A doctor and nurse flown by helicopter to one of the state's most hard-to-reach villages gave swine flu shots until 2 a.m. Friday as health officials scrambled to inoculate an entire Alaska community for the first time since the flu scare started.
About 130 people live in Diomede, 2.5 miles across the Bering Strait from Russia. The Alaska Army National Guard this week airlifted three patients with flu-like symptoms from the village to the hospital in Nome, with one testing positive for the virus. Back on the island, vaccines were given to virtually everyone living there on Thursday and Friday.
"They're going house to house, to the places where any family member is too sick to go to the clinic," Jamie Ahkinga, a Diomede city clerk, said Friday.
Public health agencies took the unusual step of sending a medical team to the village because of its extreme isolation. This time of year you can only get there by helicopter and, sometimes, by boat.
While mail and groceries still arrive on a regular basis by chopper, the village lost passenger flight service more than four months ago. That means people can only catch a helicopter flight for medical emergencies.
On Friday, the governor's deputy chief of staff held a conference call with the helicopter company, the regional health corporation, congressional aides and others looking for ways to provide reliable transportation to the village -- a potentially expensive challenge.
Health officials wanted to move fast to vaccinate Diomede while the weather allowed, said Roy Agloinga, chief administrator for the Nome-based Norton Sound Health Corp. "If the weather closes in and we have a bunch of people sick over the next couple weeks and we can't reach people ... it would just be disastrous."
The effort began on Wednesday as the Alaska Army National Guard flew two people with severe flu symptoms from Diomede to Norton Sound Regional Hospital in Nome, where one tested positive for H1N1, or swine flu.
With a growing number of sick people in the village, Diomede Mayor Andrew Milligrock asked for a medical team and medication in the village, according to the state. On Thursday the Guard flew in a doctor, a nurse and two medics to distribute enough flu vaccine for the whole village.
That night, the team flew a 1-year-old girl with respiratory problems to Nome, but the child tested negative for swine flu.
A doctor and nurse vaccinated patients until 2 a.m., starting again at 8 a.m., said Greg Wilkinson, spokesman for the state Department of Health and Social Services.
"We've got everybody on the island vaccinated except for four people," he said Friday around midday. The doctor and nurse were scheduled to leave Friday night.
Ahkinga said it seems like three different flus have circulated through town over the past two months. Other residents said it's hard to say how many people are sick.
"One of the reasons that we're doing these missions is because it's such an isolated community," said Jeremy Zidek, a spokesman for the Division of Homeland Security and Emergency Management. "It is prudent to take these steps, where in other communities, it may be able to be handled through more traditional means."
Unlike Diomede, even Aleutian Islands villages have regular air service and runways, Zidek said. "As far as communities go, there's not many that are more remote than Little Diomede, or harder to get to."
Residents can sometimes boat the nearly 30 miles to Wales and then grab a plane to the Nome hospital. But only if weather allows.
The helicopter company that flies mail to Diomede stopped selling passenger tickets in July. The regular chopper is under repair and Evergreen Helicopters eventually had to switch to a single-engine helicopter that's not as safe for ferrying passengers over open water.
"It's company and industry standard that single-engine aircraft ... aren't predominately used for passenger service," said president David Rath.
It could be weeks before passenger service is restored.
"I think they're hoping that they can get all the parts supplied and replaced in the helicopter and have it back in service by mid-December," said Randy Ruaro, deputy chief of staff to Gov. Sean Parnell.
Ruaro called a conference call with Evergreen, Norton Sound Health Corp. and others Friday to talk about what happens next.
In an Oct. 21 letter to the governor, Sen. Mark Begich suggested the state split the costs of subsidizing passenger flights with the federal government. Under the program the village could also pay part of the bill.
Evergreen is calculating how much it would cost to provide one or two passenger flights a week to the village, Ruaro said.
Another option is to add Diomede to a list of rural communities where the federal government subsidizes flight service through the Essential Air Service program. Unlike dozens of other Alaska villages, the community isn't included because it didn't have regularly scheduled air service when Congress deregulated airlines in 1978.
If there's a medical emergency in Diomede, the state troopers, the National Guard or Coast Guard could respond, Ruaro said.
As for non-emergency medical flights -- flying Diomede residents to Nome for checkups and doctors' appointments -- Norton Sound Health Corp. is in talks with Evergreen to transport patients on a limited basis.
President Carol Piscoya said in October that a deal was likely. But as of Friday nothing had been signed, Agloinga said.
"We're not sure that we can afford it," he said.