Southwest Alaska recorded 46 of the state's 77 tuberculosis cases, at 19 times Anchorage's rate

Southwest Alaska carried 46 of the state's 77 tuberculosis cases in 2025, according to the annual infectious disease report the Alaska Section of Epidemiology published Wednesday as Bulletin No. 12.

The report tallies confirmed and probable cases of infectious disease reported to the section. About 40,755 people live in Southwest Alaska, roughly 5 percent of Alaska's population of 738,737. Anchorage, with 289,221 residents, reported 17 cases, the Interior and Northern regions five each, Southeast three, Mat-Su one and the Gulf Coast none. Per 100,000 people that works out to about 113 cases in the Southwest against 5.9 in Anchorage, roughly nineteen times the rate, and 10.4 statewide. The Southwest reporting region includes the Aleutians East Borough, the Aleutians West Census Area, the Bethel Census Area, the Bristol Bay Borough, the Dillingham Census Area, the Kusilvak Census Area, and the Lake and Peninsula Borough.

The report itself is a table of counts, carrying no commentary from State Epidemiologist Joe McLaughlin or epidemiologist Louisa Castrodale. But the section's 2023 tuberculosis summary brief said the Southwest and Northern regions "consistently have the highest rates of TB in the state, and the Alaska Native population bears a disproportionate burden of cases."

A January 2023 bulletin documented a 66 percent rise in active cases in 2022 over the prior three years, reaching a provisional 96. Most people infected with TB never develop active disease; the state puts the lifetime risk at 5 to 10 percent. Alaska reported 91 cases in 2024 at a rate of 12.3 per 100,000, the highest in the nation, per the state's 2024 summary brief. Provisional CDC data show cases falling to 77 in 2025.

The same 2023 bulletin gave the section's own account of why the rate is high: "the lingering effects of a devastating TB epidemic in the 19th and 20th centuries, coupled with ongoing challenges with TB control in many rural Alaska communities."

Researchers in a 2024 study breaking tuberculosis rates among American Indian and Alaska Native people down by state found that from 2010 through 2020, age-adjusted annual TB incidence among Alaska's AIAN population was 21 times that among AIAN people in other states.

Counts in the report are provisional and may change as new information arrives.