GERM
00:00:09.200 – 00:00:11.120
Salut. My name is Germ.

WORM
00:00:11.440 – 00:00:12.320
I’m Worm.

GERM
00:00:12.640 – 00:00:29.280
Welcome to episode 92 of the germ and worm travel Health podcast. Eating healthy on the road. Can it be done? (Spoiler alert: Yes, but it’s painful.) It’s a big planet. See it in good health. I’m Dr. Paul Pottinger, also called Germ. I’m a professor of Infectious Diseases at the University of Washington in Seattle.

WORM
00:00:29.820 – 00:00:37.900
I’m Dr. Chris Sanford, also known as Worm, Associate professor in the Departments of Family Medicine and Global Health, also at the University of Washington.

GERM
00:00:38.220 – 00:01:37.540
Well Chris, here we go. Great questions from our listeners across the country and around the world.

We’re going to tackle at least eight of them today and they include: Should I go news free while I’m on vacation to de stress? What if I travel to a country in spite of a United States Department of State level four warning? What will happen? mRNA vaccines: awesome tech or destroyer of my DNA? And norovirus: Is it really not on cruise ships anymore?

These questions and more. A reminder to all of you: Thank you for joining us and please reach out to us with your questions on travel, health, your stories, your tips for success. If you have a request for clarification, just reach out. You can get us online germanworm.com or drop us an email germandworm@gmail.com.

Before we jump in, as always, our medical disclaimerL This podcast is designed to inform, inspire and entertain. However, you should not use this podcast as clinical care before you travel. Please see a qualified healthcare professional for recommendations specific to you and to your itinerary.

WORM
00:01:37.700 – 00:01:42.980
Paul before we go into the questions today, any recent travel you want to share with us?

GERM
00:01:44.500 – 00:03:13.810
I got a hell of travel to share with all you folks. Yeah, I recently had wonderful trip to both Singapore and Sri Lanka. My first time to both of those countries.

Each was spectacular, fascinating, different and I learned a lot and really enjoyed myself in both places.

And as soon as I got home, hopped on a plane and went to Colorado for my annual ice climbing trip in Ouray Colorado with my friends Justin and Ann and had a great day ice climbing, very plastic or warm ice. It was fun. I’d actually not been in the mountains for a couple years for various reasons.

Anyway, great day in the mountains until I was walking out to the car, slipped on a patch of ice, shattered my left ankle, something called a trimalleolar fracture so that kind of sucked and as we speak I’m lying in bed with my gimpy foot up on a foam block. I’ve had surgery plates and screws are in place. And now I’m starting the painful recovery process. It’s all going to be fine.

I learned a lot about that process and in fact, Chris, I think this should be a topic of a future episode. What to do if you break your ankle when you’re away from home.

Because I learned a lot about this, not just the financial side of it, but just what it’s like to be in a cast roaming through a busy airport. How terrifying that is that somebody’s going to step on your foot. So I have all kinds of learnings and bottom line, I’m going to be fine.

And I just had great care and support from everybody. But we’ll talk about that. And that’s not going to hold me back from creating content with you here on Germ and Worm.

WORM
00:03:14.450 – 00:03:21.570
So sorry to hear about it. What an incredible pain. Just to be clear, the ice climbing went well, but it was the parking lot that got you.

GERM
00:03:22.020 – 00:03:38.180
Oh, the ice climbing was fine. I mean, I’m on a rope. What’s going to happen? You’re safe. No, it’s walking that’s the problem! This could happen in New York City, here today in Seattle, it’s snowing. Like it could happen outside my house today. So, yeah, it’s. Yeah, ice climbing is easy walking. That turns out to be the hard part.

WORM
00:03:38.580 – 00:03:39.700
Well, that just sucks.

GERM
00:03:40.900 – 00:04:06.750
You’re not wrong and thanks for the sympathy, but no need for people to send me gift baskets or anything like that. I just need to get through this. And you know, as the old saying goes, this too shall pass.

Okay, Chris, here’s a question I want to start to you. I love this one from an anonymous listener, which is great. What happens when you ignore a United States Department of State level four warning and you go to that country anyway?

WORM
00:04:07.630 – 00:05:51.170
You know, great question. Basically, the U.S. state Department has a four level warning system for every country in the world.

And about 10% of them, or about 20 countries are level four where they flatly recommend do not go. Now, this is not enforced by law. You can go to these countries, most of them, if you can get a visa or get past the border.

But these are countries like Somalia, Ukraine, Central African Republic, where either there’s a war or some other high level of violence or kidnappings or some other reason. The State Department doesn’t think it’s a good idea to go there.

Now, I’ve talked to people who’ve been to places like this, like Afghanistan, and some of them have come back and even reported a good time. I would avoid it because I think in general they are unstable and there is a high risk of violence or something else bad happening.

There was a really interesting article that came out in the New York Times and this was on the 7th of March of this year and the title was a globetrotting US citizen landed in a Venezuelan Hell. And it details this 28 year old US guy named James Luckey-Lang. And he went to Venezuela, walked across the border and he was imprisoned within a day.

Didn’t have the right visa in his passport and he was in jail for over a month and he was beaten and he was starved. It was a horrible experience. And then the US invaded and a few days later he was released. So it sounds hellacious.

I have heard other stories of very bad things happening when people go to these high risk countries. So in short, if you go to one of these, maybe you’ll have a nice time.

But I think there’s a reason for these warnings and personally I avoid these places.

GERM
00:05:52.750 – 00:07:26.310
Yeah, I don’t know James Luckey-Lang, but his last name seems inept. He was not at all lucky about this, although maybe he was. I mean, how often do you actually benefit from your country invading another country?

I’m thinking about this in the context of today’s news. We’re recording this mid March 2026 and our country has just declared war without declaring war actually in the country of Iran.

And so this questioner was very smart saying, what happens if there is a level four war? Remember, there’s not always a warning.

I mean, there was so many Americans, expatriates and others who were in countries which are now in combat and being bombarded.

They didn’t know that our country was going to invade and bombard Iran and that Iran was then going to retaliate by bombing Qatar and, you know, UAE, etc. So sometimes you don’t even know that the warning is there until after the war has started.

And there are these stories of people trying to repatriate to the US coming from the Middle East. It’s quite a journey, apparently. So with you, I’m glad Lucky Lang came through. He did get Lucky and got released.

It sounds like a very, very difficult situation. That decision about how he chose to go to Venezuela, that’s a good discussion in and of itself. But folks, if it’s level four, please do not go.

And if you must go for personal important reasons, family reasons, etc. Just understand that you are very much on your own and the embassy has very little power to try to help and repatriate you.

Short, I guess, of invading and performing coup d’. Etat.

WORM
00:07:31.830 – 00:07:37.670
Paul, question for you. Do norovirus infections only occur on cruise ships?

GERM
00:07:37.990 – 00:11:10.920
Oh, hell no. They occur everywhere.

In fact, just as we were sat down to record this, a friend of mine sent me a text that they probably have the winter vomiting disease as it happens. So norovirus, we used to call it winter vomiting because it happens mostly in the winter and people barf their brains out.

Now we know that it’s caused by a virus, actually a family of viruses with many subtypes. Used to be called the Norwalk virus, then the Norwalk like virus. Now we call it Noro, but it comes from where it was originally described.

It’s a GI bug. It’s a virus. Not a bacteria, not a fungus, not a parasite. It’s a virus like the name says.

And you get it when you eat food or drink that’s contaminated with somebody else’s poop. I don’t know what else to tell you. This is a fecal oral experience and we have talked about it many times here.

German worm, because it is notorious for getting onto cruise ships where you have everybody eating and touching things together.

And even if you use that alcohol hand rub when you’re walking into the buffet line and you’re careful around the sneeze guarded food that you’re getting on a cruise ship, this stuff is relatively resistant. It’s one of the few germs. It’s relatively resistant to the germ killing power of alcohol, hand rubs, soap and water is the only way.

And hyperchlorinating with hot water, the entire plumbing system of a ship, this is what’s required. So it’s well well known for happening in wintertime on cruise ships. But no, it happens anywhere else. You do not need to cruise to get this.

We have reports here from early February in South Korea with a significant increase in norovirus infections. More than 590 cases per week reported by public health authorities in South Korea.

Meaning that since late December 2025, within a month or two they had more than 2,000 of these cases. This is a doubling of their normal average.

Likewise, our friends and neighbors to the north in Canada, they are having an explosion of this right now of explosive diarrhea norovirus due to raw oysters in British Columbia, a place called Nanoos Bay, which I sounds like it’d be a fun place to go. I’ve never been there before, but I would not dine on the oysters when I’m up there.

In the context of this British Columbian outbreak, it does seem to be people grooving on oysters, which I happen to love. I think they’re a delicious food. But remember the oyster, what it does is it’s a filter feeder.

So it’s taking all the nutrients from the water and building itself upon that. If there’s human feces in that water, it’s going to just concentrate the feces as well, and in this case, norovirus.

So people eating these uncooked oysters full of norovirus and just getting sick this way, it’s pretty gross. I still do love me a good oyster when it’s the right time, but it. Unfortunately, we do see this happening too. So what do I want to tell you?

Look, if you’re going to travel in the winter, you’re going to eat. If you’re going to eat in the winter, please wash your hands before you do. If you do catch norovirus, this too shall pass.

Although you may end up with the rooster sign of explosive diarrhea, or god forbid, the screaming eagle: When it comes out both ends at the same time. I’ve been there. It’s not a good look. If this happens, just hydrate, take care of yourself.

It’ll be okay. What we need, Chris, is a good vaccine. There may be vaccines coming for norovirus, but it’s really challenging. There’s multiple subtypes of nor.

I do not think a vaccine is going to be our savior here. You are likely at some point in your life to have noro, and if you do, I am so sorry.

And just avoiding cruise ships to get away from this is probably not the right travel advice. What’s your thought about this, Chris?

WORM
00:11:11.320 – 00:11:28.680
Yeah, I think cooking is a wonderful technology invented by our forebears many tens of thousands of years ago. I admit that I eat sushi at restaurants, but I don’t eat raw oysters.

I think a cooked oyster can be delicious as well, and that can bring your risk down a little bit.

GERM
00:11:29.000 – 00:11:50.200
Wise words from a wise man. Thank you. I will not take your advice, but it’s good. It’s good advice. All right, Chris has a question to you.

Another anonymous listener who says, I’m attending some of the matches in the World cup in the United States. Any advice for staying safe when I’m around bazillions of people?

WORM
00:11:51.410 – 00:13:00.650
Yeah. So the World cup is being held in three countries in North America.

The three countries in North America this upcoming June to July, and there’s 48 teams from all over the world. And there’s going to be millions of people coming to the US there’s going to be big crowds, few things to do.

One, read the security warnings concerning pickpocketing and things like that. Get your basic vaccines, everything from tetanus, measles and of course Covid and influenza.

It can be really hot in the summer in a lot of these cities, so you want to stay well hydrated. Use sunblock, get a hat with a brim and check out the CDC site, Traveler’s Health.

It’ll have information on reducing both infectious illnesses and trauma that might happen. And this would apply anytime people get together.

So this would be the same advice we’d get if you’re going to Carnival in Rio and maybe even those big crowds on beaches during spring break. So anytime big crowds get together, they tend to cough on each other. So again, those vaccines for respiratory things, Covid and flu.

Always a good idea. Paul, what would you add?

GERM
00:13:01.770 – 00:14:49.480
Well, I agree with everything you said.

I just as a friendly reminder to our loyal German worm nation, Chris, you and I recently came out with a recommendation against visiting the United States from overseas and that had nothing to do with FIFA. Although FIFA turns out to be corrupt and crazy, creating peace awards for people who start wars. I’m not a soccer guy, but that’s not the issue.

The issue was the corruption and ineptitude of so called ICE Immigration Customs Enforcement here in the United States.

And the concern has been that we have a bunch of thugs, basically Gestapo, who are running around kidnapping, gassing, shooting innocent people in the street. And so that remains relatively rare.

And in fact there has been since we put out that warning to our friends from overseas, there has been at least a nominal titular change in the way that ICE is being governed. In fact, as you and I record this, there actually is no funding of that entire agency.

Our government has frozen to a standstill out of outrage and argument over this issue. It remains unsettled.

And I would simply say for our loyal friends who do like a good soccer match, I mean, obviously we want you to come to our country. We just want you to be safe.

So in addition to everything you mentioned a moment ago, if you are visiting from overseas, please make sure that you have your identification with you, that your passport and visa is there, and that you have a good itinerary and contact with someone back home who can help keep tabs on you. I’m not saying that everyone from overseas is going to be scooped up by these people. They’re too incompetent to do that even if they want to.

But it is a concern and unfortunately that has not yet been resolved. This may get better by the time the summer games start, but it may not.

So I just wanted to make sure people understand this remains unfortunately a failure and an issue in our country.

WORM
00:14:50.040 – 00:15:12.020
Yeah, thank you. Agreed. All right, Paul, question for you.

Back in early February, the FDA, the U.S. food and Drug Administration declined to review Moderna’s application for the first MRNA based flu vaccine. What’s up with that?

GERM
00:15:12.660 – 00:18:41.780
Yeah. So in the ongoing Germ and Worm saga, ourmeat and potatoes, which is the stupidity and foolishness of this guy called RFK Jr.

Here’s yet another example. So what’s going on is that we have a beautiful technology which is called messenger RNA vaccine technology.

We’ve come to know it, rely upon it with respect to Covid prevention. It saved a lot of lives. Why not take that same technology, Chris, and app to other deadly viruses, including the flu virus.

And so in doing this, what we have to do of course is prove that the technology works and have it reviewed by something called the Food and Drug Administration. This is a well worn, time honored process for approving vaccines.

And so that’s where the chaos came in mid February 2026 the announcement that the FDA said no, we’re not even going to review the application from Moderna, one of the companies that, that makes these vaccines to decide if the flu vaccine based on MRNA tech is safe and effective. This may have happened before, but I’m not aware of it happening.

It certainly should not happen in the concept of a well established biotech firm like Moderna who had just saved a lot of lives. This is crazy, this is chaos. You know the story should end there, but of course it doesn’t end there because what we have two pieces of news.

Piece of news. Number one, they’ve changed their mind.

There is an announcement from Food and Drug that in fact they will at some point, we don’t know when or how, but at some point they will review this application for approval of an mRNA based flu vaccine. Let’s wait and see if that actually comes to pass. Encouraging news.

We also have this idea that someone called Vinay Prasad is going to step down from their role directing this branch of Food and drug. Vinay Prasad is the person who has been in charge of vaccine seen approval and regulation at Food and Drug since the new administration came in.

I guess I don’t even need to call it new administration. Has been a year since these fuckers been in place.

But anyway, Vinay Prasad is someone who is controversial, slightly crazy, maybe very crazy and certainly unqualified to hold this office. So I was very encouraged to see that Prasad is going to no longer hold that office.

But as we record this conversation, Chris, in mid March 2026, I do not know that this is actually going to be good news.

My sense is that they decided they weren’t going to review this particular vaccine because they were biased against it and they weren’t at all interested in helping protect American lives.

Now with the idea that, oh, yes, we will definitely review it, maybe they’ve already made up their mind and they have votes from within their committee members that they’re simply going to fail to approve it. So chaos, uncertainty, and lack of clarity. Right.

Whether this will be a legitimate discussion among experts, or will it just be, you know, this vaccine getting spit roasted by. By a bunch of people who don’t know their ass from their elbow? Let’s. Let’s find out.

Let’s keep tabs on this story, Chris, and come back to German Worm. As this story develops, we’ll be happy to cover it as best we can and give you our advice. My sincere hope is that this will have an honest review.

And, of course, hopefully the data supports its approval. I don’t know. I’m not on that committee. The hope is that this will be a win for everyone. It certainly should be.

And there’s no philosophical defensible reason that it shouldn’t at least be discussed.

WORM
00:18:42.340 – 00:19:01.360
Yeah, I really hate to see this technology not taken advantage of. It saved a lot of lives concerning Covid. It has potential for so many other illnesses and even some malignancies.

So what’s going on currently is horrible. And I hope that this kind of vaccine research will progress as it should.

GERM
00:19:06.400 – 00:19:15.680
Okay, Chris, a question to you. This is a great one, and I want to get your honest answer. Eating healthy on the road. Any tips for success?

WORM
00:19:16.960 – 00:21:17.670
Yeah, it’s easy to eat really poorly on the road, and I’ve certainly done this myself. I’ve lived off, I don’t know, hamburgers and Dorito chips for several days running. And this is not ideal person food.

A writer who probably many of you are familiar with, who I like a lot, is Michael Pollan. He’s written many books on food. He’s a smart guy. He’s. He reads the evidence. He’s also funny sometimes, which is nice.

One of his books was published in 2009. It was called Food Rules An Eater’s Manual. And you may know this mantra, but he recommends eat food not too much, mostly plants.

And there’s a lot of wisdom in that brief Saying now I like maple bars and Twinkies and Count Chocula as much as the next guy. But we really did not evolve to eat this kind of ultra processed junk. And Pollan has a phrase for this kind of food, which I love.

He calls these kind of foods edible food, like substances. And basically, as at home on the road, the higher fiber, the more fruit, vegetable, grain you can go, the better your body will. Thank you.

Someone who I disagree with, sorry to keep this name keeps coming up. RFK Jr. Recommends a high meat, high animal fat diet with a lot of saturated fats. That’s nutty.

It’s been known for many, many decades that a high animal meat, red meat, beef and pork, high saturated fat diet will elevate your risk of heart attack and stroke and other cardiovascular bad. So in a nutshell, try to get that fiber in. Try to find a grocery store. If you’re at a hotel, go for the salad.

And the less kind of sugary junky stuff you eat, the better you’ll feel. The better you’ll sleep, the quicker the jet lag will go away. So I have to admit I don’t always follow that, but that’s what I recommend.

Now, Paul, you travel a heck of a lot. Give us some words of wisdom.

GERM
00:21:17.990 – 00:22:39.030
I was reflecting on this good question because I did just get back from a few weeks overseas. Great cuisine in both Singapore and Sri Lanka, different from each other and delicious. I have a very adventurous, curious stomach.

I don’t have a strong stomach, but I love to try new foods and this was a great way to do that. In fact, in a future episode, I want to talk to you about the food hawkers and the hawker alleys of Singapore because they were spectacular.

What I found was that I was enjoying the food. I loved the new tastes. Both of these countries are wonderful. They really had very little crude fiber. I mean, salad is not a thing.

And unlike my previous trip to Mexico where I was having a lot of whole grains, that was just not a thing in either of these countries. So I had to go out of my way to try to add fiber in a supplemental way to my diet, because that’s here in Seattle.

I mean, I’m, I’m an omnivore, but I’m basically a plant based guy. So that was different and it was worth it. But definitely bowel patterns changed and suffered for that reason as well.

And by the way, as for RFK wanting people to eat, eat a lot of high saturated fat animal diet, I think he should do that. I’m good with him doing that. Let’s have him and don’t have him. Listen to this podcast, RFK Jr. If you’re out there, you’re onto something, keep doing that. You can be our canary in the coal mine. You work on that and we’ll, we’ll get back with you after your next heart attack or stroke.

WORM
00:22:43.590 – 00:23:00.960
Paul, this came to us on Instagram, and that’s always welcome. We’re traveling to the Seychelles in May. I read that there’s maybe some chikungunya there and maybe a little Zika.

What’s up with those two infections? I’m considering getting pregnant during this trip.

GERM
00:23:02.240 – 00:26:16.730
Yeah, thanks for the question and for your family planning foresight. So I’ve never been to Seychelles, so this is based on my understanding of the biology and the ecology of the area.

So, beautiful place. I have many friends who’ve gone and they’ve enjoyed those trips. Chikungunya and Zika, these are both viral infections that are spread by the bite of a mosquito.

And I mean, the only thing worse than, you know, chikungunya infection would be chikungunya while you’re pregnant, which sounds miserable. So, with respect to both of these viruses, are they there and what are the implications for pregnancy?

So, first of all, you know, the epidemiology within Seychelles is imperfect as it is anywhere else. But you’re correct, there is at least concern for relatively recent transmission of both chikungunya and some Zika.

I actually hadn’t realized this, not having traveled to Seychelles. I think of Zika being primarily in other areas, including Afro Caribbean islands, but they have apparently detected it there too.

So I appreciate your question. The relative risk of these apparently is small.

Seychelles has a good reason to try to do a lot of vector control because, you know, know, tourism is a big part of their economy, so they have no interest in people getting sick when they come to visit. But having said so, it is possible. And with global climate change flooding, you name it, mosquitoes are very adept, hardy creatures.

So I think you are smart to be thoughtful about this. I think your absolute risk of catching either chikungunya or Zika virus in Seychelles is low, but it’s not well quantified.

And so thanks for thinking about that. To reduce the chance of chikungunya infection, please do get your vimkunya shot. That’s the chikungunya shot that I got before I recently went to Sri Lanka. It was painless, easy, and it’s relatively effective. I think that’s Good. We do not have a Zika virus vaccine, although I wish we did.

And so your question about pregnancy is apropos not only because we lack a vaccine, but also because there is that small number of very catastrophic issues that early during pregnancy.

In the original experience with this in Brazil, Right, Chris, we had people who had pregnancies that were very severely impacted when the mother acquired Zika virus infection early in gestation, and including kids with anencephaly, malformations of the brain and the head. It’s still not clear why this happened.

That experience, thankfully, has essentially gone away, at least to my understanding, with respect to the Brazilian experience. And it’s not clear why that happened almost exclusively in Brazil, but that seems to have gone away for some years now.

Was that a change in the virus? Was that a different virus that was in one part of the world? We don’t yet know. To your plans to go to Seychelles and potentially become pregnant.

Do that. I think that’s great. Get your Chikungunya shot and then let’s do some bug avoidance measures.

Try to reduce your chance of being bitten by a mosquito that could carry these or other infections. So, Chris, that begs the obvious question. Can you use bug repellent when you’re pregnant?

What’s your advice for bug avoidance for someone who’s pregnant or might become pregnant?

WORM
00:26:17.130 – 00:27:08.010
You know, usually we hedge and say it depends, but on this one I can give a thumbs up. Bug repellent is safe in pregnancy and it’s markedly safer than the risk of getting certain infections that it can bring the risk down of these infections.

So both Zika and Chikungunya are vectored by mosquitoes. And so if you don’t get bit by a mosquito, then you won’t get it. And it’s the same standard stuff.

It would be Picaridin or DEET to exposed skin, permethrin to clothing and sleeping under a bed net if your sleeping quarters are not air conditioned. Now, you don’t want to do 100% DEET. I wouldn’t. If you were pregnant, maybe don’t go higher than 30 or 35% for picaridin. You want to go 20%.

But these standard bug avoidance measures will markedly bring your risk down of everything transmitted by a mosquito. Not only chikunguni and Zika, but also dengue and a number of other infectious illnesses.

GERM
00:27:08.960 – 00:27:44.250
Yeah, agree. And so my hope is that this listener will enjoy their trip. In fact, even though we don’t know who you are, we’d love to hear from you.

If you do have an experience over there. Let us know what you’re seeing, what people are talking about with respect to these infections. And you know, we’d love to hear from you.

Send us an email please. Germandwormmail.com. Okay, Chris, here’s a question to you from an anonymous writer. I think this is great to boost my mental health.

Should I go news-free when I’m on vacation?

WORM
00:27:44.730 – 00:29:14.580
You know, I’m going to give a few different answers to that. On the first hand, yeah, you’ll feel better.

A lot of us, myself included, are getting kind of bummed out by reading the newspaper every day at politics and wars and other issues and actually just waking up in the morning and having no media, no phone, no laptop. Talk to your sweetie, have a cup of coffee, look at the sunrise can be a wonderful way to start the day.

On the second hand, you might miss something important. A couple things recently that you might want to know about.

For example, there was in Spain there was a transportation strike and all the trains shut down. And if you went to the train station and didn’t know about that, that could be an unwelcome surprise.

Or sometimes in the Middle east, in Saudi Arabia, again, February, there were sandstorms and you had a few days warning and you could prepare. So sometimes stuff happens that you want to know about. On the third hand, and this might be my final answer. There’s probably a happy medium.

I think it would be great both at home and traveling to consume less media than most of us do. Maybe really reduce it when you travel.

But check in periodically if you’re traveling with your partner, maybe alternate days, somebody could go on the Internet 15 minutes once a day to check what’s going on. But I think a relative detox on vacation could really make you kind of feel less stressed. But I’m not sure what exactly the happy medium is.

So Paul, give me some guidance here.

GERM
00:29:14.820 – 00:30:04.650
I mean, I’m with you.

I’m trying to consume less doom scrolling here in the good old US of A where I live and work and on vacation to make it a real true vacation to have that reset to be refreshed and come back feeling well, feeling better than you did before you left. Yeah, I think less is more. And you make a good point about safety and being up to date on travel issues.

There may be a way to filter your feed to do that. If folks have a tip on that, let us know.

I sense that when it comes to something like a sandstorm that’s coming in, a hurricane, natural disaster, you’re going to know about this because that’s what people are talking about that locally. And so if in doubt, leave it out and skip the news. And we hope that you have a great time on your upcoming vacation.

Let us know if we got it wrong and if we got it right, that would be welcome too.

WORM
00:30:04.890 – 00:30:25.140
Yeah, I did that on my recent trip to Mexico, Belize and El Salvador. Is unlike my usual morning routine. Sometimes I would just get up and do a tourist thing or read a book or write in my journal.

And actually it was really, really nice. It was as close as I come to meditation. And I’m going to try to imitate that a little bit more at home.

GERM
00:30:25.460 – 00:30:28.100
Something we should all aspire to in our daily life.

WORM
00:30:35.540 – 00:30:44.980
Paul, question for you. Someone writes in I’m reading a lot about measles here and there. Is this primarily or exclusively in low income countries?

GERM
00:30:46.410 – 00:34:15.530
Yeah. Unfortunately, no. Measles is a global resurgence phenomenon. It’s a failure of modern society across the board.

So this is a little bit different from some of the infectious risks that we talk about here on Germ and Worm. One of the themes that emerges as we go through this process.

Right, Chris, is that the risk of infection with any number of infections, it’ll be different in different places, in different locations with different risk factors in different times of year, year. There are some things that are very seasonal. There are some things that are very much attached to a vector or a foodstuff. Measles is different.

Measles is spread human to human. There is no animal reservoir. And measles does not care where you live, what your socioeconomic income is, what your skin color is.

It infects every human being that it possibly can. It’s where the people are. That’s where measles is. And we have many reports of this.

First of all, here where we live in the United States, there’s more measles today than we’ve had in decades. This is inexcusable.

It’s due to a failure of a number of social opportunities, including education and leadership at the highest level and at local levels. Plus some faith based missteps which are unfortunate, all of which are remediable. It’s a big deal. Deal, right.

Because here in the usa, why should you get measles? Well, you shouldn’t because you should have your vaccines. One shot will confer about 93% protectivity.

Two shots gets you up to about 97% protectivity. That’s not 100%.

But if we all get our shots, if everybody’s at 97% protectivity, then the chance of spreading it unknowingly to other people is extremely small. And yet this is happening here in the United States, which at least for the moment is considered not to be a low income country.

I think for a lot of people they do consider themselves to be low income. But that happens even in our socioeconomic context. For sure. Our friends in England are having the same story.

Experiences of measles transmission are reported in United Kingdom, mostly in London. That’s where a lot of the people live and where people live close to each other.

And you know, this is being reported in numbers that are far in excess of what England would have seen in recent decades. Just like what we’re seeing here in the United States. Our friends in the Netherlands are experiencing something similar as well.

So no, unfortunately this is not something that you get only in so called lower income countries. It’s everywhere. So to all of our friends listening, please, if you are uncertain whether you’ve been immunized, talk with your doctor.

If in doubt, you can do a blood test or just get a boost. This is always an easy, safe, effective thing to do.

And remember when you do that, you’re protecting yourself from this miserable and potentially life threatening infection. And the life you save may be of a perfect stranger or someone who has been immunized but can’t respond to that vaccine.

Someone who remains susceptible because of biological factors with their immune system. This is something where all of us together do the right thing by getting our shots and we can be done with this.

There are so many crises, opportunities and problems in modern society. This one has a solution. We just get our shot. So I’m eager to put this one to bed forever.

If we all get our shot and eradicate this stupid infection, let’s see whether we can abide by that vision. Shining vision of a social contract. What’s your thought, Chris?

WORM
00:34:15.850 – 00:34:37.350
Yeah, I’m with you all the way.

I mean, sign of a times at the family Medicine residency at the University of Washington that I teach at were having to spend more time training the residents on how to diagnose measles. And you know, we spent minimal time on that a decade ago.

So that this preventable illness is coming back is really, really unfortunate and unnecessary.

GERM
00:34:38.070 – 00:35:56.390
This is the most contagious or communicable infection known to man.

If someone has measles and then leaves that room, someone else could walk into that, that room within an hour and be at high risk of catching measles if they have not been vaccinated. So the only way out is also the easy way out. Get your damn shots.

And if people have questions about this, please do talk with your physician about it, because everyone deserves a chance to live a life free of measles. If you’re unsure about this, talk to your friends who’ve had it. It can be a miserable situation.

Thank you for joining us here on episode 92 of Germ and Worm. As always, we welcome your questions on travel health. Send them to us or Tips for Success Suggested Corrections we’d love to hear from you.

Shoot us an email germandworm@gmail or Visit our website germandworm.com if you’ve enjoyed the episode, we would appreciate you subscribing to us. Rate us favorably 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
00:35:56.710 – 00:36:00.110
I’m Worm. It’s a big planet. See you in good health and we

GERM
00:36:00.110 – 00:36:20.980
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 in this podcast are Dr. Sanford’s and Dr. Pottinger’s alone and do not necessarily represent the opinions of the University of Washington or UW Medicine.