. Some of it is their loss of status because Canada accepts people on the basis of being highly qualified, but when they get here, they often can't work in the fields in which they've qualified.

Citizenship and Immigration committee  I think that's outside our.... You would have to know more about how the labs work in different countries. In some countries, it would be easy to get a lab that was fully accredited by some kind of international standard. The other piece of it, if you're worried about identity, is to have the place where the medical tests take place accredited, because of course, there are ways of trying to ensure that people are giving specimens themselves and are not bringing them along.

Citizenship and Immigration committee  Has that ever been an issue with TB cases?

Citizenship and Immigration committee  I would add a focus to protect the health of immigrants and would include a health screening on arrival. They'd have to have access to health care to do that. So one is access to a screening process on arrival in Canada. I suppose another thing would be that the immunization records should be part of the health check before they arrive.

Citizenship and Immigration committee  It could be. I'm not sure I know enough about the other departments. We mentioned the Public Health Agency of Canada. They would be a good group to involve, for sure.

Citizenship and Immigration committee  There is a similar system in the U.K. It's called Port Health there. These are portals of entry into the U.K. It's very similar to what is here. There is somebody whose responsibility it is to pick out people who are sick when they're travelling, or who might present a security risk.

Citizenship and Immigration committee  There is, but it's not the detailed screening we were talking about, where people arrive and they get fully checked out for things like hepatitis or HIV. You don't see that when you walk through an airport. The airport screening is more about somebody who has one or more of those 56 diseases that are reportable.

Citizenship and Immigration committee  Thank you.

Citizenship and Immigration committee  The problem is that the women are getting infected in Canada, and there are outbreaks in Canada. It's not something that immigrants are bringing to Canada. We have plenty of our own. The women are screened in pregnancy, but if they get infected afterwards, during pregnancy, they're not going to be re-screened.

Citizenship and Immigration committee  We do our absolute best to try to know what's going on. There is a worldwide network of people who are examining data every single day. The World Health Organization picks up information from all around the world and relays it to the Public Health Agency of Canada, and there is a cascade system within Canada that goes through the provincial and territorial governments and into agencies such as the one I work in, and we work very closely to keep a constant watch for new emerging issues around the world.

Citizenship and Immigration committee  I'm not sure. I think it's the travel. It depends. It's hard to identify whether it is Canadians travelling or immigrants. The risk depends on where they go. The well-known factor is people visiting friends and family. It's people who are Canadians, but who are visiting friends and family in areas of the world where diseases are more common than they are in Canada.

Citizenship and Immigration committee  We've just had a huge outbreak of measles in Quebec linked to travel to France, so I wouldn't rely on it.