Decline of the Tuberculosis Epidemic in Alaska

THERE can be little doubt that tuberculosis was epidemic among Alaskan natives dur¬ ing the first half of the present century (1-Jf).Although the pattern of spread will probably never be known, the disease appears to have been introduced by white visitors and immi¬ grants (5) and to have followed in their wake as they sailed Alaska's coasts and floated down her rivers.Thus the disease probably came first to the Aleutian Islands, the southern coast, and the southeastern panhandle with the ex¬ plorers and fur traders some time in the latter part of the 18th century.The search for gold and whales late in the 19th century provided additional opportunities for the introduction of tuberculosis into the interior and along the northwest coast.When the disease arrived in the delta of the Yukon and Kuskokwim Rivers is not known, but it seems likely that the epi¬ demic peak came later in this area than else¬ where in Alaska.In any event, the first systematic examination of Alaskan natives for tuberculosis, a tubercu¬ lin survey conducted from 1948 to 1951, indi¬ cated that the tuberculosis problem was most serious along the lower Yukon and Kuskokwim Rivers (6).The prevalence of tuberculin reac¬ tors among native children, standardized for age, was 32 percent in southeastern Alaska and the Aleutian Islands, 56 percent in the interiqr