Natives more vulnerable to harmful bacteria, study says

Rural Alaska Natives about twice as likely to carry bug as U.S. rate

Posted: Sunday, December 24, 2000

A study on a harmful bacteria common in Alaska Natives has produced some "alarming" preliminary findings, according to the Alaska Native Medical Center in Anchorage.

The center's research has found many Alaska Natives are resistant to antibiotics used to treat infection by the bacteria Helicobacter pylori, which is linked to stomach cancer and bleeding ulcers.

The study also has found that Alaska Natives, if cured, are more likely to be reinfected than patients in the Lower 48.

"That has a lot of implications," said Dr. Frank Sacco, chief of surgery at the center. "Do we keep treating people who get reinfected every year? Are we really helping folks or causing more trouble?"

Previous studies have found 30 percent to 40 percent of people in the United States are infected with the bacteria, but that it's more common among people in rural areas. Research shows 80 percent to 90 percent of people in developing countries carry the bug and 70 percent to 80 percent of Natives in rural Alaska are infected. Approximately 60 percent of Natives in Anchorage harbor the organism a lower figure than in rural Alaska but still nearly double the rate in the Lower 48. A 1999 study found 63 percent of Southeast Natives are infected.

The bacteria is associated with stomach cancer, although experts say most people infected do not develop tumors. Studies also link the bug to bleeding ulcers, suspected of contributing to a high rate of anemia among Native youth. Anemia can lead to fatigue, difficulty concentrating and slower development in children.

The center's preliminary findings show antibiotics cure only 65 percent of Alaska Natives infected with the bacteria, compared to a cure rate of 80 percent to 90 percent of patients in the Lower 48.

Sacco said the Centers for Disease Control and Prevention has set up a lab in Anchorage to grow the organism, and experiments have found that the bacteria in Alaska is more resistant to antibiotics commonly prescribed to treat infection.

He said the research also found 30 percent to 50 percent of Alaska Natives cured of the bug will be reinfected within two years, compared to a 5 percent reinfection rate among people in the rest of the country.

The findings mean treatment is less effective and resistance to the antibiotics could increase, according to the center.

"I think for a long time we thought everyone with the infection should be treated," Sacco said. "Hopefully, we'll be able to refine that, so maybe we're just going to treat the patients where we think it can make the biggest difference maybe (treat) only the patients who develop bleeding ulcers. We need to get more information."

No one knows how the bacteria is contracted or why it seems to hit Natives harder in rural areas than in cities. Researchers also don't know the rate of infection among non-Natives in Alaska compared to Natives, although anecdotal information from doctors suggests non-Natives in Anchorage are less susceptible to the bug, Sacco said.

The Alaska Science and Technology Foundation last week awarded a $64,000 grant to the center to expand its research to non-Natives who harbor the bacteria.

"Hopefully (the study) will lead to saving lives. That's really the bottom line," said Jim Palin, grant administrator for the foundation.

The foundation grant will help the center study infected non-Natives living in Anchorage, particularly how many are cured by conventional treatment and how many are reinfected. The center will compare the data to existing research on Natives in rural and urban areas.

"Maybe by talking to people that get reinfected and who don't get reinfected, we might get a better idea of what factors contribute to reinfection lifestyle, public health (issues) like water and sewer supplies and whether there is a cultural difference," Sacco said. "Hopefully by looking at different groups and comparing them, we can get some insight."

Kathy Dye can be reached at kdye@juneauempire.com.



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