Alaska News

For second straight year, Alaska ranks No. 1 in the nation for highest rate of tuberculosis

In 2020 Alaska once again recorded the highest rate of tuberculosis infections in the country, with 58 documented cases, according to a federal report released this month.

Although the nation as a whole saw a 20% reduction in incidence of TB last year, Alaska’s rate remained equally high in 2020 as it was in 2019, at 7.9 cases per 100,000 people, the report from the Centers for Disease Control and Prevention indicates.

Tuberculosis is one of the world’s oldest infectious diseases and is still a leading cause of infectious death worldwide. According to the World Health Organization, around 1.8 billion people — a quarter of the world’s population — are currently infected with TB, which kills more than a million people every year. TB spreads through the air when a person with active TB coughs, sneezes or talks.

The majority of people with TB have a latent, non-contagious form of the disease and will go decades without having any symptoms. Experts say the public health goal is to identify latent cases, which are far cheaper and easier to treat than active TB disease.

Symptoms of active TB include a cough that lasts more than three weeks, a fever, night sweats, weight loss and coughing up blood.

Alaska has long had one of the highest rates of tuberculosis infections in the country. High rates in the southwestern and northern regions of the state “are still due in part to the lingering effects of high historic rates,” said Michelle Rothoff, a medical epidemiologist with the Alaska Division of Public Health, in a statement Thursday.

Rothoff told the Daily News in July that many of the residents in these regions “are living in very small villages and crowded living conditions, which contributes to the potential for transmission and difficulty accessing health care.”


A brief history of tuberculosis in Alaska, compiled by Dr. Bruce Chandler, a medical officer with the Anchorage Health Department, documents how colonizers in the late 1700s to the mid-1800s brought TB to Alaska, sparking a deadly epidemic in the state.

Until 1950, TB was the leading cause of death in Alaska, Chandler’s report said. The lingering effects from those early outbreaks haven’t gone away, and Alaska Native populations continue to be disproportionately affected.

“TB rates have been lowered through contact tracing, medical treatment and isolation,” Rothoff said in a statement Thursday. “But work remains to be done to eliminate this preventable, curable disease.”

Annie Berman

Annie Berman is a reporter covering health care, education and general assignments for the Anchorage Daily News. She previously reported for Mission Local and KQED in San Francisco before joining ADN in 2020. Contact her at