Rabies Awareness


Rabies is a fatal but preventable viral disease. It can spread to people and pets if they are bitten or scratched by a rabid animal. The first symptoms of rabies may be nonspecific and include lethargy, fever, vomiting, and anorexia.

Here at the Toe River Health District (Avery and Mitchell County Health Departments) we respect your freedoms; however, with any freedom comes personal responsibility – especially when pets are involved. Even though rabies is relatively rare in Avery and Mitchell Counties, we do see it in the area on occasion. Since August 1, 2008, Avery County has only had one raccoon test positive for rabies (2020); Mitchell County has only had one bobcat test positive for rabies (2011) and two raccoons test positive (prior to 2020). Here is a link to the North Carolina Department of Health and Human Services website with the statewide statics for all known rabies positive tests since August 1, 2008

We want you to protect yourself and others from rabies and prevent any possible exposure,

 click here for more information.





Healthy people, healthy environment, thriving communities

Our health clinics are committed to providing quality care for everyone, regardless of their ability to pay. We have a sliding fee scale for people who are uninsured or underinsured, whose incomes are below 200% of the federal poverty level. We consider your family size and your income when using the sliding fee scale. Fees for services will be reduced based on the sliding fee scale at all three health clinics.

To apply for our sliding fee scale, you will need to provide proof of income and family size. Eligibility is extended to all patients, regardless of other medical coverage.

Patients may be insured and still qualify for a sliding fee.


Toe River Health District

Awareness & Access to Care

Avery County

Health Department

Mitchell County

Health Department


Substance Use and Mental Health Resource Guide for Mitchel County

We have created this guide of substance use resources for Mitchell County residents. We are working hard to address the issues of substance use in our community. Please contact us if you have suggestions about how we might improve our efforts to serve you and our community.



Welcome to The Toe River Health District. Serving Avery & Mitchell Counties

Toe River Health District works to improve the quality of life among community members by promoting healthly lifestyles and preserving the environment in Avery & Mitchell Counties.



Our Mission

Awareness & Access to Care

To assure the conditions allowing the people of Avery & Mitchell counties to be healthy. Our mission is accomplished through an organized community effort focusing on: health promotion, disease prevention, education and awareness, access to and provision of care, and quality and value.

Our Goal

Protect & Improve Health

To protect and improve the health of the citizens of Avery & Mitchell Counties and to maintain a healthy environment. We provide the services mandated by statutes or regulations of the Department of Health and Human Services, Department of Environment and Natural Resources and other services as approved by the Toe River Health District Board of Health.


Featured Resources

Interested in working with Us?

We are looking for qualified people to serve our communities.


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Toe River Health District

Healthy people, healthy environment, thriving communities

Toe River Health District is an equal opportunity provider. Services are available to all who may benefit and who meet regulatory requirements regardless of race, color, religion, national origin, sex, sexual preference, disability, age, socioeconomic level, marital status, source of payment, political affiliation, number of pregnancies, DNR/Advanced Directive status, or diagnostic status.

TRHD Health Departments

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