# Getting ahold of clinic docs in UAE



## socksie (May 10, 2010)

Alright, so all the GCC nations have cracked down on a lot of blood borne diseases lately, the UAE seems to be adding to their list rapidly.

However, there are so many ways a person can be cleared of these diseases. TB in particular.

I heard that hep-B exceptions have been granted for those who aren't working with food or consistently touching people. Exampe: An attorney or business consultant will get a pass, while a chef gets returned to their country of origin. 

Furthermore, a vaccinated person will likely clear hep-B on their own and be "cured". So what is the deal?


Also,

What tests are being run to check for the diseases? 

Are they running PCR or anti-body tests for things like Hep and HIV?

*More importantly, is there are way to speak with a clinic doctor WITHOUT running up a $100 phone tab?*

I am quarantining myself and keeping clear of any "cooties" that anyone may have for the next several months before I even bother seeking jobs. I have had one preliminary test come back negative but I'm going to be extra careful before I go through the rather elaborate ordeal of finding employment and moving to another nation.


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## Jynxgirl (Nov 27, 2009)

Do you have both of these diseases? Is that why this is being asked. Just seeing if this is theoretical or this is serious. If its serious, I would think a doctor would tell you what can be 'got' around.


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## socksie (May 10, 2010)

Jynxgirl said:


> Do you have both of these diseases? Is that why this is being asked. Just seeing if this is theoretical or this is serious. If its serious, I would think a doctor would tell you what can be 'got' around.


Well according to my last round of tests, that were fairly recent and covered all deport able diseases, no I don't have anything worth getting excited about. *I'm working strictly in the world of hypotheticals at this point.*

I would just like to fully understand how this all works in the event of one of those being a false negative and how I am to approach the situation. The information on this sort of thing is very poorly explained, somewhat ambiguous, and remarkably poorly published. With so many people trying to get in, one would assume the countries would be more clear about their rules.

As I am sure you will understand, picking up and moving X-thousand miles away from your country of origin is quite an adventure and I would like to be as fully prepared as possible before embarking on this journey. 

So if anyone can clarify for me, or point me in the direction of comprehensive information, I would greatly appreciate it.


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## socksie (May 10, 2010)

I'm thinking someone who has recently gone in for a renewal and could let me know where they went and what was checked and how. This is good additional info for me.

This whole health inspection thing really isn't made very clear on any UAE site.


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## Jynxgirl (Nov 27, 2009)

We are doing ours right now for our visas as seems things are changing around the workplace. Have to have a blood test done and a chest xray. They did a test for hiv and sexual diseases in the blood panel I believe. Went, and then had to go back after a few days to get the results and signature from the medical office on the medical certificate. No one keep tracks of the certs. If you get a 'false' negative (HUM??), once your false negative isnt going to show up anymore... then go get another one. 

Dubai Health Authority - Directory of Services - Individual Services

If you do not have any of these diseases nor tb then you shouldnt have any problems. :confused2: Maybe I am just a bit confused.


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## socksie (May 10, 2010)

Jynxgirl said:


> We are doing ours right now for our visas as seems things are changing around the workplace. Have to have a blood test done and a chest xray. They did a test for hiv and sexual diseases in the blood panel I believe. Went, and then had to go back after a few days to get the results and signature from the medical office on the medical certificate. No one keep tracks of the certs. If you get a 'false' negative (HUM??), once your false negative isnt going to show up anymore... then go get another one.
> 
> Dubai Health Authority - Directory of Services - Individual Services
> 
> If you do not have any of these diseases nor tb then you shouldnt have any problems. :confused2: Maybe I am just a bit confused.


False negatives are not uncommon. Additionally, the tests do not always work overnight. Some tests, like those for HIV can take 3-6 months after an individuals exposure to return a valid result, though this is uncommon. 
In the US, the local health authorities recommend testing all the way out to 6 months on hep c and HIV for this reason.

Additionally, HEP C can be gotten in the most harmless of means. It is often recommended that people not even share toe nail clippers when one has HEP C. So the most innocent transmissions can occur, hence my "cootie fear"

*Translation: you cannot always trust the tests, so I'll be taking the side of caution.*

Nothing fishy here, just a very caution and curious individual. I'm not too worried, I'd just like to know WHAT it is they do and how they handle every situation.


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## Jynxgirl (Nov 27, 2009)

Understand. Good luck in the move over the uae.


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## sandypool (Sep 12, 2009)

Hmmm I have 'Acquired Immunity" from one of the Hep's (not sure how, prefer not to think about it) and am immunised against the other (I travel a lot and pretty much am immunised against everything). These immunities have had no bearing on my Visa.

HIV wise - well I guess I wouldn't be any more concerned about exposure whether I was coming here or not! Though it is a manageable thing these days, the fact it precludes you from working in the UAE is probably the least of your worries.

The test is quick & painless, I really wouldn't worry too much about it. Assuming you are currently clear of TB, HIV and HBV (think they only test for B), and haven't been exposed in the last 3 months I would just carry on as normal. (Unless that involves sharing needles or something).

If you are curious as to what test they use then all I can suggest is an email to the Dubai authorities who may be able to help you, most of us just give our vile of blood and forget about it.

Good luck with your preparation!


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## sandypool (Sep 12, 2009)

PS HCV - don't worry too much about it. It is transmitted via the blood alone. Normal sterilisation at Salon's, beauticians etc. will clear it from their equipment.


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## socksie (May 10, 2010)

sandypool said:


> Hmmm I have 'Acquired Immunity" from one of the Hep's (not sure how, prefer not to think about it) and am immunised against the other (I travel a lot and pretty much am immunised against everything). These immunities have had no bearing on my Visa.
> 
> HIV wise - well I guess I wouldn't be any more concerned about exposure whether I was coming here or not! Though it is a manageable thing these days, the fact it precludes you from working in the UAE is probably the least of your worries.
> 
> ...


Yeah I've gotten every shot under the sun apparently. I ordered a list from my pediatrician recently and it would appear I've had every shot known to man-kin 

Your acquired immunity is either hep to A or B probably. I was just curious about C because even if you get it, statistically 1/4 of people who catch it will have a correctly tuned immune system that wipes out the virus but a positive antibody result will likely show up if the infection was recent. I don't think those folks are contagious either, and even people who aren't as fortunate are often without symptoms.

Overall I am not that concerned about passing, I believe I'm in the clear but I wanted to know what they did so I could recreate it before traveling out here.

Where do I email these folks at?


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## Elphaba (Jan 24, 2008)

I am not clear why you are so concerned. :confused2: Due to the medical tests that everyone undergoes there are relatively few people in the UAE with infectious diseases. We are not a third world country in that way. The populace are checked way more often then people would be in your home country. We also have a very good healthcare service.

-


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## NAUAE (Jun 4, 2010)

socksie said:


> I heard that hep-B exceptions have been granted for those who aren't working with food or consistently touching people. Exampe: An attorney or business consultant will get a pass, while a chef gets returned to their country of origin.
> 
> Furthermore, a vaccinated person will likely clear hep-B on their own and be "cured". So what is the deal?
> 
> ...


Ok, I think I will add my two bits to the discussion having done a lot of research on the topic due to my paranoia on the same _(waiting for medical results pre-residence visa - should arrive tomorrow or day after)_.

1) As a new visa applicant, the tests that were done for me in JAFZA were HIV Antigen / Antibody, Hepatitis B HBSAg, Syphilis by ELISA Antibody and Chest Xray for TB. So to answer your question, no PCR's are being done and besides, they are very expensive. The HIV test is a 4th generation test which looks at the Ab/Ag combo allowing it to detect infection much quicker (I think within 2 months) as opposed to 3-6 months for previous 3rd generation tests. No testing for Hep C was done. 
2) There is no exception granted for Hepatitis B for "new" visas irrespective of profession. You will be deported. For renewal of visa cases, the profession rules apply i.e. Hep B is only tested and deportable for people in the food industry, healthcare professionals and teachers etc.
3) A vaccinated person in whom the vaccine has taken hold will not "clear" infection, rather he / she will not be infected at all. The level of immunity can be determined from the Hepatitis Surface Antibody test; if reactive, it means you are immune. If you are not immune, you can catch Hep B. If you catch it in adulthood, your body may clear it within 6 months _(HBSAg will be positive during this period, this is called acute infection) _and you will become immune....but if you get tested during this period, you will be deported. For the unlucky few, HBSAg remains positive beyond 6 months and chronic infection results which never goes away but can be controlled via medication.
Hep B or C infection through barber's etc is possible as the virus can survive for a long period outside the body on unsterilised equipment (which has drawn blood). But the risk is low as it would require blood to blood contact i.e. infected scissor with blood on it to cut you and draw blood.
4) Chest Xray will only discover cases of active TB (present or past). Simply put, if you have ever had active TB; you would definitely not have missed it - hard to, with all the coughing up of blood etc
5) Elphaba, that may not be true. Millions of people pass through UAE in transit and are not tested. Furthermore, a lot of tourists indulge in certain pleasures and may communicate diseases onwards. The detection window means that only upon visa renewal will you know if you caught something - unless you are paranoid. Secondly, I would have questions on the quality of the screening methodologies for blood transfusions as in the past some patients contracted Hepatitis C due to contaminated blood in Government hospitals _(and were deported)_

I would agree with sandypool; HIV is something which one should worry about irrespective of a UAE job!


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## NAUAE (Jun 4, 2010)

Sorry, missed out on the tests methodology. Standard HIV, Hep B & C tests looks for the antibodies to the virus and therefore, there is a period of time before the test becomes effective _(antibodies generate in response to virus entering body but it takes time)_. To give yourself peace of mind and especially in case if you are within the window period i.e. within 2-3 months of possible exposure, do the PCR's for HIV, HBV and HCV. 

Do the Qualitative PCRs i.e. ones which look for the virus in the blood as opposed to quantitative PCR which measures viral load _(Qualitative much more sensitive)_. The logic is that in the initial months when the infection is taking hold, the antibody count may not be high enough to be detected by the standard tests but the viral load is very high _(virus replicating...many many copies and antibody production happens during window period to tackle this, but fails and antibodies as a result are detectable beyond window period)_. Therefore a high degree of reliance can be placed on the PCR in the initial months whereas in the later stages of the disease; PCRs for Hep B and C can be negative but with the antibody tests being positive. Why? because the person may have become an inactive carrier with almost undetectable viral loads _(PCR negative)_ but with antibodies to the diseases present in the blood _(Hep B or C positive on the standard test)_.


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## socksie (May 10, 2010)

Thanks,


I was most curious how they handled HEP since it is very common to naturally clear B (US health authorities say 90% do). Statistically, in the US at least, 1/4 people even clear C and as you mentioned, become antigen negative over time for that as well. 

I couldn't figure out why they'd do an antibody, unless as a preliminary for for vaccination, for B but wanted to be certain. Same for C, with the exception of vaccination.

We do not have the 4th generation tests in the US, the manufactures just submitted for approval by the health authorities recently and who knows how long that process will take as our health authorities are very cautious and conservative with these things.

Little of of the above is news to me as far as how testing works in general, but I'm glad you explained it all for the rest of the curious population, very accurate and informative. A link to this or a quotation of it in the "what you need to know" thread would be greatly beneficial to everyone.

It seems that the UAE will be requiring all the same tests I demand of my personal doctor anyway. 


Thank you once again for all your help.


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