GERM
00:00:09.120 – 00:00:11.120
Yatahey! My name is Germ.

WORM
00:00:11.520 – 00:00:12.480
I’m Worm.

GERM
00:00:12.720 – 00:00:26.880
Welcome to episode 113 of the Germ and Worm travel health podcast. Impaled on your trekking pole. What to do? It’s a big planet. See it in Good Health. I’m Dr. Paul Pottinger, also called Germ.

I am an infectious diseases specialist at the University of Washington.

WORM
00:00:27.290 – 00:00:32.890
I’m Dr. Chris Sanford, also known as Worm Family Medicine Doc, also at the University of Washington.

GERM
00:00:33.370 – 00:01:20.410
Here at Germ and Worm, we answer questions from our listeners across the country and around the world. And here are four of them today. What should I do if I’m impaled on my trekking pole? Can I save money on getting rabies vaccine while I’m overseas? What are the least visited U.S. national Parks? And catnip oil: Is it an effective bug repellent?

A reminder to our listeners, please contact us with your travel health questions, your stories, your and your tips for success. Just Visit our website, germandworm.com or drop us an email germandworm@gmail.com as always, our medical disclaimer.

This podcast is designed to inform, inspire and entertain. But before you travel, please see a qualified healthcare professional for recommendations specific to you and your itinerary.

Chris, tell me about some recent travel you may have taken. Yeah, you bet.

WORM
00:01:20.410 – 00:02:08.290
I think we were both in Idaho recently. My wife and I drove to a wilderness medicine conference in Montana, passing through Idaho and much of Montana on the way.

And, and a couple of highlights. One is on the Flathead Native American reservation in Montana.

We went to a huge bison preserve, a buffalo preserve where there’s 300 plus Buffalo free range. And it was wonderful to drive through the middle of a herd of maybe 100 buffalo and just hang out and listen to the sounds they made.

Another thing we did that was super fun in Helena, Montana. Something I don’t usually do is we went to the rodeo.

There was the big annual rodeo there and we saw bronco riding and calf roping and barrel racing and ate really superior junk food and made me think that I need to go to more rodeos.

GERM
00:02:08.770 – 00:03:11.520
Well, that’s amazing. So yeah, I was also in Boise. My son’s a wildfire fighter actually in eastern Oregon and he wanted to see the Odyssey, the new movie the Odyssey.

And so you can’t do that in eastern Oregon. So he drove like three hours to Boise. I flew out to see him and then we, we saw the movie. It’s great. By the way, I do recommend it.

Make sure you go to a place that has a good audio system that’s Important. So, yeah, Boise was extremely smoky and the air quality was around 250, which is a bad thing. You want it to be zero. So it was very, very smoky.

Hard to be outside for that reason. Plus blazing hot. I mean, for us, where we were in the mid-90s when I was there, so, you know, lots to recommend. Idaho.

This, the weather and the smoke was not one of those things. Oh, we also started shooting crossbows at an indoor crossbow range. That was kind of a fun thing to do as well. So I do recommend that. Yeah, it was.

It was interesting and sort of a fun way to catch up with my son. He’s doing a great job fighting wildfires in eastern Oregon. It’s one of the biggest problems in America. So I’m really proud of him for.

WORM
00:03:11.520 – 00:03:21.120
For doing that in question. Paul, how did that high AQI 250 is pretty darn high. How did that affect you in terms of your eyes, your lungs or other?

GERM
00:03:21.600 – 00:03:57.980
Yeah, it was really bad. I mean, I don’t have asthma. I’m lucky that way.

But yeah, I could only be outside for a short time before I would get this slime dripping down the back of my throat. A lot of coughing. My eyes were super irritated. It was almost like I was kitchen pink eye. So I think I’m just more sensitive to this.

My son has adapted to it. I guess that can happen when you’re exposed to this stuff. It’s unhealthy. It’s unwise. And I suggest people avoid this if they have that option.

I gotta tell you, the people of Boise have figured this out. There’s nobody on the street. Nobody. It was like a ghost town. You go into a restaurant and it’s jammed with people.

Movie theaters are full, but no one’s outside. They’re smarter than I am, that’s for sure.

WORM
00:03:58.140 – 00:04:06.140
Paul, this first question comes to you. Can I save money if I get rabies vaccine not in the US but somewhere abroad where it’s cheaper?

GERM
00:04:06.700 – 00:07:17.890
I think you probably can save money that way. And sometimes that’s the right thing to do. In some cases, you really should not. So let’s talk about this. First of all, what is rabies?

It’s a fatal encephalitis with severe inflammation of the brain. It is generally not survived. And those people who do occasionally survive are typically injured for life. So you don’t want rabies. It’s what to avoid.

You get it when you’re bitten or scratched by another mammal that has rabies. And it’s typically dogs in most of the world.

Although here in the United States it happens to be when you’re kissed or licked by a bat or handle a bat. So in America it’s bats, everywhere else it’s dogs.

And although any mammal in theory can give this to you, and so you don’t want to get it, if you’re exposed to an animal that has rabies or might have rabies, we can give you what’s called post exposure prophylaxis, rabies immunoglobulin injection and then a series of vaccines.

But if you know that you or you think that you might be exposed to rabies, you can do something ahead of time, which is to get the vaccines two of the shots in advance. And we recommend this for people who are going to be well exposed to the possibility of being bitten by a dog.

If they’re going to a place that is known to have a lot of rabies, for example, or someone who’s going to be caving and being exposed to bats, for example, you can do this ahead of time. In that context, you still need to receive vaccines after you are exposed. I’m going to say that again.

Even if you’re pre immunized, you still need your post exposure prevention shots, but you just usually do not need to get that rabies immunoglobulin. So even this vaccine, you still need to see a doctor if you are exposed. I want to put that out there.

But number two, why would you worry about the cost? Well, it’s expensive. I mean, here in the United States, where I live and work, the cost is typically between 800 and 1500 bucks in total.

About half of that is the cost of the vaccine, Half of that is the facility fee or the doctor’s fee. So it’s expensive, I get it. But I would hate for someone who knows that they are going to be exposed to rabies to avoid it for that reason.

So it’s natural to think about getting it overseas to save money. And this is okay if you’re going to someplace that has a reliable healthcare system, a good vaccine supply.

The problem is that there are some places that do not. And this has been a real issue. Right, Chris, we have reports from 30 July 2026 for counterfeit rabies vaccines in the Philippines.

Now, a lot of Philippine rabies vaccine may be okay, but some of it is not.

And this is a huge issue that for a number of different vaccine formulations, they look for all the world apparently, like you’re getting a true rabies vaccine, but that is not the case. And so public health authorities in Philippines are now trying to figure out how this happened. Who’s trying to profit by creating fake vaccines.

Someone’s of course trying to turn a buck.

And the issue of course is that people could potentially die if they get the wrong post exposure prophylaxis under the assumption that they’ve been immunized. So Philippines is not the only place presumably in the world where this is happening. Counterfeit vaccines is a big business.

It’s a big scam, It’s a big problem.

And although, you know, I would say this could happen in other areas, we do have this information that unfortunately Philippines is one place where that has happened. What are your thoughts about vaccines outside of our good old US of A. Here? Chris?

WORM
00:07:18.210 – 00:08:04.530
Yeah, in general, I would avoid getting them in low income countries or in countries where there’s a history of counterfeit vaccines.

And first, just to go back a little bit, you’re correct when you say that you can potentially survive rabies, but we’re talking less than one in a thousand only with intensive ICU support. And the people who survive usually, as you said, have permanent severe neurologic problems. So using the word fatal is essentially accurate.

And it’s a bad way to go if you have a significant exposure to rabies on your itinerary.

If you’re a backpacker, any exposure with animals, I would get the series and I would cough up the expense of money because although it’s rare, it’s really bad. So I agree with you. I would tend to hold off on getting it in most places overseas.

GERM
00:08:06.370 – 00:08:21.410
Okay, Chris, this one I think is ripped from the headlines and I’m catching up on this story. But you’ve asked what should you do if you fall and impale yourself on a trekking pole? Why would you, you know, I love trekking poles.

Why are you trying to plant this nightmare into my mind? Why does this come up and what do you recommend?

WORM
00:08:22.170 – 00:10:41.140
Well, first I recommend trekking poles. So I am a late adopter.

I just started using them recently and I fall down less often and I am less sore at the end of the day, so I think they’re great. But recently you may have read just a few days ago, this guy, let’s use his first name, David.

He was hiking on a high mountain in Montana, a place called the Froze to Death Plateau, which sounds ominous. And he fell and he fell onto his hiking pole which impaled him and it came out his back, basically. And he appeared to be generally okay.

He wasn’t immediately dying. He was Conscious. And it’s not entirely irrelevant that he was a medical professional. He was a nurse.

And his buddies with him said, hey, should we call for a helicopter? He didn’t want to pay for the helicopter. And so he said, no, I’ll hike. And he did.

This guy with his couple of buddies walked for 10 miles, 16 kilometers, taken about six hours. He descended 5000ft, 1500 meters.

And finally they got together with the rangers and he got taken to a hospital and they took it out and he’s doing well. So a few, a few lessons from this. One, don’t fall on your hiking pole.

Two, you know, when a large metal object protrudes into your abdomen and back, the first thing to think about is not the cost of the helicopter. This guy really didn’t know how severe this was. He could have had a bleed that could have caused his death on the way down. He didn’t really know.

He just thought, well, it’s not that bad.

And on one hand, you know, I tip my hat in respect for his stoicism, but I hate to say it, but docs and nurses can make the dumbest mistakes about ourselves. Sometimes we think, oh, I understand the rules of biology, so I’m exempt from better than other people.

So I basically think it was a really dumb decision to keep hiking with this thing in his body and go online. There’s a nice news article and video of this guy hiking. And then at the ER and they took it out and he’s got the, the wounds from it.

So bottom line, don’t do it. And if you do, call the highest level of care immediately.

If this had gone just a tiny bit deeper, it could have caused a life threatening bleed or other issue. So I was kind of titillated and horrified when I read about this. Paul, give me your take.

GERM
00:10:41.620 – 00:10:56.900
I think in general. So first of all, I always keep my snow basket on the trekking pole, even in the summertime. Maybe that would limit the depth of the penetration.

Who knows? I got to catch up on what happened to this poor guy. David. Number two, Chris, should people pull it out or leave it in place?

WORM
00:10:57.060 – 00:11:34.480
Oh, great question. And this applies not only to hiking poles, but basically any object that you have the bad luck to impale upon your person.

Whenever possible, leave it there. Let the professionals take it out in the setting of emergency room.

So, for example, suppose you have the bad luck to get something impaled into your chest and it goes partly into your heart.

That foreign body may be staunching a blood flow and if you pull it out in the field, you could potentially start up a huge bleed that could be life threatening. So big chunk of metal in somebody. General rule, let the ER doc or the surgeon pull it out in a very controlled situation.

GERM
00:11:35.360 – 00:12:05.170
Yeah, when I got trained as a wilderness emt, this was part of our process, you know, creating some way to stabilize that foreign body so it doesn’t wiggle around so much as we extricate them. Well, this poor guy had to walk out. How much stabilization he could do, I don’t know. That’s a crazy story. First of all, the froze to death plateau.

Just the name alone should give you a hint. Stay the hell away. Number two, eager to find out more about this, so thanks for raising that.

And for those of you out there who are on the fence, use the trekking pole. Just keep it outside your body.

WORM
00:12:05.570 – 00:12:12.770
And of course, listeners, if you have any other anecdotes about being impaled by metal objects, please drop us an email and photos.

GERM
00:12:13.170 – 00:12:14.210
Oh, hell yes,.

WORM
00:12:16.210 – 00:12:24.050
Paul. Coming up, next question for you. Cyclospiriasis. It’s big. Is it getting better? Is it getting bigger? What’s going on?

GERM
00:12:24.810 – 00:16:36.400
Yeah, I told you, I just saw the Odyssey. I was thinking about the Cyclops. This is the cyclo. So the cyclosporiasis cyclospora we’ve talked about a couple of times.

Remember, this is a parasite, single celled organism that you get in your body when you eat food that’s been on the ground and soiled by the diarrhea, the feces of someone who has the infection. That has happened in the United States, primarily through lettuce. Now in 2026, lettuce pray that we don’t get cyclospora from lettuce.

This is a huge problem. And remember, in a normal year, right, Chris? CDC may report between 500. On a big year, 2,000 cases.

Last big year we had was 2019 at more than 4,000 cases. That was huge. Well, right now, as we record this end of July 2026, I mean, there’s currently, you know, more than 10,000 cases.

And no doubt that’s an undercount and that number will continue to go up. So the epidemic curve continues to rise. Remember, there’s a delay between the time that someone gets exposed and when they get infected.

It takes seven days of incubation and then there’s a delay between when they’re infected, when they seek care, from when they seek care to when they get a positive test and when that positive test works its way up to our federal system. So there’s always a lag. I suspect that we are now at the peak or past the peak, but the numbers that we’re seeing continue to go up for this reason.

So it’s an embarrassment. It’s a problem. How does this happen? You know, this comes to us primarily, we think, through lettuce.

There’s one particular supplier, Taylor Farms, that sources its lettuce primarily from Mexico, and they sell throughout the Midwest, in fact, potentially throughout the United States. But most of these cases are from Michigan, where there are just many thousands of cases.

But elsewhere also, some of those people who got infected seem to have picked it up by consuming lettuce from Taco Bell, but many did not. They could get it through bagged lettuce at their grocery store as well. So a couple of things. Number one, to prevent this, you don’t eat any lettuce.

Well, that’s a terrible idea. In fact, we have reports that people are just not consuming fresh vegetables this summer. That’s very unhealthy. You need your roughage.

You need to eat more vegetables, not less. And so if you’re going to have a salad, please do.

Number one, if you’re in an area of high concentration, where this has been happening, you know, these are recalled products. You can go to the CDC website and look for the recalls, the different batches of lettuce that are out there.

Most restaurants, certainly Taco Bell, but other restaurants and also grocery stores, you know, they’re pulling these products from their shelves. By the time you hear my voice, those recalled products should be long gone.

So I strongly suspect that you can probably go out and have any kind of lettuce. But if you’re concerned, you’re cyclo frightened. I get it. You consider getting a head of lettuce off the shelf.

With that, you can peel off the first couple layers of the lettuce, wash what’s left behind, and your risk is dramatically reduced even further. You can think about this sort of the way, you know, with E. Coli when we said it’s usually a hamburger that gets it right.

Chris, there’s so many cows that go into a single hamburger, whereas with the steak, you can sear it and you’re good. It’s like that with respect to this, those bagged salads, that’s like your hamburger. And the head of lettuce, it’s like your steak.

So if you’re really worried about this, have a head of lettuce instead of of the mixed salad. And number two, if you do get sick, see your doctor get tested. We do have treatment.

The best treatment is called Trimethoprim sulfa or Bactrim, and it works well. This is evidence based and has been done in randomized clinical trials. It’s not the end of the world.

It is just something that I wish we didn’t have as much of. And by the way, the way we prevent this is by treating agricultural workers with respect. Think about it.

If you’re an agricultural worker, Mexico or elsewhere, if you get sick, do you have time to get away from work and still support your family? Is there a clinic nearby that has high quality testing? And if they do, can you afford to get that test?

And if so, do they know to give you the right antibiotic? And can you take that antibiotic? And by the way, can we please give these guys latrines, outhouses or honey buckets?

You know, out in the field, if people just defecate in a way that has normal sanitation, this whole problem goes away. It’s not from animals. It’s from people who are working very hard to support their families and they just don’t have another choice.

So I think feeding the American people is a privilege and I think people should earn that right by treating their workers with respect. That’s all I have to say.

WORM
00:16:36.960 – 00:17:03.780
Yeah, I agree with all of that.

And also, if you want a little more info on this, the jama, the Journal of the American Medical association, has a series of what are called patient information pages, and they have a very nice one on cyclospirasis.

So just put into your search engine of choice, JAMA Cyclospirasis, and you will get some very good succinct information on this, which is not in medical lingo but is in easily understandable English.

GERM
00:17:05.700 – 00:17:14.820
Chris, a question to you from Tarek. It’s a very simple question, totally unexpected for me. And Tarek says, does catnip oil repel mosquitoes?

WORM
00:17:15.060 – 00:18:36.120
Yeah. Thank you, Tarek. So I was at this Montana wilderness medicine conference and this nice young man came up to me after my talk on bug repellent.

And he said, hey, Dr. Sandra, what do you think about catnip oil? I hear that it’s as good as diet or picaritin. And I have to admit I hadn’t heard of it. And I was somewhat dismissive.

I said, well, that’s going to attract cats, but I don’t really have much optimism that’ll do much about mosquitoes. But then I read about it that night and actually it’s a real thing and it shows a lot of Promise.

They’ve done studies in Uganda and elsewhere, and catnip oil first, that it comes from the. The mint family. It’s an herb. It repels mosquitoes very nicely.

In fact, some studies show that although it doesn’t last as long as deet, it is as strong as DEET if you use it at a higher 6% percentage.

And there’s a very good study, particularly on Aedes mosquitoes, which are the vectors for dengue fever and other diseases, that catnip oil at 6% worked as well as DEET. Now, like I say, it doesn’t last quite as long, so you have to apply it more frequently.

And I’m not yet going to officially recommend it because I want to see bigger studies both on safety and efficacy.

But there is growing information that it may be an option for folks who go abroad, which is great because currently there’s not really a great botanical option. Paul, is this something that you’ve heard about?

GERM
00:18:36.440 – 00:19:11.470
No, totally not. I mean, my daughter has two cats, but they go crazy when they eat the cat niper and chew on it. But, I mean, it’s possible. I don’t think it’s crazy.

You know, natural products can have all kinds of other unexpected benefits. Maybe this is one of them. I certainly would not reach for that over Picaridin. I mean, to me, picaridin, 20%. That’s how you keep the mosquitoes away.

And if they’re horrible flocks of mosquitoes, that’s your deet. Like you said that to me, those are still the gold standard.

But I’m hopeful that maybe this would become an alternative for somebody who, for whatever reason, can’t use any of the things that we really know can work.

WORM
00:19:11.870 – 00:19:30.110
And one big benefit of this, and this is pointed out when the researchers published their study in Uganda, is this thing can be grown around the world, this herb, this mint, and it doesn’t require the big manufacturing process of Dieter Picaridin. So I think that, you know, stay tuned, but I’m definitely going to pay attention to this one.

GERM
00:19:30.590 – 00:19:35.150
And when you go outside, all the alley cats will think that you’re the Pied Piper. It’s going to be super fun.

WORM
00:19:35.550 – 00:19:45.510
That’ll keep the rats away. All right, Paul, coming up for you, what is this? There is a new medication that can prevent Covid in folks who’ve been exposed?

GERM
00:19:46.390 – 00:23:58.060
Yeah. And it’s not Ivermectin or aquarium cleaner. Yeah. This is actually true fact.

So there’s a medication, the trade name is xocova, which to me sounds like a chocolate filled drink you might get when you’re on vacation. I’ll take some chocolate in my xocova. But xocova, that’s the, the trade name. Somebody got paid to come up with that name. Can you believe that?

Chris, we’re in the wrong business. Xocova. Ask your doctor if xocova is for you. What is this stuff? This is ensitrelvir. Ensitrelvir is an antiviral.

This is another antiviral that is designed to kill off and inactivate the COVID 19 virus. And this is true. This is now FDA approved. I’m excited about this. Although there’s major caveats.

Ensitrelvir is a pro approved for the post exposure prophylaxis prevention of disease in someone who’s been exposed for COVID 19 in anybody age 12 and above. But you have to start it as soon as you’re possibly exposed and definitely within the first 72 hours, although earlier is better.

Beyond 72 hours, we simply do not think it’s going to do much of benefit hasn’t even been studied in that regard. And what’s the dose? I mean it’s three pills on the first day and one pill a day for then days two through five. So a total of five days of treatment.

And the benefit was demonstrated in a trial. It was called the Scorpio PEP trial.

You got to come up with a sassy name for your drug trials and this one’s called Scorpio PEP has nothing to do with scorpions. It also has nothing to do with Al Pacino. No Scorpio pep.

This is a trial where people who were exposed to COVID 19 either got in ensitrelvir or they got a placebo. And then they were followed for the first 14 days to see if they got sick and. And they were less likely to get sick.

In fact, about 3% of the people who were exposed and got the drug would go on to develop infection versus 9% of those who were exposed and got placebo. So there is a benefit final analysis. The most rigorous, aggressive way they decided this was about a 57% reduction with confidence.

And so it cuts your risk about in half of catching COVID 19. That’s exciting.

It did not matter whether the person who took the drug was high risk for Covid immunosuppressed elderly or were they just a normal person. The benefit was the same. They even looked at the amount of shedding of virus. This was also reduced.

And so your chance of passing it on to another person was cut down. Although not to Zero, but was reduced as well. Pretty safe.

Some people had some diarrhea and cough and headache, and there were some minor issues of side effects, but overall relatively clean. And so this is felt to be safe. The biggest issue with this medications are several fold. Number one, it’s, it’s expensive.

It’s about $1,400 if you want to take a course. And insurance was going to be upset about paying for this and you may have to go through that, you know, prior authorization process.

As I said, it’s no good with within unless you take it within the first 72 hours. So that’s a major issue unless you want to just pay cash money for it. And a lot of pharmacies don’t currently stock this.

Number two, it does rev up your cytochromes. Cytochromes are the enzymes that we all keep in our liver. They’re important for detoxifying the blood.

But a number of other medications are processed through the cytochrome system. And so if you’re taking a medicine that’s already processed by cytochromes, there may be a drug interaction this way as well.

Finally, to me, the biggest issue, of course, is knowing that you’ve been exposed. Like, when are you really exposed to COVID 19. So many people who spread the infection are pre clinical, they’re pre symptomatic.

You may not realize that this happened.

And by the time someone calls you, if they ever do, to say, oh, geez, my bad, I exposed you to Covid, that’s going to be beyond the 72 hours that you need. I could imagine a scenario, Chris, in which someone would benefit from this. You could come up with an idea of that.

And theoretically we should all run around with a dose pack of this in our, our travel kit.

I mean, if you can afford it and you don’t mind paying cash money for it and you’re willing to do this because you just don’t want to have Covid, you don’t have time for the COVID I could see that being something to consider, but as you can see, there’s a number of caveats. And sadly, this really is not that simple. Single dose that we could all take preventatively, that we all need and deserve.

But it’s important to know what xocova is about. And with those caveats, Chris, what’s your take on the. This new technology?

WORM
00:23:59.260 – 00:24:05.660
You know, I’m just reading about it now, but from what I can tell, it’s really nice to have as an option. So I’m glad it’s hitting the market.

GERM
00:24:06.060 – 00:24:23.780
Stay tuned. And if there’s anybody out there who’s used it and had a good experience or otherwise, kindly let us know. Drop us a line. Germanworm gmail.com.

So, Chris, here’s a different epidemic, Bundabujo form of Ebola. Can you give us an update on what’s going on with Bundibugyo virus Disease?

WORM
00:24:23.780 – 00:25:58.840
The news is not good. This has very quickly turned into the second biggest ever Ebola outbreak.

Only that huge outbreak, 2014-16 in West Africa was bigger, and that one killed over 11,000 people. This one is rapidly expanding. In fact, this is the very fastest expanding Ebola epidemic ever. We have over 3000 confirmed laboratory cases.

We have over 1400 deaths. And it’s not controlled. The rate of growth is worrisome for how big this thing’s going to get.

It’s in drc, Democratic Republic of Congo, and it’s primarily in the Ituro district, which is a very unstable rural area in the extreme east of drc, right on the Ugandan border. The good news, the only good news that I can see is that the case count in Uganda is down to zero. Uganda, relatively organized country.

They did quarantine and isolation and case control controls and so on. That’s not happening in drc. So this is huge. It’s getting bigger, faster.

And also it’s not due to the Zaire strain for which there’s treatment and a vaccine. It’s due, as you mentioned, to this other strain, this Bundibugyo strain. And there’s no vaccine and no treatment for that.

So this would be a really good place for the WHO to be fully funded and to do their intensive containment. That actually brought an end to that big 2014-16 epidemic. The US has pulled out of WHO and for other reasons.

And that reason, the funding is not as solid. So this is really a good time for public health that I’m afraid is not fully occurring right now. Paul, your take?

GERM
00:25:59.800 – 00:27:17.310
My take is that we should invest in the public health of the world. If we want to protect ourselves and each other from this Bundibugyo virus, we should take care of everybody.

I mean, the way to deal with this is to do prevention work and care right where it’s happening and not to wait until it approaches your shores to deal with it. That’s insular and silly. And the viruses just don’t work that way.

I would emphasize Bundibugyo is different from the Zaire form of Ebola because it is slightly less virulent, slightly less deadly. That Might sound good.

It’s actually the reverse, I’m afraid, because with Zaire strain, so many people die so quickly and so horribly that the chance of it spreading is reduced. Here, unfortunately, people may catch the infection and have a greater opportunity to spread it around.

The incubation period may be a little bit longer. The variability of the clinical course means that we’re going to have greater spread where people are able to travel, to move around.

That’s why it really does present a significant threat to public health. You don’t catch it by breathing the air. It’s not that way as we do with COVID 19. It is still by direct contact.

It’s an emergency, it’s a crisis, and it’s an opportunity for nations who choose to lead to stand up and do so. I’m embarrassed that our country is not doing that right now.

WORM
00:27:17.630 – 00:27:33.400
Yeah. And the containment measures are not easy, even in this country. It would be expensive and you need a lot of manpower.

Doing it in a politically tumultuous area such as DRC is really challenging. With a lot of resources, it could be done, but it’s not happening currently.

GERM
00:27:37.560 – 00:27:45.480
Okay, Chris, here’s one more question to you. The question is national parks. Which ones are most or least visited in the us?

WORM
00:27:46.040 – 00:29:41.010
Yeah, great question. And personally, I like to go to the parks without billions of people. So I really enjoyed going to Yellowstone recently, but it was really crowded.

There were long lines, bad traffic, and so on. The most crowded, the most visitors, the very most.

Number one is the Great Smoky Mountain national park, and that’s on the border between North Carolina and Tennessee. And over 13 million people go there per year. So it’s beautiful, I’m told, but it’s crowded. Number two, Grand Canyon. Almost 5 million people a year.

Number three is Zion.

And these are all beautiful places, but on the crowded side, the least crowded ones, which I looked up recently, was interesting and includes one very close to where Paul and I live. So the fewest would be the Isle Royale national park in Michigan. It’s an isolated island archipelago on Lake Superior, and you have to take a ferry or a seaplane to get there. Looks lovely from the photos. I’ve never been the one that’s next, though. Surprises me because I’ve been there dozens and dozens of times.

In fact, I used to live close to it when I lived in Arlington, Washington. It’s called North Cascades National Park.

It’s maybe a couple hours by car out of Seattle, and I kind of feel like saying, so it doesn’t get overcrowded that It’s a hellhole with rabid skunks. So a lot of people don’t go there. But in fact, it’s beautiful.

You can drive on a road, not see anybody, and then hike up to these tall mountains that are gorgeous. And indeed, there’s very few people there.

So actually, between friends, this North Cascades national park, there’s dozens of hikes there is one of my favorite places in the world, a couple others that are not very often traveled to. One is the Dry Tortugas national park in Florida. And, and then there’s one that I’ve never been to, but I looked up recently.

It’s called the Great Basin National Park. It’s in Nevada on the Utah border. Looks gorgeous. Not many people go there. It’s desert plus forest plus lakes.

Have you heard of that, Paul, or have you been there? The Great Basin National Park?

GERM
00:29:41.650 – 00:30:18.500
I’ve not been to Great Basin, but I certainly have heard of it. It’s the place that’s on my list.

I personally would not go in summer to damn hot, but in the fall or the winter I think it sounds special and it’s on my list. And as for North Cascades. Hey folks, you’re listening to Germ and Worm. So this is part of your, part of your benefit of being a part of Germ Nation.

We’re going to give you these tips, but please keep it in the family. Do not tell your friends about North Cascades. Don’t post to the socials. It’s just too beautiful. That’s because it’s empty.

We want to keep it that way. So thanks for keeping that gem under your. Under your coat pocket.

WORM
00:30:18.580 – 00:30:29.940
Yeah, if you go there, please post a photo afterwards and get AI to do like that hiking pole impalement in your chest or have some animal eating you so that a lot of other folks don’t go there as well.

GERM
00:30:41.540 – 00:31:05.710
The Everybody, thanks for joining us here on episode 113 of Germ and Worm. As always, we would love to hear from you. Send us your questions, tips for travel success, or suggested corrections.

Drop us an email germanwormmail.com or see us online germanworm.com if you’ve enjoyed what you’ve heard, please subscribe, rate us favorably on your device and spread the word with friends and family and on the socials. Those are free ways to support our podcast. I’m Germ.

WORM
00:31:05.790 – 00:31:10.020
I’m Worm. It’s a big planet. See it, good health and we’ll see you next time.

GERM
00:31:10.100 – 00:31:29.380
This podcast is designed to inform, inspire and entertain, but it does not establish a doctor patient relationship and so it should not replace your conversation with a qualified healthcare professional. Please see one before your next adventure.

The opinions in this podcast belong to Dr. Sanford and Dr. Pottinger alone and do not necessarily represent the opinions of the University of Washington or UW Medicine.