Operating on the assumption that swine flu is active throughout Alaska, the state is concentrating on quickly responding to cases of the flu and monitoring the virus for mutations.

The Army National Guard medevaced three people from Little Diomede Island to Nome this week when it was suspected that they were sick with the H1N1 virus. One of those individuals did test positive for the virus, and a doctor and nurse team from Norton Sound Health Corp. stayed in the village overnight Thursday and worked Friday vaccinating villagers and administering the antiviral Tamiflu.

Enough doses of the H1N1 vaccine for the entire village of Diomede, which sits on the island's west coast and has about 130 residents, were flown in from Nome. Replacement doses were immediately shipped to Nome from state supplies in Anchorage.

Little Diomede is extremely isolated; a weekly supply helicopter and very infrequent boat traffic bring the island's only visitors. Still, the state is not launching an effort to determine how the virus reached the island.

"The fact that it was there wasn't surprising to us," said Greg Wilkinson, spokesman for the Department of Health and Social Services.

The doctor and nurse from Norton Sound Health Corp. were scheduled to be flown back from Diomede Friday before dark, and as of Friday afternoon it appeared that it would not be necessary that they bring any patients back with them, according to Wilkinson.

Because of the difficulty of reaching Diomede, state agencies used the medevac as an opportunity to fortify the village against the virus.

"We're not concerned that the community is being harder hit than other communities in Alaska, but if that window of transportation closes we wouldn't have been able to get the vaccines and antivirals out there," said Jeremy Zidek, spokesman for the Alaska Division of Homeland Security and Emergency Management.

Dr. David Head, medical director at Norton Sound Health Corp., said the response was impressively quick, and that it was only four hours after he contacted the state that they had identified a source of the vaccine and received clearance to mobilize the National Guard helicopters.

As to how the virus actually reached the remote island, Head said he wonders about that as well.

"This could have come in weeks ago and been percolating in the community before it started to show itself," he said.

Contact Joshua Saul at jsaul_alaskadispatch.com.