GERM
00:00:09.440 – 00:00:11.280
Pryvit! My name is Germ.

WORM
00:00:11.360 – 00:00:12.240
I’m Worm.

GERM
00:00:12.320 – 00:00:26.400
Welcome to episode 118 of the Germ and Worm Travel Health Podcast. West Nile in Europe, Risks and realities. It’s a big planet. See it in Good Health. I’m Dr. Paul Pottinger, also called Germ. I’m an infectious diseases specialist at the University of Washington.

WORM
00:00:26.740 – 00:00:32.100
I’m Dr. Chris Sanford, also known as Worm, family medicine Doctor, also at the University of Washington.

GERM
00:00:32.500 – 00:01:34.330
Well, today we tackle a number of fascinating questions coming to us from our listeners across the country and around the world about how to stay safe when they travel. Questions for today include preventing jet lag for a particular event, which is better arrive early or pop in and out really fast. The new MRNA vaccine for influenza. Is it safe? Is it effective? Pregnancy and travel, when and how can it be done safely? And West Nile virus in Spain and Greece. What’s the risk?

These questions and many more. A reminder to our listeners. Please contact us with your questions on travel, health, your stories and tips for success.

We would love to hear from you. Visit our website, germandworm.com or send us an email germandworm@gmail.com first, 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 to your itinerary.

So, Chris, here we are in Seattle in mid September 2026. You, my friend, just came back from Burning Man. What? What was. What was that like?

WORM
00:01:35.690 – 00:02:28.560
This was my first burn. So I am now no longer what is termed a “burgin.” I’ve got that under my belt. Yeah, it was wild. I was there nine days. I worked in the clinic there.

I did graveyard shifts, always starting at 11pm and ending at 7am it was intense. It was surreal. I’m still kind of coming down off of it. It was overwhelming. It was bizarre. It was lovely.

I kind of went back and forth multiple times between euphoria and misery and more euphoria and more misery. It was too hot. It was too cold. I met really nice people and in fact, Paul and I were just talking this morning.

I think we’re going to do a whole episode where I’m going to talk about it, sort of both Burning Man in general, but what it was like to work at the medical clinic, who I saw and advice for you should you go to a large medical festival such as Burning man on how to stay safe.

GERM
00:02:28.800 – 00:02:35.760
So you said you’re coming down from the experience, to be clear: Are you coming down from GHB? What are you really coming down from?

WORM
00:02:36.640 – 00:02:53.700
Adrenaline, sleep deprivation, too much noise, too much caffeine, too much dust, being hot and cold, too much…. And just the overwhelming music and the art and the conversations and the newness of. But no, it is surreal.

GERM
00:02:53.700 – 00:02:59.860
Before you do any hallucinogenic drugs, I’m glad you felt the burn. And I’m really looking forward to talking more about this and other big festivals like that. Great idea.

WORM
00:02:59.940 – 00:03:03.700
Thanks. And, Paul, maybe you could mention you and I published an article last Sunday.

GERM
00:03:04.500 – 00:04:03.720
Oh, yeah, Chris and I did publish an article in the Seattle Times. We hope you’ll look it up. And in fact, if it’s behind a paywall, let’s put it on the website.

Germandworm.com this is an op-ed that we were asked to write by the editors of Seattle Times.

Just talking about these most recent changes proposed by our fair leader, AKA the President and his minions, trying to reduce the number of vaccines and make it harder for people to get vaccines and stay safe that way. So this drives us crazy. It’s a bad idea. And this is a op ed that has gotten a lot of attention, I think, on social media and such.

And I’m proud of that because, number one, very few death threats, not a lot less hate mail than we typically get. Number two, I mean, we said what we intended to say and I think very few euphemisms.

There’s a little bit of foul language in there, but not enough to keep it off the Seattle Times. So if you’re interested in learning more about this.

Yeah, please check us out and you can just search our names at the Seattle Times website or we’ll put it onto Germandworm.com.

WORM
00:04:03.720 – 00:04:13.200
Yeah, and the title of it is “Trump’s Ideas for Changes to Childhood Vaccines Are Dangerous.” But as Paul says, if you don’t get to it, let us know. We’ll send you a copy or check out our website.

GERM
00:04:13.920 – 00:04:48.610
The last line of that article was a quote from a member of Congress who said, president Trump should stick to what he knows best: Bankruptcy, ballrooms and bullshit. And I think he was exactly right. And that’s our opinion, too.

Okay, Chris, here’s a question to you.

This one’s super interesting. This is coming from me because I didn’t realize that this was happening. Jet lag and professional US Football. Which approach is best? Should people show up early and acclimatize? Get over the jet lag? Or should they jet in and out and never actually readjust? Tell us about what happened most recently with respect to football in Australia and what your recommendation is, right?

WORM
00:04:48.610 – 00:06:32.780
You bet. So this is interesting and it’s sort of a natural experiment.

So two West coast pro football teams, the Rams and the 49ers, 49ers in San Francisco and Rams in Los Angeles, just flew and played a game, I think early this morning in Australia, which is 17 hours ahead or seven hours behind depending on how you figure it. And they had two different strategies for dealing with the marked jet lag.

One team, the 49ers, they left nine days early on purpose to acclimatize and get over the jet lag. So they were on the local time.

The rams just landed 24 hours before game time and their thought was arrive still beyond west coast time, no jet lag, play the game. And this, the outcome of this doesn’t really prove anything.

There’s a put down within medicine called n of 1 and n of 1, n means the numbers of subjects in a study and N of one means, well, that’s a one off. You can’t really draw any conclusions from just one data point.

But I will say that the San Francisco team, the 49ers who got there nine days early, they won and the score was 27 to 7. So what can we conclude from this?

Well, it doesn’t prove anything, but I will say that in my experience, if I want to feel clear, it doesn’t happen in the first day or two. So if I have an important talk to give or something like that, I don’t get there the day before. I’m not on local time, I feel crummy.

I like to get there early.

Like I’m going to Bhutan in a week and I’m deliberately getting to Bangkok a few days early just so I can acclimatize and get on the local time so I’ll feel less crummy. So I go with the 49ers strategy. Both are realistic.

There’s no data, but I thought it was fascinating that these two high stakes, well paid teams had very different approaches.

GERM
00:06:33.260 – 00:06:59.140
I think that’s right. And if you’re in a situation where you have a particular date, you need to be somewhere many time zones away. But you can’t pre acclimatize on site.

We’ve talked about this before. You can start adjusting at home.

And I don’t know if the Rams did this, but if they started moving their bedtimes by an hour a day, maybe they, maybe they did this. But if they didn’t, maybe they shoulda, coulda, woulda done that so that when they land they were a little bit more circadian. Correct.

WORM
00:06:59.540 – 00:07:04.420
And you Say, Paul, you’ve done that at home, you’ve changed your waking up and going to bedtime.

GERM
00:07:04.820 – 00:07:24.480
I mean, I try to do it all the time. I’m almost always too busy to actually do it. But on the few occasions when I’ve actually done this, it helps.

Even if you’re just cutting four or five hours off of this adjustment, there’s something to that. It’s not socially acceptable to go to bed at 6pm Maybe it’s kind of good. Maybe I should do that more often.

But anyway, that’s something you can do if you must.

WORM
00:07:24.800 – 00:07:30.440
I think it works if you do it. Personally, I’ve never been able to do it successfully. I’m always too busy right before I go.

GERM
00:07:30.440 – 00:07:30.920
Yeah, I know.

WORM
00:07:30.920 – 00:07:32.080
I think it looks good on paper.

GERM
00:07:32.080 – 00:07:33.880
Do as we say, not as we do. Right?

WORM
00:07:33.880 – 00:07:44.880
Right.

Paul, different topic. There’s this new, much publicized mRNA vaccine for influenza A. Is it safe? B, does it work?

GERM
00:07:45.600 – 00:08:27.840
Yeah. Yes and yes. This is really exciting. I’m so happy to give you this story and strong supportive advice.

So the new vaccine is vaccine against seasonal influenza, which means it covers a number of different flu strains as we usually do, as we have covered for quite a long time here in the US it’s different for a couple reasons. First of all, the name, it’s called Fluciva, which I still think is a good name for somebody. “Flusiva. Get off the roof!”

I can tell you that any good medication name, it should be a name that you would be proud to have on your pet dog. Like I’m going to take Flusiva for a walk. So somebody got paid to name it Flusiva. I don’t know how they did this, but I love it. It’s super cool.

Not only because of the sassy name, but most importantly because of the way it’s built.

WORM
00:08:27.840 – 00:08:27.960
Right.

GERM
00:08:27.960 – 00:12:17.840
So Flusiva, the first FDA approved influenza immunization built on mRNA technology. This is the same tech that’s gotten people Nobel prizes and that has saved much of the world from COVID 19.

So we love this idea that instead of growing the vaccine in chicken eggs or in tissue culture, we can do it in the laboratory, industrial pharmaceutical labs using MRNA tech. mRNA tech is amazing for a couple reasons.

Number one, it’s will stimulate a very good robust immune response and that has been studied here in terms of correlates of immunity, a good immune response level with our antibodies getting boosted this way. That happens with Fluciva, just as it has with the Moderna and the Pfizer flavors of COVID 19 shot.

It’s also exciting for me because we can do it very quickly. If you need to grow your vaccine supply in chicken eggs, it means you need to make a choice about what you’re going to cover. What strains of flu?

At least 9 months in advance, 6 months would be the bare minimum.

So we’ve talked about this before, right, Chris, the flu shots that we give in Northern hemisphere flu season, that’s based on what we saw in the Southern hemisphere, Australia, for example, you know, the previous. In the middle of their own flu season, which is half a year in advance. It’s a slow process. Flu can change.

It may be that what we predict to happen is right. It may be that our predictions are wrong.

Boy, if we’d had a quicker turnaround time to build those vaccines, we’d have a better match between the antigens that are in the vaccine and what’s actually in the community. Well, mRNA can do this. I mean, theoretically it gives us a two month turnaround instead of a six to nine month turnaround.

So I like that aspect of it as well. But to answer your question, Chris. Yep. This is approved by our Food and Drug Administration here in the United States for adults age 50 to 64.

And that’s fully approved in that age. And that it also got what’s called accelerated approval for those age 65 and above. What does that mean exactly, accelerated approval?

Well, the idea was this is there was no safety signal or concerns whatsoever and they really felt that this was something that was going to be highly protective and important for that older age group. And so they let it through that way. What they did not do was to approve it for people under the age of 50.

So I think this is why did they not approve it for people under the age of 50 because those individuals did not have substantial representation in the clinical trials.

So instead of saying, oh, it’s safe in older folks, let’s give it to kids too, they said, nope, we actually want to study it in younger people as well. So for the current respiratory season, if you go to get your Fluciva, the pharmacy may ask to see your birthday. Are you under age 50?

If you’re under age 50, they are not currently approved to give you that vaccine. I have absolutely no reason to think it would be unsafe in younger people, but it’s something that we should look at.

You may recall one of the flavors of COVID vaccine built on MRNA in some young kids, especially teenage boys, had an increased risk of causing pericarditis.

And so maybe that was part of the concern that they had here in the context of COVID We know that the best way to protect yourself from pericarditis is to get your Covid shot because Covid itself gives you more pericarditis than the shot does. But anyway, that’s part of the confusion concern. Check in with germ and worm in about a year from now.

I’m strongly confident that we’ll have a lower age restriction for people to get fluca. Meantime, please, you know, go when it’s time for your flu shot. And by the way, that’s about now, folks. It is fall time. Get your flu shot.

And I don’t care, honestly if it’s fluciva or something different, but I would say the immunologic response in Fluciva looks really good. I’m hopeful I could get this myself.

I happen to work in a hospital where this stuff is not yet on supply, so I don’t think I’m going to get it this year. But if I had the opportunity, I would do and I recommend it and I have high confidence that it should, should work well.

WORM
00:12:18.410 – 00:12:57.700
Yeah, I like it too. And there’s a couple more things to mention that are in its favor. One is it’s even more protective than the usual flu shot.

So studies show that it’s about 27% better than pre existing flu shots, which is great. Another thing is you can get this shot and still get the flu, but if you do, it’s more likely to be a milder case, which is no small benefit.

So if you do get the flu after this immunization versus getting the flu after no immunization, you’re less likely to be so sick you have to be hospitalized and you’re less likely to die. So that in itself is a big benefit of getting this. So no, it’s not 100% protective, but it’s really protective against a bad outcome from influenza.

GERM
00:12:58.420 – 00:13:05.460
Chris, here’s a question from one of our listeners. Is it safe for me to travel when I’m pregnant?

WORM
00:13:05.860 – 00:16:09.310
Ooh, thank you for the question. That is a large, complex topic. And the bottom line is somewhat, with many caveats.

There was a nice article that came out in the New York times, came out 28 August, just recently, a couple weeks ago. Few thoughts. Talk with your doc, get your doctor’s opinion on this. But if it’s a normal pregnancy, yeah, many people can do some travel.

The best time is that middle trimester. So the first trimester medical issues are more common. A lot of people, a lot of women feel crummy with nausea.

The last trimester, the final trimester of the three. Again, there can be medical issues and people can feel crummy with the additional weight.

But usually the middle of the third is when people feel least affected by the pregnancy. A few things to consider during the entire pregnancy, women should avoid contact sports.

So if you’re into taekwondo or parachuting or motorcycle stunts, I would hold off of that during the pregnancy. Also, scuba diving, absolute contraindication, total pregnancy, any depth, any kind of scuba diving is bad for the woman, it’s bad for the fetus.

Also, there’s not a lot of research on extreme altitude and I don’t know what altitude is safe, but I wouldn’t go super high. There’s not a lot of data on that.

And given that we tend to be cautious with pregnant women, I wouldn’t go really high on a mountain, but I can’t give you an altitude. Something to consider, a few things. One, consider where you’re going and if your water broke, would you be okay with a local hospital?

So if you’re going to New York or London, you know, Tokyo, you’re going to get good medical care. But a lot of low income nations around the world, the care is going to be less than what we see in western hospitals. So consider that.

Also in general, I discourage pregnant women from going to areas where there’s malaria. Out of the medications that are approved for malaria prevention, only one of them in the US is approved for pregnancy and that’s Mefloquin.

But Mefloquin by far has the highest rate of side effects, including mood changes and even worse. And so I kind of hate to give it because it causes so many potential side effects.

So my advice is if you’re pregnant, don’t go to areas where there’s malaria because none of the medications are low side effect that work. So back to your question. Is it safe during pregnancy? Not 100% safe, but of course it’s not 100% safe when you’re not pregnant.

Think about where you’re going to think, what medical care you would get if you needed it. And also if you don’t have a normal pregnancy, I wouldn’t leave the high income nation.

So if you have diabetes or some other complication, your placenta is in an abnormal place. I wouldn’t recommend going outside of high income places because you may need care.

And one final consideration before I turn this over to Paul is check your medical insurance because if something happens and you need medical care abruptly, most US Medical insurance plans do not cover your care outside of the US So read the little information on the back of your card, call the number, look up who pays for what where. If you’re going outside the US Maybe consider buying evacuation and medical insurance as a separate coverage plan.

GERM
00:16:09.710 – 00:16:21.870
Yeah. In the old days, didn’t they call part of pregnancy confinement where you were like literally stuck in a room or something? We don’t like that.

We like people to travel and pregnancy should not be a contraindication to doing it. But it totally depends. It just depends.

WORM
00:16:22.110 – 00:16:31.650
And some airlines after say eight months will not let you fly. But it’s totally at the discretion of the person at the gate. And so I can’t really give you a firm rule on that.

GERM
00:16:31.890 – 00:17:06.110
That’s right.

And I think when it comes to specific health questions, as always, folks, talk with your physician, especially your obstetrician, but in addition, family medicine doctor or someone who is smart about travel, seeing a travel medicine specialist with and disclose to them that you are pregnant or may be pregnant or you’re thinking you’re pregnancy curious you might get pregnant. What are the implications for your itinerary?

I think most people can travel most places, but, but some of those specific activities probably really should be taken into consideration and avoided, as you say. So thanks for that question and thanks for talking to your healthcare provider before you do this.

WORM
00:17:10.670 – 00:17:19.550
Paul, question for you. Most of the stuff we see in the newspapers about West Nile is in the U.S. what’s up? Is there West Nile risk in Europe?

GERM
00:17:20.270 – 00:19:00.750
Okay, so thanks. So what is West Nile virus? This is a flavivirus. It’s an RNA virus that is spread to us through the bite of a mosquito. It’s related to yellow fever.

It’s related to dengue, for example. It gets the name because it was originally described in people who were suffering after being bitten in that part of the world.

But it’s not just there in the United States. We absolutely have it. For example, you know, here in 2026, we had actually a pretty early start to the West Nile season.

This seems, we think, to be a pretty bad West Nile season in the United States. Although the full epidemiologic reckoning and information and summary coming from Centers for Disease Control is still in process.

We don’t currently have that, but states currently like California, California, Arizona, Illinois and as far north as North Dakota are really having an increase in seasonal West Nile virus. It can be bad, it can be flu like, it can be fatal.

And in between you can have something called neurotropic disease where People get inflammation of the brain, that’s encephalitis, inflammation of the meninges, that’s called meningitis.

This can be bad in those people and they can have a lasting neurological implication and impact, especially people with a reduced immune system for whatever reason, treatment of cancer, transplant, something like this. So it’s a real disease. We worry about it here in the United States and of course we worry about it in Europe too. So a couple places come to mind.

I’ve had questions about this for people traveling to Spain and people traveling to Greece. Now, I was just in Mallorca, which is part of Spain, and I was so worried about this that I made sure that we all wore our bug repellent.

The truth is we had, I think one of us got a single mosquito bite the whole trip. What would you say, Chris, if somebody’s planning a Spanish vacation, would you tell them to, I don’t know, wear their bug repellent?

WORM
00:19:00.750 – 00:19:44.940
You know, I would, and I’m glad you mentioned that shirt. There’s some clothing that’s pre impregnated with permethrin.

At a minimum, I would either get that clothing which is pre impregnated with permethrin, which is a little pricey, or it’s just cheaper. Spray the permethrin on your clothing yourself and use bug repellent.

Because there’s actually been an uptick in West Nile in Spain, not the whole country, but in Extremadura, which is the province on the Portuguese border, and in Andalusia, which is the province to the south on the coast there. This year is twice the usual incidence of West Nile. So there are some mosquitoes there. It’s more common than usual. It’s not super common.

There’s not like huge epidemics. But if I went there, I would do bug repellent. A, just so you don’t get the itchiness that’s common, but B, so you don’t get this more rare illness.

GERM
00:19:45.260 – 00:21:42.590
I think this is true in other parts of Europe as well.

For example, Greece has a whole number a big increase in the incidence of West Nile virus that they’re reporting a three fold increase over their average so far, at least reported as of late June 2026. It’s not all of Greece, but they’re seeing this in Attica and Thessaly, Central Macedonia, central Greece, the Peloponnese Peninsula.

This is happening. And so to me it’s fascinating because as you know, this has been an incredibly hot and incredibly dry season in Europe.

So I would have thought this would be a great time to go. I mean, it’s miserable because you’re hot, but mosquitoes breed in water. They breed in puddles.

I was thinking that after a monsoon or a very rainy season, we’d have more West Nile and other mosquito borne illnesses. Wrong again. Yet again. The chaos of climate change comes to us in different ways. It’s not just how many mosquitoes are out there.

There’s other pieces in this dynamic of, you know, the animals that are being fed upon by the mosquitoes, how many mosquitoes are out there and how long that virus will transmit in the community. So it’s complicated. Right now is a bad time when it comes for West Nile, domestically, here in the US as well as in certain parts of Europe.

Travel, do it and be well. Just please do whatever you can to avoid being bitten by a mosquito.

Because we do not have an effective countermeasure such as a vaccine against West Nile. And we also lack a specific West Nile treatment. It’s supportive care and most people do well with this, except for the people who don’t.

If I was heavily immunosuppressed, might I consider staying away from those regions of Spain this summer? Chris? Yeah, maybe. Maybe so. And I like to go where I would like to go.

But I’m actually worried enough about bad outcomes that I might consider modifying my itinerary. Okay, Chris, question for you.

There’s something called the United States Preventive Services Task Force, uspstf, which sounds like a four letter word. What’s up with that right now? What’s going on with USPSTF?

WORM
00:21:43.470 – 00:23:54.280
It’s bad. This is another example of Trump and RFK Jr attempting to dismantle the protective public health services on a national level.

And he’s having some success at that, sad to say. So USPSTF again, United States Preventative Services Task Force. I’ve been studying this and following their recommendations for my entire career.

They were founded about 40 years ago. They’ve put out about 90 recommendations in that time. And basically it’s what’s worthwhile screening for.

So like for colon cancer or cervical cancer or breast cancer or for vitamin supplementation. They will look at all the research in a very rigorous way. And these are not just yahoos.

These are like the best scientists and physicians and researchers in the country. And as I say, I’ve been studying them for 40 years and I tip my hat in respect to how much data they look at and how good their recommendations are.

And these are important not only because it’s the best evidence based Recommendations there are, but this ties into things like insurance payments because if they come up with the recommendations, a lot of insurance plans will base their recommendations recommendations on the or what they pay for, rather on these recommendations. And RFK Jr and Trump have just screwed it up right and left.

Of course, this thing until March of 2025, met regularly to come up with recommendations and RFK Jr and Trump have blocked meetings, they have delayed meetings, they have canceled meetings. They also fired the leadership who were very qualified positions and the guidelines are not coming out.

And this is super important because this changes when there’s for example, a new cervical cancer screening or when there’s a new vaccine, hpv, which brings down the risk of cervical cancer. When they delay decisions and recommendations on that, it affects the health of millions of people. So it’s a big deal. Like the cdc.

It’s this collection of bright people who come up with my mind the best possible recommendations. And to throw a big wrench in this clockwork, I think is tragic and horrible and criminal.

But their work has really been impaired over recent time under Trump and RFK Jr.

GERM
00:23:54.280 – 00:24:30.710
We need to change. And it’s very clear sometimes institutions and processes exist for a good reason. Medicine is complicated. Our healthcare delivery system is not ideal.

We need experts to come together and say, hey, here’s the way we’re going to put this together to keep people safe. Why in the world would someone disassemble this unless they had just lost their damn mind? I don’t know how else to say it.

There’s just no good reason for this. So if you’re worried about this, if you’re angry, if you’re even just curious about this topic, please vote–if you’re going to vote the right way. We need to regain control of our government and this could be one of the many things on the agenda to fix and put back to rights.

WORM
00:24:31.270 – 00:24:55.310
Yeah, like the CDC, prior to President Donald Trump going into office, this was an entirely non political group. So to have this become a political weapon essentially is tragic. Paul, question for you.

There was a lot of press about monkeypox a few years ago now called mpox. Is it a thing of the past?

GERM
00:24:56.190 – 00:28:37.580
I wish it were. This is such a miserable infection. But no, it’s still here and with us.

Mpox is a viral infection that we can catch through direct contact with someone else who has this condition and it’s miserable. It’s a condition that I’ve treated for patients in our clinics and in our hospitals.

It can be a source of tremendous pain and suffering in The United States of America. Currently the numbers are not in the past.

I mean every single month, if I’m not mistaken, for this year we’ve had between 1 and 200 cases per month detected, diagnosed and reported to Centers for Disease Control. So a couple hundred cases of something per month doesn’t sound like a lot.

But I assure you, if you are one of those people, people who is acquiring this infection, it’s miserable, terrible skin disorder, the lymphatic system is involved. It’s not just a skin disease. This is a systemic body wide infection.

The skin is a part of the infection we can see, but all your internal organs are involved with it as well. So it’s one that we’d like people to avoid if at all possible. And we do have some good advice and countermeasures.

If the numbers that we’re seeing are say a couple of thousand, two to three thousand in a year in the United States, that number should be reduced. And I think that’s true for people who are in the US in smart certain circumstances.

We’ll talk about it could also be true in travel for people who are traveling to areas where there’s even higher risk of acquiring this infection. It’s a little bit complicated because there’s two different kinds of MPOX.

There’s Clade 2, which is the one that we have by far and away most commonly here in the United States. Almost no one dies of this. About one in a thousand people will die. So it has happened, but it’s uncommon.

Then there’s Clade one, which is the kind that we see more commonly in west and Central Africa. And therefore if you’re traveling to those areas, you may be at higher risk.

We don’t think of it as a high risk to the general public, but if you’re traveling to Central or West Africa, even some parts of Western Europe, they’re seeing more of it and it can be more dangerous indeed.

The good news is that we have a great vaccine which works quite well, not perfectly, but very, very well against both Clade 1 and Clade 2, the trade name is Jyneos Jeanniose is two shots that are given to get up to full immunity against Clade 1 and Clade 2 of Mpox. And here in the United States, you know, we recommend that people get jynneos if they’re going to be at risk of this.

That could be someone who is at high risk through their sexual behavior.

Currently in the US this is often in people who are gay or bisexual or men having sex with other men or non binary individuals that’s where we’re seeing most of these infections. So if you’re in that category, any of those categories, please talk with your healthcare provider because that’s something that is.

This is a safe, effective vaccine with very few side effects and it’s something that we recommend.

Likewise, if you’re planning to travel to Central Africa where there is more Clade one of mpox, that’s something that we would also like you to talk with your healthcare provider about. Regardless of sexual behaviors and such, it just depends on your occupational risk, on what your activities will be.

For example, if you’re planning a trip to, let’s say you’re going to Uganda, you want to go on safari, that would not be by itself an indication usually to get this vaccine because it is hard to catch except through direct contact.

On the other hand, if you’re planning to be in direct or even intimate contact with people who are living in these areas, regardless of sexual orientation, that’s when I would really have that strong recommendation to do so. And it is two shots, four weeks apart. And so it takes a little bit of advanced planning to do. So you asked whether it’s in the past. It is not.

It is very much here in the present. I would like it to be in our rear view mirror. Let’s keep up our vigilance and keep the conversation going about how to keep people safe from Mpoke.

WORM
00:28:37.740 – 00:29:26.440
Yeah, as you say, this is not a routine vaccine. We recommend for everyone.

So suppose you’re traveling pretty much anywhere in the world but you’re with your usual partner and you don’t anticipate any new partners, very low risk. But certainly if you are gay or bisexual, have sex with men and you’re a man and you’ve had multiple partners, the vaccine’s a good idea.

But also regardless of your orientation, if you are going to pay for sex, then it’s a good idea to get this. Also, if you are partners of someone who is high risk, then you become high risk and you should get this.

Also occupationally, if you’re a nurse or a doctor or other healthcare professional working with people who are potentially affected by this, then it’s a good idea. So it’s a good vaccine. It’s fairly low side effect. Efficacy is pretty good, but not something we recommend for everybody.

GERM
00:29:42.680 – 00:30:10.100
Everyone, thanks so much for joining us here on episode 118 of German Worm. As always, we would welcome your questions on travel health. Send them along or, or send us your tips for travel success.

You hear something you want to learn more about, we would love to hear from you.

You can get us by email germandworm@gmail.com or visit our website germandworm.com if you have enjoyed this episode, please subscribe, rate us favorably right on your device and spread the word with friends, family and on the socials. Those are free ways to support this podcast. I’m Germ.

WORM
00:30:10.260 – 00:30:13.540
I’m Worm. It’s a big planet. See it in good health.

GERM
00:30:13.540 – 00:30:33.560
We’ll see you next time.

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 you hear 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.