Is TB screening required for foreign residents entering Japan?

Depending on your country of origin and visa type, you may be required to undergo a medical examination including chest X-ray screening for tuberculosis before a visa is issued, or after arriving in Japan. MHLW maintains a list of countries with elevated TB incidence for which entry screening applies. Annual workplace health checks in Japan include a chest X-ray, which also functions as ongoing TB surveillance.

Is TB treatment free in Japan?

Yes, for active tuberculosis. Japan classifies tuberculosis under the Infectious Disease Control Law as a notifiable disease requiring public health management. Treatment for active TB is publicly funded and administered under supervision of the public health center — patients do not pay the standard copayment. The municipality covers treatment costs.

What is DOTS and will I need to do it?

DOTS (Directly Observed Treatment, Short-course — 直接服薬確認療法) is the internationally recommended approach to TB treatment where a health worker or trained volunteer observes the patient taking each dose of medication. Japan's public health centers administer DOTS for active TB cases. It is required for active disease to ensure treatment completion and prevent drug-resistant TB.

What should I do if I think I have been exposed to tuberculosis?

Contact your local public health center (保健所, hokenjo) and tell them you believe you have been exposed to a TB-positive person. The hokenjo will arrange contact tracing and screening. If you are a close contact of a notified TB case, you will be offered tuberculin skin testing or IGRA blood testing to determine whether latent infection has occurred.

Work & Conditions

Tuberculosis Screening and Treatment in Japan

How Japan's tuberculosis surveillance and treatment system works for foreign residents — who is screened, what treatment looks like, and what the notification and support obligations are.

Who this is for

Foreign residents in Japan who are subject to TB screening requirements, or who have been diagnosed with or exposed to tuberculosis.

Tuberculosis in Japan’s public health system

Tuberculosis (結核, kekkaku) is a legally notifiable disease in Japan under the Infectious Disease Control Law (感染症法). The public health management of tuberculosis is centralized at prefectural public health centers (保健所, hokenjo), which are responsible for case notification, contact tracing, patient support, and treatment supervision.

Japan’s TB incidence rate has declined significantly over the past three decades due to sustained screening and treatment programs, but remains higher than in some high-income countries. MHLW and the National Institute of Infectious Diseases (NIID, 国立感染症研究所) publish annual surveillance data.

Who is screened and when

Entry-level screening. Japan requires visa applicants from certain countries with high TB incidence to submit medical certificates, including chest X-ray results, as part of the visa application. The list of countries subject to enhanced entry screening is managed by MHLW and Ministry of Foreign Affairs and changes periodically.

Workplace annual health check. The annual workplace health examination (定期健康診断) mandated for all employees includes a chest X-ray (胸部X線検査, kyōbu X-sen kensa) specifically as TB surveillance. Any finding requiring follow-up is referred to a physician for further evaluation.

Municipal TB screening programs. Many municipalities conduct free annual or biennial TB screening for all residents, typically through chest X-ray campaigns at municipal facilities. Foreign residents are eligible to participate and are encouraged to do so.

What happens when TB is suspected

If a chest X-ray shows findings consistent with tuberculosis, further diagnostic testing is ordered:

Sputum smear and culture (喀痰検査, kakutan kensa): examines sputum for mycobacteria
CT imaging for more detailed assessment of lung lesions
Nucleic acid amplification testing (NAAT) for rapid species identification

A confirmed positive case triggers mandatory physician notification to the public health center within 24 hours under the Infectious Disease Control Law. The hokenjo then initiates case management, contact tracing, and treatment coordination.

Treatment for active tuberculosis

Treatment for active TB in Japan is provided through the public health system with no cost to the patient — the municipality bears the treatment expense. This applies to all residents including foreign nationals.

The standard first-line treatment regimen follows international guidelines: a six-month course of isoniazid, rifampicin, pyrazinamide, and ethambutol (abbreviated as HRZE/HR). Treatment must be completed fully to avoid drug-resistant strains developing.

Japan uses DOTS (直接服薬確認療法) for active TB cases. A public health nurse (保健師, hokenshi) from the hokenjo visits regularly or arranges observation of medication-taking. For foreign residents with language barriers, hokenjo staff increasingly have access to interpretation services, and some centers have multilingual TB support materials.

Latent TB infection

Latent TB infection (潜在性結核感染症, senzaisei kekkaku kansenshō) — where TB bacteria are present but inactive and not causing symptoms or disease — may be diagnosed after contact tracing or as an incidental finding. Preventive therapy (isoniazid for 6–9 months) is recommended in certain situations, particularly for close contacts of smear-positive cases and immunocompromised individuals. Discuss your situation with the hokenjo or a treating physician.

Last reviewed: September 2026

Key terms

English	Japanese	Romaji
Tuberculosis	結核	kekkaku
TB screening	結核検診	kekkaku kenshin
Chest X-ray	胸部X線検査	kyōbu X-sen kensa
Sputum smear test	喀痰検査	kakutan kensa
Directly observed treatment (DOTS)	直接服薬確認療法	chokusetsu fukuyaku kakunin ryōhō
Infectious disease notification	感染症届出	kansenshō todoke-ide
Public health center (TB)	保健所（結核担当）	hokenjo (kekkaku tantō)
Latent TB infection	潜在性結核感染症	senzaisei kekkaku kansenshō

Common questions

Is TB screening required for foreign residents entering Japan?: Depending on your country of origin and visa type, you may be required to undergo a medical examination including chest X-ray screening for tuberculosis before a visa is issued, or after arriving in Japan. MHLW maintains a list of countries with elevated TB incidence for which entry screening applies. Annual workplace health checks in Japan include a chest X-ray, which also functions as ongoing TB surveillance.
Is TB treatment free in Japan?: Yes, for active tuberculosis. Japan classifies tuberculosis under the Infectious Disease Control Law as a notifiable disease requiring public health management. Treatment for active TB is publicly funded and administered under supervision of the public health center — patients do not pay the standard copayment. The municipality covers treatment costs.
What is DOTS and will I need to do it?: DOTS (Directly Observed Treatment, Short-course — 直接服薬確認療法) is the internationally recommended approach to TB treatment where a health worker or trained volunteer observes the patient taking each dose of medication. Japan's public health centers administer DOTS for active TB cases. It is required for active disease to ensure treatment completion and prevent drug-resistant TB.
What should I do if I think I have been exposed to tuberculosis?: Contact your local public health center (保健所, hokenjo) and tell them you believe you have been exposed to a TB-positive person. The hokenjo will arrange contact tracing and screening. If you are a close contact of a notified TB case, you will be offered tuberculin skin testing or IGRA blood testing to determine whether latent infection has occurred.

Sources