GERM
00:00:09.200 – 00:00:11.040
Hidely-Ho! My name is Germ.

WORM
00:00:11.040 – 00:00:11.920
I’m Worm.

GERM
00:00:12.000 – 00:00:25.360
Welcome to episode 125 of the Germ and Worm Travel health podcast. Mosquitoes try frickin lasers. 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
00:00:25.530 – 00:00:30.810
Dr. I’m Dr. Chris Sanford, also known as Worm Family Medicine Doc, also at the University of Washington.

GERM
00:00:30.890 – 00:01:09.610
So many great questions today, Chris, from our listeners across the country and around the world, including: Would I need a polio booster before I visit Kenya? What is happening with Bundabugio vaccine trials in the drc? Is Colombia a safe country to visit now? And can I really kill mosquitoes with lasers? Please say yes.

A reminder to our listeners, contact us with your questions, your stories and your tips for success. Visit us online germandworm.com or shoot 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 to your itinerary.

WORM
00:01:09.850 – 00:01:13.770
Now, Paul, you just got back from abroad. Can you tell us a little about that?

GERM
00:01:14.090 – 00:03:13.570
Yeah, this is a super exciting trip I did with my wife Julie. We were in Cape Town just for six days. It was a quick trip.

The reason to go was because, you know, she sits on the board of Landesa, which is a wonderful human rights and legal advocacy nonprofit. And every other year there’s an African Philanthropy Forum which is held somewhere on the continent. And this time it happened to be on Cape Town and she happened to be invited to sit on a panel and talk about her work, telling stories and really inspiring other people participating in the meeting about how to do some philanthropy within the continent of Africa, which is more important now I think than ever. It was a great success. Everybody loved her and I was just her plus one.

And you know, we’ve supported Landesa for many years, so that was fun, you know, to do a little bit of fundraising and some advocacy work.

But then we also got a chance to, you know, meet some new friends, visit with some old friends and see this beautiful part of the Western Cape, which was our first time being there.

And I have to say, I know you’ve been a couple of times, Chris, I’d love to get your, you know, do not miss opportunities, I think for it’s been named one of the world’s great cities, in fact to the number one destination for world travel and you can see why it’s very beautiful. The people are warm and friendly and it’s a fascinating place. Such a complicated history and very inspiring.

So, I mean, for me, the natural beauty was all there. And we visited, you know, the Botanical Gardens and went up Table Mountain. We took the tram once and then I hiked up on my own another time.

And then we also went down to the Cape to see the penguins and the ostriches on the beach, where there are ostriches on the beach. That’s what they have down there, baboons running wild. And it was really inspiring.

But also museums, including the slave lodge, where they have this really incredible museum about the history of slavery. And. And then of course Robben island, the prison island, which has this incredibly difficult history that is now a full museum.

And our guide was, you know, was a survivor of having been imprisoned there for 13 years. So it was very inspiring and a lovely visit at the same time. I can’t say that for every place I’ve visited. What would you say about Cape Town?

WORM
00:03:13.570 – 00:03:27.070
Yeah, I would agree. If you’re going to see one place there, it’s Robben Island.

Similarly, when I went there with one of my sons a few years ago, we had a tour by one of the previous inmates and it was just very fascinating and emotional.

GERM
00:03:27.390 – 00:03:52.830
Yeah, agree. So nothing but good things to say about visiting Cape Town. And I look forward to going back to see other parts of South Africa.

It’s a very diverse country. This is only one little piece of it, although a beautiful piece indeed. So from that inspiring background, Chris, bring us back down to earth.

In fact, a part of the earth that many people dread to tread. Pennsylvania. What’s going on with the measles outbreak in Pennsylvania, please?

WORM
00:03:52.910 – 00:04:49.130
Ordinarily a lovely state. They’re currently having a huge outbreak of measles. And when I say huge, I mean the current case count is over 1400 cases of measles.

And this actually in the United States is the biggest outbreak in over 30 years. There have been five deaths due to measles in this outbreak. And this is a large tragedy. This is an entirely preventable disease.

When they look at the people who have gotten measles in this most recent current outbreak, fewer than 1% of cases have had the full two dose MMR measles, mumps, rubella vaccination series so people are getting sick and dying because they or their parents are choosing not to get vaccinated. Not only that, but this outbreak appears to be even worse than usual. It seems to have a higher than usual fatality rate.

And Paul, can you speculate or discuss a little bit why the fatality rate might be higher in this current outbreak?

GERM
00:04:49.210 – 00:06:31.190
Yeah, I’m not sure. This is, of course, a hot topic at our international meeting called ID Week. Just got back from dc.

That’s where I was before Cape Town was at our annual meeting. It’s an incredible meeting for many, many reasons. I’ll go into that more in a different episode if we have time.

But one of the inspiring things about this and humbling things about this meeting was a Beautiful lecture by Dr. Andy Pavia. He’s a specialist in infectious diseases at Utah, and he gave an invited lecture called Measles From Rinderpest to Eradication and Back.

And there were four crucial things that he imparted to us. I won’t go into all the technical details. I learned a ton about the scourge that is the current outbreak, including Pennsylvania and elsewhere.

He emphasized that this is a very serious infection and it’s not rash and fever, that there is a risk of acute death, especially if there are other comorbidities. But in some cases, not or no identifiable reason why one young child would die and another one would survive.

We’ve neglected this area of science for a long time because measles was a solved problem, because we had the MMR vaccine. I say had. I mean, hopefully at the time people listen to this, we still have it.

Of course, the federal government’s trying to destroy that vaccine to take it off the market. I am optimistic that will not happen.

By the time you hear my voice, which will be in sometime in the month of November, 2026, at least you’re okay for a little while. So the point is, this has been a neglected science because we fixed it in terms of prevention.

So it may be that some people just have an inherent immunological susceptibility to a worse outcome. There may be other factors, Chris. I don’t know, but it’s not good. So he emphasized that this is a serious infection. It’s not just a fever and rash.

And he emphasized that the complications may not show up for years, especially children under the age of two. You know, if you’re a kid on the age of two and you get this infection, you may not show serious, deadly effects for up to 10 years.

WORM
00:06:31.190 – 00:06:31.870
Oh, wow.

GERM
00:06:31.870 – 00:07:59.730
It’s a disease called a complication called sspe, the subacute sclerosis, pan encephalitis, all of which is really bad. Basically, your brain scars and you die. And that takes years in some cases to manifest in these Young children. It’s a tragedy.

He also emphasized that the epidemiology is very complicated. If you actually analyze the virus itself, it is not just one virus.

We have multiple different strains or clades of virus that are running around currently. Today, what we saw in Texas is different from what we’re seeing in Pennsylvania. That’s different from what we’ve seen in Minnesota.

So the virus spreads around in a way that is difficult to. It’s incredibly adept at doing this. And his final point was we shouldn’t have to worry about any of this because we have a great prevention.

The vaccine works. There is no reliable treatment. There is only prevention. It’s everything. And so many other sessions at that meeting.

Chris, to answer your question devoted to this concept, how do we gain people’s trust? How do we get people to do this? In the case of Pennsylvania, many of those survivors and victims of measles are people who are not immunized.

And they’re doing that in the context of either the Amish and or Mennonite traditions. What it is about those particular cult cultures that makes it tougher to get the populations immunized, I’m not clear.

The numbers of immunized people is rising. People are in many cases responding. But it’s just an interesting situation. It’s unexpected. It’s caught us a little bit flat footed.

Now we’re having to catch up and do more. Hopefully the government will do the right thing by helping to step up and make a difference here.

WORM
00:07:59.810 – 00:08:06.970
So just to make a couple points clear, even though there are these different clades of viruses, the vaccine is good at preventing all of them.

GERM
00:08:06.970 – 00:08:07.510
100%.

WORM
00:08:07.820 – 00:08:12.060
Yeah. And also, once you get this viral infection, we don’t have good drugs.

GERM
00:08:12.780 – 00:08:16.300
There’s no reliable treatment for the infection. This is all about prevention. You got it.

WORM
00:08:16.300 – 00:08:20.940
So once you get it, we can treat the symptoms, which means we can’t do very much at all.

GERM
00:08:21.260 – 00:09:02.680
Some people will ask about vitamin A. Can we supplement a baby’s diet with vitamin A? I mean, yeah, the American Academy of Pediatrics.

Other groups have said you can give a dose of vitamin A. That is clearly something that can save the eyes of malnourished babies, especially in Africa.

Does that apply to malnourished kids in the United States? I mean, it used to feel unthinkable that could be the case. It’s unclear.

So I think that’s part of a standard response, Chris, that we do supplement with a single dose body weight adjusted pediatric dose of vitamin A. Not too much.

Pediatricians are now learning how to recognize vitamin A toxicity and how to deal with that, which is hard because people are giving too much. So the point is there’s tiny little things we can do which may make a difference, but it’s not enough. Nothing replaces prevention.

WORM
00:09:02.760 – 00:09:21.450
Got it. Thank you.

Paul, question for you. This horrible, speaking of horrible outbreaks, this big outbreak of Ebola in DRC and elsewhere, it’s now moved into a new country. Can you tell us a little about that?

GERM
00:09:21.610 – 00:11:55.320
Yeah, it’s interesting. We talked a moment ago about measles, which is a fully preventable, potentially eradicatable virus on our planet.

And yet we also have this explosion of another communicable viral infection in Central Africa, especially Democratic Republic of Congo, and that’s Bundabugio, Ebola virus disease. And so in that case, there is no vaccine. And so people are dying in tremendous numbers.

And in fact, it has now spilled over once again out of Congo and back into, in a small number of cases into Kenya. We talked on a recent episode about how Kenya had two cases and they got rid of it and it went away.

No surprise, it’s now come back across international borders. The viruses don’t care about political borders. They simply infect human beings as they move around. And so, you know, they’re trying.

There’s a really inspiring and fascinating, I think, positive situation in drc, which is this multinational series of vaccine trials that are now getting underway, to be clear, for the original strain of Ebola, which we call the Zaire flavor, we do have a vaccine that works. That vaccine does not, unfortunately, seem to work against Bundibujo. So we need new technology.

So the answer is yes, there are several trials that are now getting underway as we speak in drc, and that includes, number one, getting people immunized against the old flavor with Zaire vaccine, but also preparing those people to receive some new vaccines. In fact, there are three of them that will soon be rolled out in clinical trials.

One’s made by Merck, one’s made by Moderna, and one’s made by Oxford. And these three vaccines will soon enough start rolling out in well designed clinical trials, including run by partners on the ground in drc.

They really do look like well designed trials. I’m not involved in any of these, but what I’ve learned about them is they really care about this. These are three different vaccines.

It’s in effect, a race to the top. We’ll see which one of them may be better than the others. Who knows, maybe all three of them are excellent.

Think about what we did with COVID we actually had multiple different great vaccines that came out at the same time.

This strategy is really great that we’re going to simultaneously try multiple different ways to protect the people who live in these high risk areas in drc. So stay tuned here to German Worm.

We’ll talk about whether it’s the Moderna, which is an MRNA platform, or the ones made by Merck and Oxford, which are made slightly differently. I’m hopeful that one or more of these may actually make a huge difference here. People need it because this is an out of control problem.

This is certainly the biggest and deadliest form of any Ebola virus outbreak that we’ve seen in recorded history.

WORM
00:11:55.720 – 00:12:02.200
And Paul, can you touch on your opinion on the US pulling out of who? The World Health Organization?

GERM
00:12:03.000 – 00:14:07.020
Yeah, I mean we’ve talked about this many times, so that’s a disaster. We shouldn’t have done that. It’s stupid. And likewise a terrible idea how we have largely defunded major portions of the work of usaid, for example.

So is there a role for leadership from the United States in these trials? I mean, the answer is yes. And interestingly, Chris, there are some bright spots. And I’ll give you an example.

We have reports on 28th October there is an international research organization called IAVI which was happy to announce that it recently received a large gift, US$36 million from the US Biomedical Advanced Research and Development Authority to help get some of these clinical trials on the ground in DRC vaccine trials against Bundabugio.

In fact, this award from the US Biomedical Advanced Research Development Authority could potentially be worth up to $99 million if things go well and they meet certain metrics, as I understand it from the original initial $36 million award. So I’m proud of that. I think that’s a great example of what we can do. In my opinion, A grant of $36 million is peanuts.

I know that doesn’t sound like a small amount of money.

Believe me, when it comes to these big international trials, especially for an emerging infectious disease like this, that is a small, tiny investment.

And as you and I have said many times, if we can stop this stupid epidemic in its tracks and keep it from spreading elsewhere, including on our shores, that would certainly be worthwhile doing so that’s a good thing that’s coming. It’s not enough. And I’m hoping that there’s going to be a lot more of those examples. All right, Chris, here it is.

Now, a couple episodes ago we were talking about lasers, frickin lasers and the question that came to us was somebody had read about using lasers to try to shoot mosquitoes out of the sky. Now I have certain friends, I’m looking at you, Chris Haggerty, my friend who loves killing mosquitoes.

It’s just, that’s his thing, that’s his one and only thing. He, I can see him wanting to pick up a rifle and start shooting these things.

There’s a story recently from the New York Times with lasers used to kill mosquitoes. What’s your take on this? What’s the story?

WORM
00:14:07.100 – 00:14:50.880
Well, you know, it was kind of thrilling.

This came out a few days ago in the New York Times and there’s this Chinese startup called Photon Matrix and they’re marketing their device and it costs about a thousand bucks and it uses AI, specifically LiDAR, the same technology that drives and operates and controls self driving cars. And basically they shoot lasers at mosquitoes guided by AI and it kills them per lovely quotation from the New York Times.

Per them, the witness who saw this, each bursting into a green or blue flame with a tiny pop. Which, you know, it’s not nice to laugh at the death of anything but it kind of cracked me up.

GERM
00:14:50.880 – 00:14:52.560
I’m good with it actually. I’m good with that.

WORM
00:14:52.800 – 00:15:10.620
So does it work? I don’t know. It looked like it killed a whole bunch of mosquitoes in a hurry. Is it safe? I don’t know. Is it expensive? Yes.

I’m not going to go out and purchase one of these things right away. I’m still going to keep my fly swatter in my bug repellent. Paul, can you talk a little bit about some potential concerns with this new system?

GERM
00:15:11.020 – 00:16:50.870
Yeah, I mean the idea of giving AI a bunch of lasers is this, they made movies about this I think. It’s not just fake news. No, this is a small laser beam. It, it’s really super fascinating.

It shoots pulses of light 100,000 times per second. That’s how quickly this thing jabs out at the mosquitoes. And it’s, it is guided by a LiDAR system. I think that’s what drives Tesla around.

So again, coming back to putting lasers onto Tesla cars. This is headline don’t give elon the lasers. But anyway, the tech is apparently very well proven and they have demonstrated that it works.

The issue is that stuff will blind you. I mean if you get hit in the fovea back on your retina, you’ll end up with a blind spot.

They’re very powerful lasers and the company to their credit has come up with apparently some smart ways to deal with this. You have to take a test, I forget how many 30 or 50 questions or something.

And you have to get 100% on the test before they will give you the keys to make the thing activate. And it’s a thing like, you know, should you look at at this? Should you look at the laser? No Even what rooms of the house are unsafe?

They gave the example of never put in a bathroom because there might be wet surfaces or tiles that the lasers could bounce off of. So they’ve tried to deal with this issue and supposedly the camera knows when there’s a person around.

Sort of like the Tesla thing is supposed to know when there’s a truck even though it drives into those trucks. So anyway, there are some safety pieces that are there. Let’s see what happens with this. I honestly am fascinated by it.

If I had a backyard that was mosquito free, I’d be very happy about it. So we can’t cover the world, blanket the world with these lasers.

Are there going to be some folks who can afford 1000 bucks to make their backyards less burdened by mosquitoes? Maybe. I think it’s way too soon and I am not aware of us FDA filings on this. Let’s wait and see what happens.

WORM
00:16:50.950 – 00:17:14.069
Yeah, I’m not going to buy one right away, but I’m going to stay tuned. Now, Paul, speaking of mosquitoes, there was this vaccine called Icscheck that still exists. It’s a vaccine for chikungunya spread by mosquitoes.

But the US took it off the market and the FDA did and now another country has too. Can you tell us about that?

GERM
00:17:14.629 – 00:19:28.250
This is no surprise, but I’m happy to talk about it briefly. Yeah. The United Kingdom has also revoked the authorization for marketing of Icschick as you recall.

I still think Ickschik’s a great name for an all girl rock band like southern rock or rockabilly, the Ickschicks. Ickschick is a live attenuated chikungunya vaccine. It’s a good one.

It seems to work well and I have friends who have received it and they’re happy about it.

The problem with this was that in post marketing surveillance there was an unexpectedly increased small but unexpectedly increased number of elderly people. Elderly meaning older than I am. I think it was actually 65 and above who had an unexpectedly increased risk.

Although the absolute risk was small, but it was increased compared to the background of demyelinating neurological disease. And so guillain Barre would be one example of this. Right, so you don’t want to give people Guillain Barre Syndrome. How could this happen?

It’s not clear, but it looks like this live attenuated virus was so immunogenic that unfortunately it led to a non specific immunological activation that attacked not only chikungunya when it gets into your body, but it started attacking in these small number of people. It started attacking the neurological tissue of the patient themselves. Guillain Barre is treatable, but it can be very serious.

And so that alone was enough for the United States and other countries to withdraw approval to give icjic. And that apparently has happened in the uk. Why it took them this long to catch up, I’m not sure.

Now you can still get it in the European Union, you can get it in Brazil, you can get it in Canada. I just want to remind our listeners, as we talked about before, there is a wonderful and effective and very safe alternative called Vimcuna.

That’s what I and my wife received, you know, before we visited Sri Lanka earlier this year. I do recommend it.

Different technology, not live attenuated, but a virus like particle, the same tech as we have in our beautiful human papillomavirus vaccine, for example. So this is, you know, the death knell, I think, of Icschick.

My hope is that if people have no access to Vimcunya, that they would still do this if they were under the age of 65 and they’re in a country where they can. My hope is that Vimcuna will become broadly available and affordable.

I do think it’s better tech and, and should probably replace what we’re seeing with what we have seen with icg.

WORM
00:19:28.410 – 00:19:30.250
Yeah, yeah, I agree with that.

GERM
00:19:34.330 – 00:19:43.530
Chris, tell me this, a question we got from one of our listeners who says, I’m traveling to Kenya this December, that’s next month for safari. Should I get a polio booster before I go?

WORM
00:19:44.170 – 00:20:43.720
The short answer is you could, but your risk is really, really low. And the reason possibly that you asked this is you read about the recent case.

There was a case, per the Kenyan Administrat of Health of polio, and specifically it was vaccine derived polio. And this was in July and it was in a refugee at a refugee camp in Garissa county, which is on the eastern border of Kenya.

One case in a refugee in a refugee camp doesn’t really change national policy. It’s not a common thing. Certainly if you’re a doc or a nurse going to a refugee camp. Yeah, I think that’s a reasonable thing.

If you’re a sewage worker and you’re working, working with sewage water. Yeah, maybe think about it. If you’re going to that county, maybe think about it.

But if you’re just a routine tourist going to game parks, you could if you wanted to, but your risk is extraordinarily low. If I was going, I wouldn’t get an additional booster. Paul, can you talk a little bit about what does a vaccine derived polio virus mean?

GERM
00:20:44.200 – 00:24:50.550
Yeah, it’s just super fascinating. So as our listeners will recall, polio is a terrible disease. In fact, I was just in South Africa. I have also visited the.

I should have put this before. And I do not miss this museum called the Heart of Cape Town where they have a museum.

This is where the first heart transplant was performed in the world. And all the original operating rooms and stuff are still now a museum for whatever reason.

They also had a polio virus iron lung that was there, the last iron lung they used in Cape Town. So it was a reminder to me just a few days ago about the reality of this. It’s myelitis, meaning inflammation of the spinal cord.

And it can lead to paralysis, in some cases inability to breathe on one’s own. So it’s serious. That’s why we have a wonderful vaccine policy in this country and around the world. The vaccines come in two flavors.

There’s the killed and there’s the live attenuated. Live attenuated. That’s the stuff that you get when you stick out your tongue. They put a drop.

Many of our listeners will have had this, as I did when we were kids. The beautiful thing about vaccines built on live attenuated virus is that, number one, it elicits a great immune response right in the GI system.

That’s how the virus gets into our body. That’s where you want to fight it off, is in the gut, what we call the gut associated lymphatic tissue. And the oral polio virus does that well.

It also comes out in your stool. Now in the United States, when we take a crap, it’s usually in a toilet.

It goes to central processing and the waste processing is done and that’s, that’s the end of it. But for so many people around the world, the water that they drink is befouled by human waste, which is awful and unjust.

But there is an interesting issue which is that if in your species there is some vaccine, polio virus, you may inadvertently vaccinate your friends who didn’t get the vaccine itself but are drinking water with your own poop. This can lead to an increase in what we call herd immunity. Strengthening the herd. It’s a great idea and it has made huge difference.

And I think the technology in that, I’m going to say this out loud, the technology in that oral polio virus vaccine has saved many, many lives. It’s brilliant, but it’s not good enough anymore in my opinion.

What we are seeing here is people who are now getting actual infection and disease caused by that very same virus, the circulating meaning out in the world virus that is caused originally by one of these attenuated strains. So as we give the vaccine, it’s extremely safe, in very rare cases can actually cause a mild or in some cases even a real case of poliomyelitis.

And as it gets out into the world, it may start to revert and go back to its more wild type and virulent strain. So it’s a problem.

The good news is that you can also get an injection that’s a killed flavor, more similar to what Jonas Salk did back in the day compared to what Dr. Sabin did. And as everybody knows, Jonas Salk is a true hero. And this is the same idea, different tech in the current killed vaccine.

But the nice thing about it is, number one, you don’t need a cold chain to do it. It’s like any other vaccine. It’s easier to administer if you can do shots into people’s shoulders.

And number two, the risk of this vaccine derived infection is zero. So for many years, the world has gotten to be a better and better place because of the oral polio vaccine.

This single case in Garissa is a reminder to us that actually it may be time for the world to change. In my opinion, I’m speaking on behalf of myself, I think we should do better for people.

I think we are close enough to getting rid of this stupid infection that we should probably revert back to the injectable stuff. And the cold hard truth, Chris, is that today on planet or Earth, most annual cases of polio are come from the vaccine itself.

These circulating wild types with origins from the vaccine and not from wild type. So what you mentioned a moment ago, let’s say this person is going on safari in Garissa, they’re going to also volunteer digging latrines.

They should get a once in a lifetime booster if it’s been more than 10 years since their last shot. And that’s kind of crazy that we’re recommending the consideration of a vaccine to prevent a vaccine originating infection. But there it is.

That’s where we are in 2026. Stay tuned. My hope is that World Health will really try to promote and advance the use of the killed flavor of this vaccine.

If they do, then over the course of a generation to come, these kind of cases of circulating vaccine derived polio, they should theoretically go away.

WORM
00:24:51.110 – 00:25:33.920
And just to define a term that you just used, you used the term cold chain, for those of you who don’t know what that is.

Some vaccines, like the oral vaccine, the live vaccine, has to remain cold the entire time in all the steps between the manufacturing plant and when it goes into somebody’s mouth. And so if during that trip it warms up even once, it’s ruined.

And so the cold chain is the whole series of cold to cold to cold places that ends up with it being cold and still effective right before it goes into someone’s mouth. And one more point I want to make all of the polio vaccine that’s given in the US Currently is the shot, the killed.

So it’s not putting people at risk for this vaccine derived polio.

GERM
00:25:34.160 – 00:25:40.400
I agree. I’m glad about it. I’m proud of it and I think everybody in the world deserves that same opportunity.

WORM
00:25:47.040 – 00:26:06.870
Now, Paul, tell us a little bit about, about Colombia and safety and conflict. Colombia’s kind of gone back and forth. Twenty years ago some people thought it was a no go zone due to warfare and guerrillas. Then it was safe.

Now maybe the guerrilla warfare, the anti government factions are coming out a little bit. Can you address that complexity?

GERM
00:26:07.510 – 00:27:57.340
Well, I’m speaking on behalf of someone who’s fascinated by Colombia and who would love to go. I’ve never been actually. I’ve not visited Colombia in person. But I was just thinking about this the other day.

A friend of mine did just go down for a wedding and had a great experience. Came back safe and sound and all good. But the concern here is this report.

As of late September, we have this guerrilla group which has been stirring up trouble in one part of Colombia. So in fact, this has led to a curfew in the region of Santa Marta.

So this guerrilla group has announced that it’s going to continue keeping things locked down over a period of time. They originally said this would go through the end of September. Some of those lockdowns have continued subsequently.

This sounds like a dangerous, unpredictable situation.

We have reports of the group igniting vehicles on fire, blockading roads and that they’re being violent with people who are disobeying their, their capricious order. So it’s not a good look for those people.

And if you’re a traveler, recommendation would be to stay out of Santa Marta and those areas nearby, including Magdalena and La Guara, including Troncal de Carib on the Route 90 corridor, right through Palomino. Know so. Or if you’re going to the Tyrona national park or you’re going to Zona Bananera. These are regions that I’ve not visited before.

But transportation there is felt to be unsafe. The concept here is the same as what we’ve talked about before.

There are certain countries that are generally safe, some that are generally unsafe, but most are somewhere in between. I would put my own country, the United States, as somewhere in between. Right.

There’s some parts of the US That I wouldn’t go, and I think this is an example. The same is true with Colombia. There are still many places within Colombia that I think are generally safe and advisable.

This is dynamic and we’ve talked about this before.

Please do check Department of State listings before you go and if any questions, talk to a trusted source on the ground to find out the reality of what this looks like. Is that your take as well?

WORM
00:27:57.580 – 00:28:26.910
It is. And I would avoid only Santa Marta anywhere else in the country, frankly, I would go in a heartbeat. Now, I have been there.

I’ve been to Bogota, went to some national parks around Bogota, and then I went down to Leticia, which is a village in the far south Panhandle. Exactly. On the Amazon river. And I did some hiking in the jungle for a few days and it was beautiful.

So I think most of the country is calm and tourist friendly. So as you say, Paul, check with the Department of State, but I think it’s more calm than not these days.

GERM
00:28:26.990 – 00:29:04.030
Yeah, that’s my impression as well. Everyone, thanks so much for joining us here on episode 125 of German Memorial. As always, we welcome your questions on Travel Health.

Just send them along or if you have tips for success. If you’ve heard something you disagree with, we would welcome the conversation. Send us an email germanworm gmail.com or see us online.

Germanworm.com if you’ve enjoyed this episode, we would love your subscription, your favorable rating right on your device and spreading the word with friends, family and joining us on socials. Those are free ways to support this podcast. I’m Germ.

WORM
00:29:04.030 – 00:29:06.510
I’m Worm. It’s a big planet. See it in good health.

GERM
00:29:06.510 – 00:29:26.800
We look forward to seeing 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 belong to Dr. Sanford and Dr. Pottinger alone and do not necessarily represent the opinions of the University of Washington or UW Medicine.