It is not at all unusual, now, to encounter refugees with active tuberculosis.
When I started in this game, a long time ago, you needed a normal chest Xray and a medical clearance to get on the plane over in Africa. Then, slowly, the standards for “normal” on the film started to slide.
The medical exam turned into a checklist. The folders they had to have around their necks in a plastic envelope got thinner, and then disappeared. “It all goes to Atlanta electronically”.
Now, sometimes, they get off the plane into an ambulance and right to the ER, sick and speaking a language no one knows. Fortunately, federal regulations require hospitals to provide services in 73 languages, by qualified interpreters, at no cost to the refugee, the sponsoring organization, or the government.
No time for skin testing?