Tuberculosis rate increases

Posted: Tuesday, August 01, 2000

JUNEAU (AP) -- A new study of tuberculosis in Alaska shows a 10 percent increase in cases from 1998 to 1999, but a public health physician says the increase is not as bad as it sounds because a handful of cases can drive up the tuberculosis rate in sparsely populated state.

Tuberculosis mainly affects the lungs, although the intestines, joints and other parts of the body may also become infected. It is spread mainly by inhalation.

Alaska has one of the highest per-capita rates of active cases of the potentially deadly disease in the United States.

In 1998, 55 TB cases were reported in Alaska, a rate of nine cases per 100,000 population, according to a recent epidemiology bulletin. In 1999, 61 cases were reported, increasing the rate to 9.8 cases per 100,000.

''Just a couple of cases make for a change in the rate because of the size of our population,'' said Dr. Elizabeth Funk of Anchorage, a physician with the state's epidemiology office.

The highest rates continue to occur in the northern and southwestern regions of the state, reflecting ongoing transmission in villages such as Elim, Kwethluk and White Mountain.

Northern cases peaked at 31 in 1996. The lowest rates are in Southeast Alaska which had five cases in 1995, a peak of eight cases in 1997, one in 1998 and two in 1999.

Funk, author of the TB report, didn't know why Southeast Alaska has the lowest rate.

''I know there are plenty of people in Southeast who have positive skin tests and thus a risk for developing the disease, but I don't why they don't develop,'' she said.

In the 1950s, a study was conducted that showed about 50 percent of Southeast Alaska's Native children had positive skin tests for tuberculosis before they reached the age of 10, Funk said.

''In other parts of the state it was closer to 90 percent,'' she said.

Tuberculosis symptoms include listlessness, fever and loss of appetite. In its pulmonary form, symptoms include spitting up blood and severe coughing. As the disease progresses, hard swellings reduce or impair the function of tissues such as the lungs.

Tuberculosis once affected millions, but its incidence has greatly decreased with improved sanitation, early detection through X-rays and skin tests and anti-tuberculosis drugs.

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