The epidemiology of tuberculosis in Alaska, 1987

Alaska's tuberculosis morbidity and mortality rates have declined dramatically since the 1950's. At the same time, the epidemiologic characteristics of the disease in Alaska have changed. The tuberculosis incidence rate is now highest among persons of Asian ancestry, particularly the foreign-born. The high rate of disease in Alaskan children indicates that active transmission of Mycobacterium tuberculosis to previously uninfected persons is still occurring. The large proportion of cases among persons under the age of 35 implies a failure in the detection of tuberculosis infection and/or in the use of isoniazid chemoprophylaxis. Alaska's tuberculosis control efforts must focus on ensuring that persons with tuberculosis disease are appropriately and fully treated, on detecting tuberculosis infection in persons eligible for isoniazid preventive therapy, and on applying aggressively the preventive therapy recommendations of the American Thoracic Society and the Centers for Disease Control.