For the second year in a row, Alaska ranks first in the nation with the 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 TB incidence last year, Alaska’s rate remained just as high in 2020 as it was in 2019, with 7.9 cases per 100,000 people, the report from the Centers for Disease Control and Prevention.

Tuberculosis is one of the oldest infectious diseases in the world and remains one of the leading causes 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 tuberculosis, which kills more than a million people each year. TB spreads through the air when a person with active TB coughs, sneezes, or talks.

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

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

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

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

A Brief History of Tuberculosis in Alaska, compiled by Dr. Bruce Chandler, a medical officer for the Anchorage Department of Health, documents how settlers in the late 18th and mid-19th centuries brought tuberculosis to Alaska, causing a deadly epidemic in the state.

Until 1950, tuberculosis was the leading cause of death in Alaska, according to the Chandler report. The lingering effects of those early outbreaks have not 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 and curable disease.”

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