Alaska has top TB rate

State cases increase 75 percent, compared to 7 percent U.S. drop

Posted: Wednesday, June 13, 2001

ANCHORAGE - Alaska posted a big increase in the rate of tuberculosis last year, largely due to two separate outbreaks outside of Southeast Alaska.

The disease declined 7 percent nationwide, continuing an eight-year downward trend. But the TB rate in Alaska jumped 75 percent, according to figures released Tuesday by the federal Centers for Disease Control and Prevention.

Tuberculosis is a bacterial infection spread through the air. It spreads easily among people living in close quarters. Infection causes sweats, weight loss, fevers, coughing and other symptoms of the common cold. It is easily treated with drugs, but can be fatal if left untreated.

Alaska had the highest rate of tuberculosis in the nation last year. The overall U.S. rate of TB reached an all-time low of 5.8 cases per 100,000 people in 2000. But the rate in Alaska climbed to 17.2 per 100,000 people.

Officials with the state Department of Health and Social Services say the increase in the disease is due primarily to two outbreaks.

Nine cases were reported in an extended family in Anchorage in January 2000. The second outbreak, reported in April, affected several villages in Southwest Alaska and resulted in 27 cases of the disease.

There were 108 cases in Alaska last year, but only three of those were in Southeast, said Juneau Public Health Center Nurse Manager Kathleen Miller.

"We do not follow the pattern of Southwest Alaska where they're currently having most of the cases," Miller said.

There may be 40 to 50 Southeast residents at any given time taking preventative TB medication, but that does not mean they suffer disease symptoms or are infectious, she said.

Alaska has had a long history of the disease since the first half of the last century, when it was the leading cause of death in the state. At that time, large numbers of people, particularly Alaska Natives, were infected with the TB germ.

"Those people are now elders, so the state still has a large pool of people at risk of getting TB and passing it on," said Dr. Beth Funk of the state Division of Public Health's epidemiology section.

In some rural Alaska communities, as many as 90 percent of adults over the age of 60 have tested positive for TB. A positive skin test does not mean a person has tuberculosis, but it indicates they were exposed to the respiratory disease. One in 10 people who have the TB germ in their body will eventually develop the disease at some point in their life, Funk said.

"Once you have a positive skin test, you have a lifetime risk of developing active TB," Funk said.

A higher-than-average number of positive tests for tuberculosis was noted recently at the Coast Guard Air Station in Sitka. TB skin tests have been ordered for all members of the Coast Guard there, but there are no active cases, said Cmdr. Richard Stanchi.

He said six positive skin tests turned up among 70 people in the aviation section at the air station. On average, there are three to five positive skin tests a year among the 125 active duty Coast Guard personnel stationed at Sitka.

"It concerned us to see six people in five months in one select group," Stanchi said. "That's a little abnormal. The statistic is insignificant but it raised some concerns."

Because of Alaska's relatively small population, a TB outbreak can show up as a much bigger increase in the rate of the disease than a similar-sized outbreak in a more populous state.

Following Alaska with the highest TB rates were Hawaii, California, New York, Georgia, Arkansas, Louisiana, Florida, Texas and South Carolina.

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