Rural Pharmacist & Dog Collars: Six Degrees of Separation

By: Maria Paiva, BSP, BCPS

I am a visiting Doctor of Pharmacy student from Vancouver, Canada and had the pleasure of making a road trip with Drs. Lynda Bergsma and Karen Heckert from the Mel and Enid Zuckerman College of Public Health to the San Carlos Apache Reservation.  We attended a meeting with local healthcare community leaders to discuss dog collars.  So, you might be thinking, “How is a pharmacist and dog collars connected?”  Believe it or not, the connection can be explained in six degrees.

1. Ticks cause disease, such as Rocky Mountain Spotted Fever (RMSF)
2. Ticks like dogs
3. Humans like dogs
4. Humans contract RMSF from tick bites from ticks on dogs
5. Infected humans consult knowledgeable rural pharmacist for advice on how to prevent RMSF
6. Knowledgeable rural pharmacist suggests a dog collar (No, not for you… for your dog!)

The Centers for Disease Control and Prevention (CDC) has recently identified Eastern Arizona as a new area with high rates of RMSF.  RMSF is a disease that is spread to humans by the bite of an infected tick, which can be found on dogs. Reducing exposure to ticks is an important defense against RMSF.  RMSF can be fatal if effective treatment is delayed. 

The main tick exposures in the San Carlos Apache Reserve are dogs, both domesticated and free-roaming, dilapidated homes, and the surrounding environment (woods, tall grass).  As a result, the community has invested many resources on cleaning up the area and implemented collaring dogs with collars that are impregnated with pesticide products that kill ticks, with good effect on reducing RMSF cases.   

Part of my role as a pharmacist when treating patients is to think about goals of therapy; what we hope to achieve by initiating a specific treatment. Goals vary based on the clinical situation. In a patient diagnosed with RMSF, goals include preventing death and complications, resolving symptoms, curing the disease, preventing adverse effects from drugs, and preventing disease spread and recurrence.  I then think of interventions to help meet these goals and group alternatives into two broad categories: drug and non-drug measures.  (Yes, it is a very sophisticated system!)  Non-drug measures include lifestyle modifications such as diet, exercise, or reducing exposure to known health hazards, as with RMSF.  Based on what I learned in San Carlos, I now have suggestions for patients to help reduce their exposure to ticks and RMSF, thereby preventing disease spread and recurrence and achievement of the goal.     

I believe Benjamin Franklin said it best, “An ounce of prevention is worth a pound of cure.”

For more information on RMSF, visit: http://www.cdc.gov/rmsf/index.html.

 About the Author
 

Maria Paiva, BSP, BCPS, is a visiting scholar at the Arizona Center for Rural Health. She will be graduating from the University of British Columbia in Vancouver, Canada with a  post-baccalaureate PharmD in May 2013.  Her clinical area of interest is oncology and in the future hopes to be involved in health policy and education.