Alaska continued to have one of the highest rates of tuberculosis in the country last year, with 50 new cases for a rate of 7.4 cases per 100,000 people, the state reported this week.

The national average in 2008 was 4.2 cases per 100,000. Only Hawaii and the District of Columbia had higher rates than Alaska.

Alaska Natives, widely infected in the first half of the 20th century, are still suffering disproportionately from TB today, said Dr. Beth Funk, the state's tuberculosis control officer.

Between 1999 and 2008, 65 percent of the Alaska TB cases occurred in Alaska Natives.

There were 601 cases altogether reported to the state over those 10 years. Three-hundred eighty-eight of them were Alaska Natives.

"The (Native) people who were children in the 1950s pretty much all became infected with tuberculosis," said Funk. "Now there are elders in the state who have had tuberculosis germs lying dormant in their bodies." As people age, dormant TB germs tend to get active, she said.

Rates among children are also higher in Alaska than elsewhere.

Geographically, Northern and Southwest Alaska typically have the highest rates, Funk said. Last year, Southwest had the highest rate with 43.5 cases per 100,000, nearly six times greater than the rate of the state as a whole. Most of the 17 Southwest Alaska cases were in Yukon-Kuskokwim Delta villages.

Asians and Pacific Islanders, primarily Filipinos, are also infected at higher rates than others in Alaska. They make up 21 percent of the cases from 1999 to 2008.

Anchorage had an outbreak among homeless people in 2006 that caused a spike in the state's TB rate for that year, but Anchorage's homeless are not showing the same level of disease now, said Funk. "It's a lot better."

To beat back the outbreak, Anchorage health officials tested people at homeless shelters and soup kitchens, and put those who were sick on medicine to cure them.

It takes six to nine months to complete treatment, Funk said.

Tuberculosis is spread by coughing, though not everyone with TB is infectious. Those who are repeatedly exposed to someone with active TB are most likely to catch it.

Alaska's tuberculosis rate was the same in 2007 and 2008, but over 10 years shows a downward trend, Funk said.