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Tuberculosis cases surge to outbreak levels in Bristol Bay, health officials say

Dillingham Public Health Center, Oct. 9, 2025.
Margaret Sutherland
/
KDLG
Dillingham Public Health Center, Oct. 9, 2025.

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.”

Johnson says the outbreak was first detected in January. 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.

Johnson says 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,” said Johnson, “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 Johnson says, not as easily as Covid-19 or the flu. 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 is the public health nurse in Dillingham. She says 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.

Susanaga says part of the uptick in the region may be because health professionals are looking more closely.

“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,” said Susanaga. “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 Johnson says there are hurdles to finding the infection. She says stigma surrounding TB is a barrier to people getting tested.

“Because TB has always been here. People remember their grandparents being shipped off to sanitariums," said Johnson. "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 is recommending 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. Susanaga says testing is also available in regional villages through local clinics.

Margaret Sutherland is a local reporter and host at KDLG, Dillingham's NPR member station. Margaret graduated from College of Charleston with a degree in English, and went on to attend the Salt Institute for Documentary Studies in Radio and Podcasting. She is passionate about the power of storytelling and creating rich soundscapes for the listener's ears to enjoy.