Health officials in Bristol Bay say the region is in the middle of a Tuberculosis outbreak with the most cases they have seen in years.
"We are seeing an outbreak in the region at this time; the state has classified this as a TB outbreak," said Rebecca Johnson, Infectious Diseases Division Manager for the Bristol Bay Area Health Corporation. "That is a significantly higher number than we have ever seen in recent years in region."
The outbreak was first detected in January, Johnson said. The tribal health organization and public health say they are not sharing case counts or case locations to protect patient confidentiality in small communities.
Tuberculosis, or TB, is a bacterial infection that causes symptoms like cough, fever and night sweats. There are two categories of TB: latent, when TB is not contagious and asymptomatic, and active, which can spread.
TB can remain latent without the patient ever knowing they have it. But latent forms of TB have up to a 10% chance of becoming active and contagious if left untreated, according to the Centers for Disease Control and Prevention.
"TB can hide, it's very insidious, it can hide in your body," Johnson said. "It loves those areas of high oxygen, like in the upper regions of your lungs, your brain, your spinal cord."
The infection is transmitted through the air, but not as easily as Covid-19 or the flu, Johnson said. It takes prolonged exposure for hours or days.
Alaska has the highest rate of TB in the U.S, according to the state Department of Health. It's been an ongoing health problem in the state for generations, and particularly devastating for Alaska Native communities. In the 20th century, Alaska had some of the highest rates of TB ever seen in the world, and until 1950, it was the state's leading cause of death, according to a state report.
Lisa Susanaga, the public health nurse in Dillingham, said western Alaska has the highest rates of TB in the state, and right now, Bristol Bay has the highest number of active cases in western Alaska.
Part of the uptick in the region might be because health professionals are looking more closely, Susanaga said.
"I think because we're doing more testing now, and because we're doing more investigations and doing contact tracing, we're finding more and more," Susanaga said. "And that's what we want. We want to find it and treat it."
Both active and latent TB are treatable with antibiotics, and the Bristol Bay Area Health Corporation and Public Health in Dillingham have been collaborating to test and treat communities across the region since the outbreak was first detected in January.
But there are hurdles to finding the infection, Johnson said. Stigma surrounding TB is a barrier to people getting tested, she said.
"Because TB has always been here, people remember their grandparents being shipped off to sanitariums," Johnson said. "That's not at all the case anymore. It's a treatable disease now, whether you have latent or active TB."
Anyone can get tested for TB. Bristol Bay Area Health Corporation recommends that anyone who has symptoms or suspects they have been exposed to active TB be tested.
Tests and treatment are available in Dillingham at the Dillingham Public Health Center or at Kanakanak Hospital. Testing is also available in regional villages through local clinics, Susanaga said.
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