Category Archives: USA

Connecticut | State mosquito program begins testing for WN and EEE viruses

The State of Connecticut Mosquito Management Program recently announced it is monitoring mosquitoes for the presence of viruses that can cause illness in people including West Nile virus (WNV) and eastern equine encephalitis virus (EEE).

The mosquito trapping and testing program, coordinated by the Connecticut Agricultural Experiment Station (CAES), began June 2nd. Test results to date are negative.

The program also released surveillance results from the 2013 season. The results include the first confirmed human case of eastern equine encephalitis (EEE) in a Connecticut resident. In April, the Centers for Disease Control and Prevention (CDC) confirmed that an adult resident of eastern Connecticut who had been hospitalized with encephalitis and died in the Fall, was positive for EEE.

The resident had been tested for WNV, but was not tested for EEE before death. Fortunately, through the astute actions of a physician at a local hospital, further testing was initiated that led to the post mortem diagnosis of EEE infection.

“While rare, EEE is serious and underscores the importance of taking personal precautions to avoid mosquito bites,” said DPH Commissioner Dr. Jewel Mullen. “The presence of this virus in Connecticut should also remind clinicians to include EEE, along with WNV, among their possible diagnoses so that appropriate tests can be done.”

Dr. Mullen said that DPH is preparing an advisory to Connecticut clinicians regarding the current epidemiology of EEE and WNV as well as testing options for diagnosing mosquito-borne diseases.

EEE Surveillance

Mosquitoes infected with EEE virus transmit the virus by biting humans. EEE is a rare illness in humans, and only a few cases are reported in the United States each year. Most cases occur in the Atlantic and Gulf Coast states.

Last season there was significant EEE virus circulation in eastern Connecticut, including infected mosquitoes, a horse, and pheasant flocks. Mosquitoes with EEE virus were identified in five Connecticut towns: Haddam, Hampton, North Stonington, Plainfield and Voluntown. A horse stabled in Griswold died from EEE-associated illness during the second week of September. In early to mid-September, pheasants in a farm flock in Killingly and a flock in Sprague died from EEE infections.

The numbers and types of mosquitoes with EEE identified in the Pachaug State Forest in Voluntown prompted the Department of Energy and Environmental Protection to temporarily close part of the forest to recreational activities and to conduct ultra-low volume ground spraying to reduce the number of mosquitoes.

WNV Surveillance

Last season, the Connecticut Agricultural Experiment Station (CAES) identified WNV-positive mosquitoes at trap sites in 22 towns: Branford, Bridgeport, Darien, East Haven, Fairfield, Glastonbury, Greenwich, Groton, Manchester, New Haven, North Branford, Norwalk, Plainfield, Stafford, Stamford, Stratford, Voluntown, Wallingford, Waterford, West Haven, Westport and Wilton. Four Connecticut residents from the towns of Stamford, Stratford, and Bridgeport were diagnosed with WNV-associated illnesses. There were no fatalities.

Connecticut Mosquito Management program

The management of mosquitoes in Connecticut is a collaborative effort involving the Department of Energy and Environmental Protection (DEEP), the Connecticut Agricultural Experiment Station (CAES) and the Department of Public Health (DPH), together with the Department of Agriculture and the Department of Pathobiology at the University of Connecticut (UCONN). These agencies are responsible for monitoring and managing the state’s mosquito population levels to reduce the potential public health threat of mosquito-borne diseases.

The CAES maintains a network of 91 mosquito-trapping stations in 72 municipalities throughout the state. CAES began its mosquito trapping and testing season last week. Mosquito pools that test positive for WNV and EEE, as well as human cases of these illnesses, will be posted on the Connecticut Mosquito Management Program website.

For information on West Nile virus and EEE, including what you can do to prevent getting bitten by mosquitoes and the latest mosquito test results, visit the Connecticut Mosquito Management Program Web site at www.ct.gov/mosquito.

Connecticut | Governor signs legislation protecting Good Sams for administration of Narcan

Governor Dannel P. Malloy, joined by CT Department of Mental Health and Addiction Services (DMHAS) Commissioner Pat Rehmer and other state and local officials, today held a bill signing ceremony for legislation (Public Act 14-61) that grants civil and criminal liability protection to a bystander who administers Naloxone Hydrochloride (known as Narcan) in good faith to someone who has overdosed.
The new law is focused on reducing fatalities resulting from heroin and prescription drug overdoses. Narcan is a prescription medication that reverses an opioid overdose. It can be administered by a layperson with minimal training and is most commonly available as either an injection or nasal spray.
“As we work to implement strategies that will prevent overdoses and reduce over-prescribing, it is also imperative that we remove potential barriers to Narcan use,” said Governor Malloy. “This legislation may encourage someone to act to save a life and be the catalyst that causes someone battling addiction to seek treatment.”
The bill signing ceremony followed Governor Malloy’s participation in a multi-state Governor’s summit on Opiate Addictions earlier in the day in which the Governors announced a strategy addressing the epidemic that has impacted families and communities across the New England region.
Connecticut has been actively involved in efforts to combat deaths from overdoses including rapidly linking opiate addicted individuals to medication assisted treatment like Methadone, redoubling efforts to educate the public on the dangers of prescription drugs and heroin and implementing widespread drug take back days and prescription drug drop boxes to safely dispose of unneeded medication.
“We recognized that heroin-involved clients were cycling through detox and not getting priority access to Methadone. The Department of Mental Health and Addictions Services treatment protocol works to interrupt that cycle” said Commissioner Rehmer.  “We have not narrowly focused on one or two services but offer a broad spectrum of treatment and recovery support services.  We have funded care managers in high need areas so they are available to assist individuals who are ready to access treatment.  We have outpatient services, detox services, residential services, peer support and recovery support services.  Our prevention efforts include prescription drug take back days, prescription drug drop boxes and media campaigns to increase public awareness.”
“Drug overdose is a leading cause of death due to injury in the United States, and among people 20-64 years old, drug overdose causes more deaths than motor vehicle traffic crashes,” said Department of Public Health Commissioner Dr. Jewel Mullen.  “Naloxone (Narcan) is a safe and effective prescription medicine that reverses an opioid overdose.  Last week, the scope of practice for all licensed Connecticut EMS providers was expanded to include the administration of Naloxone.  This expansion, like this good Samaritan legislation, is an important strategy that will help prevent deaths in Connecticut due to opioid overdose.”
“Our focus has been on limiting improper access to pharmaceutical opioids,” Consumer Protection Commissioner William M. Rubenstein said.  “The state’s Prescription Monitoring Program is an important tool that helps pharmacists and prescribers assure that only medically necessary prescriptions are filled.  Our partnership with municipalities to provide convenient medication drop boxes takes no-longer-needed drugs out of homes and away from the easy reach of potential abusers.  While prevention and treatment of opioid abuse remains a high priority, this new law will help save the very lives that our prevention and treatment programs hope to help.”
“Drug related overdoses have increased significantly and are the leading cause of accidental deaths in Connecticut,” said State Representative Gerald Fox III, House Chair of the Judiciary Committee (D-Stamford).  “Citizens should not fear prosecution in attempting to save a life.  Enhancing access by allowing non-medical personnel to carry and administer Narcan, a drug overdose medication, is a step towards treating the epidemic we are experiencing.  Saving lives while protecting good Samaritans is good policy.”
In 2012, Governor Malloy signed Public Act 12-159 to allow prescribers to provide naloxone prescriptions to individuals in close contact with a person struggling with opioid addiction so that a medical intervention can occur in the case of an opioid overdose.

Alabama | ADPH continues investigation of foodborne outbreak

The Alabama Department of Public Health is investigating a foodborne outbreak in Russellville, AB.

Three individuals who had eaten at El Patron tested positive for Salmonella. Other potential cases of Salmonella are being investigated. Salmonella symptoms usually occur within 6 and 72 hours after infection. Most people recover without treatment.

ADPH continues to investigate gastrointestinal illness in patrons of El Patron.

Symptoms of Salmonella are diarrhea, nausea and vomiting, abdominal cramping and fever.

Assistant State Health Officer Dr. Karen Landers recommended that people reduce their risk of Salmonella by avoiding raw or undercooked eggs, poultry or other meats, thoroughly washing produce, and following safe food handling practices during food preparation. Hand washing, keeping uncooked food away from cooked food, and using clean plates and utensils are some important ways to minimize food contamination. People should also wash their hands after contact with animals and animal feces.

The investigation is ongoing and final test results will be available at a later date.

Oklahoma | State Health dept confirms first case and death of Heartland virus

The Oklahoma State Department of Health has confirmed the state’s first case and death of Heartland virus. A Delaware County resident died recently from complications of the virus. The virus is found in the Lone Star tick (Amblyomma americanum), and is likely spread through tick bites.  

Heartland virus was first identified in Missouri in 2009. The Oklahoma case is only the tenth person confirmed with the virus and the second person to die from it. Other cases have occurred in Missouri and Tennessee. All of the patients diagnosed with Heartland virus reported spending several hours per day in outside activities or occupations.

Symptoms can include fever, fatigue, headaches, muscle aches, loss of appetite, nausea, bruising easily and diarrhea. There is no routine testing available for Heartland virus. However, protocols are in place for investigational diagnostic testing. Healthcare providers can contact the Oklahoma State Department of Health’s Acute Disease Service at (405) 271-4060 for consultation regarding protocol enrollment for patients who have acute illnesses compatible with Heartland virus infection.

There is no vaccine or drug to prevent or treat the disease. Preventing bites from ticks and mosquitoes may prevent this and other infections. The Oklahoma State Department of Health recommends the following:

–Use insect repellents, following package instructions.
–Wear long sleeves and pants when outdoors so that ticks are easily seen and removed.
–Avoid bushy and wooded areas where ticks can be transferred onto you.
–Perform thorough tick checks soon and daily after spending time outdoors.

For more information on reducing exposure to ticks, visit:

http://www.ok.gov/health/Disease,_Prevention,_Preparedness/Acute_Disease_Service/Disease_Information/Tickborne_and_Mosquitoborne_Diseases/index.html

Ohio | Measles outbreak expands to Highland County in SW part of state

The Ohio Department of Health (ODH) and the Highland County Health Department have confirmed a case of measles in southwest Ohio.

The new case involves an infant less than six months old whose family traveled in mid-May to north-central Ohio, where six counties are experiencing a measles outbreak. At this time, ODH has confirmed only one case in Highland County, but that number could rise.

Ohio’s continuing measles outbreak is part of the largest outbreak in the U.S. since 1994. If your family plans to travel to affected areas of Ohio, the U.S., or abroad, this is a good time to check with your healthcare provider to make sure you are up-to-date on immunizations. The Centers for Disease Control and Prevention (CDC) website lists U.S. and international “Measles Cases and Outbreaks” at http://www.cdc.gov/measles/case-outbreaks.html .

When individuals are fully vaccinated, the measles-mumps-rubella (MMR) vaccine is 97 percent effective in preventing measles.

“Contracting measles is especially serious for infants younger than one year of age,” said ODH State Epidemiologist Dr. Mary DiOrio. “Parents with infants too young to be vaccinated should consider not traveling with them to areas where measles outbreaks are occurring.”

Governor John R. Kasich signed an executive order today that allows licensed pharmacists to administer the MMR vaccine (effective June 9, 2014) to individuals 18 years and older pursuant to Amended Emergency Rule 4729-5-38.

“It’s important to give individuals more opportunities to receive an MMR vaccination,” DiOrio said.

Symptoms for measles include fever, cough, runny nose, red eyes, sore throat, and a red rash appearing three to five days after the start of the symptoms. Those who are not up-to-date on their immunizations should contact their healthcare provider or local health department and receive the MMR vaccine if there is no medical reason not to do so.

ODH and its local public health partners support the vaccine recommendations set forth by the Advisory Committee on Immunization Practices and CDC. These recommendations include vaccination schedules for when both children and adults should receive their vaccinations.

For more information about measles, visit the ODH website at http://www.odh.ohio.gov/.

Chronology
June 9: Governor Kasich signs an executive order allowing licensed pharmacists to administer the MMR vaccine to individuals 18 years and older
June 7: Highland County Health Department contacts ODH about a suspected measles case
June 6: ODH sends out a press release about summertime travel and staying healthy
May 27: More than 13,000 doses of MMR vaccine have been distributed to local health departments to date to combat the measles outbreak. Local health jurisdictions have administered 8,240 doses (62 percent) of these doses thus far
May 23: Number of measles cases surpasses 150 in a six-county area
May 13: ODH conducts a conference call with media across the state and local health jurisdictions regarding measles outbreak
May 8: ODH Bureau of Infectious Diseases staff members begin to provide periodic on-site assistance to affected local health jurisdictions
May 3: ODH develops measles guidance for school nurses in collaboration with CDC and distributes it to school nurses, Head Start Programs and local health jurisdictions
May 2: ODH issues measles guidance to Ohio schools
May 1: ODH establishes a measles homepage on its website containing an overview of the measles outbreak, links to the local health jurisdiction in each affected county, and a list of Frequently Asked Questions about measles
May 1: ODH issues measles guidance to healthcare providers
April 25: ODH orders MMR vaccines for delivery to all counties that plan to hold vaccination clinics
April 25: CDC officially confirms Ohio’s measles cases
April 24: ODH, the Ashland County-City Health Department, the Knox County Health Department and the Holmes County General Health District issue a joint press release with the dates/times/ locations of MMR vaccine clinics
April 24: ODH and its public health partners begin regular conference calls with CDC regarding the measles outbreak
April 24: ODH, Knox County Health Department and Holmes County General Health District issue a combined press release regarding the suspected measles outbreak
April 23: ODH alerts Ohio hospitals about the suspected measles cases
April 23: ODH is alerted about a possible measles outbreak in three Ohio counties

Illinois | New state law requires CPR and AED training for students in all high schools

Governor Pat Quinn today signed a bill that will require cardiopulmonary resuscitation (CPR) and automated external defibrillator (AED) training for students in all Illinois high schools.

The Governor was joined by the Laman and Bell families and the Associated Fire Fighters of Illinois at their annual meeting in Normal to sign the measure. Today’s action is part of Governor Quinn’s agenda to ensure the safety of people in every community across Illinois.

“It is not often our high school students are faced with the opportunity to save a life,” Governor Quinn said. “Should an emergency arise, we want our students ready to step in and take action. This common-sense law will make sure they are better prepared to help their classmates, teachers, family and friends in case of an emergency.”

House Bill 3724, sponsored by State Representative Daniel Burke (D-Chicago) and State Senator John Mulroe (D-Chicago), requires that all secondary schools in Illinois train students on how to properly administer CPR and how to use an AED. The new law allows students to opt out of the training if their parents submit a written objection. The law will be effective for the 2014-2015 school year.

The bill was recommended by George Laman, whose daughter Lauren collapsed and died at her high school drill team practice in 2008. An AED was available at the school but was not used until the paramedics arrived 13 minutes after the initial emergency call. Because Mr. Laman is a paramedic, he realized there was a need for training in CPR and AED usage in high schools across Illinois.

In January, Eric Bell’s heart stopped due to a blockage in one of his arteries. His son Harry was able to correctly perform CPR on his father for twelve minutes until paramedics arrived on the scene. Harry, a junior at Fenwick High School, learned CPR during health class at the Catholic school in Oak Park. Eric believes he would not be alive today if it wasn’t for Harry’s quick reaction and previous training of CPR.

“We’d like to recognize the bill sponsors for helping make Illinois a safer place to live, and Governor Quinn for his long commitment to public safety in this state,” Associated Fire Fighters of Illinois President Pat Devaney said.

“I would like to thank the Laman family for their remarkable efforts and their tireless work for House Bill 3724,” Representative Burke said. “The loss of their daughter, Lauren, is what precipitated their efforts. It is important for people to know that this woman’s legacy is now law and kids will be trained in these areas and could potentially save thousands of lives in the future.”

“There are AEDs in schools now, but people need to know how to use them before they are effective,” Senator Mulroe said. “These tools and the CPR and AED training are life-saving measures that our young people will be able to use the rest of their lives.”

Since taking office, Governor Quinn has worked to improve public safety by supporting AED and CPR measures and programs. As Lieutenant Governor, in 2006 he announced the Heartsaver AED Fund to provide matching grants for AED purchases for public schools, park districts, conservation districts, forest preserves and public colleges and universities. He has expanded access to AEDs in public places across the state, and signed legislation to provide civil protections for citizens trained in CPR.

Illinois | First WNv positive bird for 2014 reported

The Illinois Department of Public Health (IDPH) has confirmed the first West Nile virus positive bird and mosquito batch reported in Illinois for 2014. Henry County Health Department employees collected a positive bird on May 29, 2014 in Colona and Madison County Health Department employees collected a positive mosquito batch on May 30, 2014 in Godfrey.

“West Nile virus activity is largely dependent on the weather. Despite our cold winter, mosquitoes are becoming active and infected with West Nile virus as the temperature increase. If we see a hot, dry summer, we could see a lot of West Nile virus activity,” said IDPH Director Dr. LaMar Hasbrouck. “We want to remind people not to be complacent. Take precautions to protect yourself by wearing insect repellent and taking other precautions.”

The first West Nile virus positive result in 2013 was a mosquito batch collected on May 21, 2013 in Cook County. Last year, 76 counties in Illinois reported a West Nile virus positive mosquito batch, bird and/or human case. For the 2013 season, IDPH reported 117 human cases, including 11 deaths. No human cases of West Nile virus have been reported so far this year.

Surveillance for West Nile virus in Illinois includes laboratory tests on mosquito batches, dead crows, blue jays, robins and other perching birds, as well as testing sick horses and humans with West Nile virus-like symptoms. People who observe a sick or dying crow, blue jay, robin or other perching bird should contact their local health department, which will determine if the bird will be picked up for testing.

West Nile virus is transmitted through the bite of a mosquito that has picked up the virus by feeding on an infected bird.

Common West Nile virus symptoms include fever, nausea, headache and muscle aches. Symptoms may last from a few days to a few weeks. However, four out of five people infected with West Nile virus will not show any symptoms. In rare cases, severe illness including meningitis or encephalitis, or even death, can occur. People older than 50 are at higher risk for severe illness from West Nile Virus.

As temperatures warm up, remember to take some simple precautions to reduce the number of mosquitoes around your home and protect yourself from being bitten. Precautions include practicing the three “R’s” – reduce, repel and report.

  • REDUCE exposure – avoid being outdoors when mosquitoes are most active, especially between dusk and dawn.
    • Make sure doors and windows have tight-fitting screens. Repair or replace screens that have tears or other openings. Try to keep doors and windows shut, especially at night.
    • Eliminate all sources of standing water where mosquitoes can breed, including flowerpots, wading pools, old tires and any other receptacles. Change water in birdbaths weekly.
  • REPEL – when outdoors, wear shoes and socks, long pants and a long-sleeved shirt, and apply insect repellent that contains DEET, picaridin, oil of lemon eucalyptus or IR 3535, according to label instructions. Consult a physician before using repellents on infants.
  • REPORT – report dead birds to your local health department. In communities where there are organized mosquito control programs, contact your municipal government about areas of stagnant water in roadside ditches, flooded yards and similar locations that may produce mosquitoes.

Additional information about West Nile virus can be found by logging onto www.idph.state.il.us/envhealth/wnv.htm.

Kansas | Measles cases confirmed in Johnson County

The Kansas Department of Health and Environment (KDHE) and the Johnson County Department of Health and Environment (JCDHE) have confirmed two cases of measles in Johnson County, KS. All those at risk for the disease are being contacted and the investigation is ongoing.

Measles is a respiratory disease caused by a virus. With the creation of the MMR (Measles, Mumps, Rubella) vaccine, measles cases are rare in the United States; however, it still sickens approximately 20 million and kills 164,000 people worldwide each year.

“The best way to keep from getting the disease is by being vaccinated. Protect children by making sure they have the MMR vaccine when they are 12 to 15 months old, and again before they enter kindergarten,” said Robert Moser, M.D., KDHE Secretary and State Health Officer.

Measles is highly contagious and is spread through the air by breathing, coughing, or sneezing. The signs and symptoms of measles typically begin one to two weeks after someone is exposed to an infected person. Symptoms include:

  • Fever
  • Blotchy rash on the skin, which spreads from the head to the trunk then to the lower extremities (Measles can be spread to others from four days before to four days after the rash appears.)
  • Cough
  • Runny nose
  • Red, watery eyes (conjunctivitis)
  • Feeling run down, achy
  • Tiny white spots with bluish-white centers found inside the mouth (Koplik’s spots)

“If you have a fever, stay home except to see a healthcare provider. If you need to visit your healthcare provider, call ahead so appropriate measures can be taken to protect other patients and staff,” said Lougene Marsh, JCDHE Director.

People at high risk for severe illness and complications from measles include infants and children aged <5 years, adults aged >20 years, pregnant women and people with compromised immune systems.

For more information: http://www.cdc.gov/features/Measles/index.html

Located in the southwestern quadrant of the Kansas City Metropolitan Region, Johnson County, Kansas is a community of choice with a current population of more than 550,000, making it the most populated of the 105 counties in Kansas.

Pennsylvania | Possible measles exposure in Dauphin County

The Pennsylvania Department of Health is advising the public of potential exposure to a case of measles, a vaccine-preventable disease, in Dauphin County.

A person who likely has measles may have exposed other people to the disease on the following dates at these southcentral Pennsylvania locations and times:

Kohl’s, 5125 Jonestown Rd., Harrisburg: Saturday, May 24, from 9 a.m. to 6 p.m.
Holy Name of Jesus Parish, 6150 Allentown Boulevard, Harrisburg: Sunday, May 25, Noon service
Harrisburg International Airport, 1 Terminal Dr., Middletown: Monday, May 26, 4 a.m. to 10 a.m.

Although the vaccine for measles is highly effective, the following groups of individuals are at risk of becoming infected if they have had contact with an infected individual:

Infants less than one year of age who are too young to have received the measles, mumps and rubella (MMR) vaccine;
Individuals who were vaccinated with an inactivated vaccine, which was used from 1963 through 1967, and have not been revaccinated;
Individuals born after 1957 who have only received one dose of MMR vaccine;
Individuals who refused vaccination; and
Individuals from parts of the world where there is low vaccination coverage or circulating measles.

Measles is caused by a highly contagious virus. Symptoms will begin one to two weeks after exposure and include a runny nose, watery eyes, cough and a high fever. After four days, a raised, red rash starts to spread on the face, down the body and out to the arms and legs. The rash usually lasts four to seven days.

An individual with measles can spread the virus to others for four days before and four days after the rash begins. It is spread by sneezing or coughing, touching contaminated objects, and direct contact with infected nasal or throat secretions. Infected droplets and secretions can remain contagious on surfaces for up to two hours.

Complications from measles can include ear infection, diarrhea and pneumonia, inflammation of the brain, and even death. Measles can also cause miscarriages or premature delivery in pregnant women.

The MMR vaccine can help prevent infection if it is given within three days of exposure. If it has been more than three days since your exposure, a dose of immune globulin can provide protection up to six days after exposure.

There is no risk in getting an additional dose of the MMR vaccine for individuals who may have already received it.
The Pennsylvania Department of Health urges all residents to be vaccinated against measles. The MMR vaccine is given to toddlers when they are 12 to 15 months of age, and a second dose is required for all Pennsylvania school children. However, individuals who have received only one dose of the vaccine, instead of the recommended two doses, may still be at risk of infection with this virus.

If you or your children are at risk for measles, and become ill with the symptoms one to two weeks after possible exposure, contact your healthcare provider to share that you’ve been exposed so that precautions can be taken to avoid exposing anyone else.

If you are a healthcare provider who suspects measles, please call 1-877-PA-HEALTH for consultation and to arrange testing.

Most people in the United States are immune to measles, either because they received the MMR vaccine in childhood, or because they were exposed to measles in the pre-vaccine era.

If you are not immune to measles and want to receive MMR or immune globulin, ask your healthcare provider or contact the Pennsylvania Department of Health at 1-877-PA-HEALTH.

For more information about measles, see the Pennsylvania Department of Health’s website at http://www.health.state.pa.us/pdf/epi/MeaslesFactSheet.pdf

North Carolina | NC Air Guard in western NC for Operation Appalachian Care

Story by Sgt. 1st Class Robert Jordan

North Carolina Air National Guard physicians, nurses, dentists, optometrists, medical administrators and support personnel joined peers from several states’ National Guard, Reserve and active duty units in Bryson City for Operation Appalachian Care beginning June 1.

The nearly 200 soldiers, airmen and sailors deployed to seven locations in two counties in western North Carolina providing medical care for more than 700 patients in the first two days.

“The community saw the need and asked for the professional assist,” said Air Force Capt. Warren Newell, one of the N.C. Air National Guard leaders who helped plan the mission in Cherokee and Swain counties.

The operation is an Innovative Readiness Training project for medical professionals in the military who get real-world experience while helping the community.

“We get our skills from working with patients with serious problems, and the community gets support they would not get otherwise,” said Air Force Maj. Dean Chapman, a clinical nurse with the N.C. Air National Guard.

The mission brings medical professionals from across the military together, including the South Carolina, Arkansas, Utah, California, Hawaii and North Carolina Army Reserve, the North Carolina, Georgia and Arizona Air National Guard, and individual soldiers and sailors on active duty.

“It took about a year of planning with communities submitting packets and leaders matching resources to need,” said Newell.

Community members register through local agencies and get treatment at primary care, behavioral health, veterinary, dental and optometry clinics staffed with military providers.

“It is fantastic. People I talked to love it, and it takes a lot off their backs,” said Roger Millsap, a dealer at Harrah’s Casino at the Eastern Band Cherokee Reservation who visited the vision clinic.

The training is not purely medical, logistical, administrative, communication, contracting experts work behind the scenes making sure that the clinics are ready to meet the goal of 3,000 patients by June 13.

“We get to train, enhance our capabilities and keep engaged with the community,” said Newell.