Monitoring of communicable diseases and pathogens

In these Procedures, „applicants for a residence permit“ refers to those applying for a residence permit, residence permit for relatives of EES-EFTA citizens, or international protection, as well as quota refugees, as defined by the Act on Foreigners, No. 80/2016.

Applicants from Central and South America, including Mexico, Europe outside the European Economic Area (EEA), Asia, or Africa must undergo a medical examination for infectious diseases. However, if the applicant possesses a valid foreign medical certificate that meets these Procedures, as confirmed by a physician and is not older than three months, the applicant does not need to undergo a separate medical examination, as detailed in item 4 below. Applicants from within the EEA, Switzerland, the USA, Canada, Australia, New Zealand, Japan, or Israel are exempt from this medical examination requirement. Only those individuals who plan to leave the country within eight weeks of their arrival can be exempted from the examinations, provided they do not exhibit symptoms indicative of an infectious disease.

Licensed physicians in Iceland can conduct the medical examinations described in these Procedures. Upon completion of the medical examination, physicians must submit confirmation of a satisfactory examination to the Directorate of Immigration.

A medical examination refers to:

A general medical examination that is indicative of the state of health of the applicant for a residence permit, including an evaluation of the applicant's vaccination history. If vaccinations are found to be incomplete, the applicant will be offered vaccinations in accordance with Iceland´s National Vaccination Program. If a reportable disease is diagnosed, as per the Regulation, on Reporting of Communicable Diseases and Agents Posing a Threat to Public Health, no 221/2012, it is recommended that the treatment and monitoring of the applicant be performed in consultation with an outpatient department responsible for managing such diseases, as per the Regulation on measures for health security and communicable disease control and prevention, No. 817/2012.

Tuberculosis: All children and pregnant women must undergo a Mycobacterium tuberculosis test (tuberculin skin test or an Interferon-Gamma Release Assay (IGRA). Additionally, adults under the age of 35, planning to stay over 12 months, must be tested. If the tuberculosis test indicates a tuberculosis infection, a lung X-ray is required. A lung X-ray is an adequate test in those staying less than 12 months and individuals over the age of 35, irrespective of the length of stay.

Gastrointestinal infections: A stool examination (culture and microscopic analysis) should be conducted on those who have or have had symptoms from the gastrointestinal tract. Reportable enteric infections (salmonellosis, shigellosis, campylobacteriosis, and giardiasis) should be specifically sought. This examination must be done for all children under six years of age, regardless of symptoms.

Hepatitis B and C: Investigations for hepatitis B and C must be done.

HIV: HIV testing is required.

Sexually transmitted diseases: Applicants showing symptoms or indications of a sexually transmitted disease must undergo an examination. A syphilis test should be conducted on all applicants.

A medical examination can also include assessments related to other health factors that pose a health threat from which the applicant originates. In such cases, a further examination shall be conducted according to a decision made by the Chief Epidemiologist.

Whenever possible, the medical examination and other investigations according to these Procedures should be conducted during a single visit.

When children falling under these Procedures commence their schooling, the school nurse must ascertain whether a medical examination has been carried out according to these procedures. If a medical examination has not been completed, the school nurse/health care center should assist the family in obtaining an examination, vaccinations, and monitoring where applicable. Waiting for an examination for an asymptomatic child should not delay the start of school. A child with symptoms of an infectious disease should be examined and treated according to the illness and not await a special medical examination for a residence permit.

Fees for medical examinations conducted in relation to an application for residence and employment permits, as outlined in these Procedures, shall be paid for either by the applicant’s employer or the applicant, as per Article 10 of Regulation No. 817/2012. If the medical examination reveals the need for further specific tests, the costs of any health issues other than reportable diseases within the first six months of stay in the country will be covered by the applicant or their health insurance scheme. Any medical examination specifically requested by the employer will be the responsibility of the employer.

Medical examinations conducted on applicants for international protection and quota refugees will be provided free of charge, including the costs of vaccines under the National Vaccination Program.

It is recommended that decisions on treatment and ongoing monitoring of patients be taken in consultation with the outpatient departments responsible for managing communicable diseases, as specified in Article 1 of Regulation on Measures for Health Security and Communicable Disease Control and Prevention, No. 817/2012. Costs related to reportable diseases will be covered at no expense to the individual, in accordance with Article 11 of the same Regulation.

These Procedures are issued in accordance with the Act on Health Security and Communicable Disease Control, No. 19/1997, and Regulation on Measures for Health Security and Communicable Disease Control and Prevention, No. 817/2012, and replace the previous version issued in November 2019.

• Procedures for the Medical Examination of Immigrants to Iceland (PDF). Published September 2023