GERM
00:00:10.080 – 00:00:11.280
Aluu! My name is Germ.

WORM
00:00:11.520 – 00:00:12.400
I’m Worm.

GERM
00:00:12.720 – 00:00:23.840
Welcome to the Germ and Worm Travel Health podcast. 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
00:00:24.000 – 00:00:32.240
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
00:00:32.480 – 00:01:33.520
Okay, Chris. We always field interesting questions from our listeners about travel health and travel wellness. Today is no exception.

Just get a load of a few of these we’re going to tackle today. I have a bat in a cooler. What should I do? How should I prep for a wedding in India? Will swimming with manatees rot my brain? And detoxing on vacation?

How should I do it? Right these questions and more. Please contact us with your travel health questions and your tips for success.

Just Visit our website, germanworm.com finally, our disclaimer. This podcast is designed to inform, inspire and entertain, but it should not be used as clinical care.

Before you travel, please see a qualified healthcare professional for recommendations specific to you and your itinerary.

Okay, CHris, I gotta start with this one. I think I have more questions than the questioner has, but it’s a question and we love it. It’s a great one. It comes to us from someone called Miriam in Seattle, Washington, and they say, what should I do if I have a potentially rabid bat in a cooler?

WORM
00:01:34.080 – 00:03:05.470
First, I hope you will write us again, Miriam of Seattle, and tell us how the bat got into the cooler. First, a few things not to do. Suppose there’s a bat down somewhere. As a general rule, I wouldn’t touch it.

If you did touch it, you want to seek medical attention. This actually, it’s funny you ask.

Many years ago, I was working at an urgent care center in Mukilteo, which is just north of Seattle, and somebody brought in a bat and a cooler. They had been in Arlington, Washington, up by Marysville, and a bat was acting very strangely.

They were standing in a river and as they described to me, a bat swam toward them and touched their kid’s leg. And so the guy hit it and put it in a cooler and brought it in.

Well, what the kid needed, and actually both the man, since he touched it too, was rabies exposure treatment, which I didn’t have. So I sent them to Harborview, the big medical center center in Seattle.

And as I heard later, the guy took the cooler into the emergency room and opened it and the bat flew out, which is a Big problem. I actually didn’t hear the end of the story. So what not to do is take the bat in the cooler into a medical facility. I’m not sure what to do with it.

Bottom line, any bat that’s down has an elevated risk of having rabies because a healthy bat is going to be flying around and don’t touch it. And if you do, seek medical care immediately, because once symptoms of rabies develop, it’s 100% fatal. So that’s my take on it.

GERM
00:03:05.550 – 00:04:56.350
I think that’s the right take. And we’re just so grateful that this person wrote in because it does come up.

On the one hand, we would never recommend that someone hunt, trap and cooler as a bat. We really want you to just avoid them if at all possible. It’s confusing, right, Chris?

Because people know that if the head of the bat is cut off, the brain can be examined to see if they are rabid. Now, that’s true.

But the risk to you, as someone who’s going to hunt down that bat of getting scratched or bitten actually makes it dramatically more likely that you might. As you said correctly, Chris, you might need to be someone who receives rabies prevention. So when it comes to bats, leave them alone.

If you have been bitten or scratched already by that bat, I would say it again. Number one, wash that wound with soap and water immediately.

Just go to your bathroom sink, go to the kitchen and wash it for five minutes with soap and water. That is the most important thing we can do to reduce the chance of catching rabies from a bat.

Number two, that’s when you want to get a hold of your physician. And if you can’t get a hold of your physician, you call the public health authority where you may live, and they will walk you through this process.

They will usually not recommend that you go after that bat to get into a cooler, a net or any other kind of container, because that contact itself is at high risk.

Does this mean that you might have been exposed to a bat that doesn’t have rabies and that you go to see a doctor like good old Dr. Sanford here, who says you need rabies prevention and it’s not technically necessary. I mean, yes, that can happen and I’m totally good with that. Because if we get it wrong, as Chris says, this is a catastrophe.

So if in doubt, let it out. But do not get near this bad unless absolutely unavoidable. And even then, do not stay away from your doctor.

You’ve got to get in with a healthcare professional. We have wonderful prevention, if only you’ll come and see us.

WORM
00:05:03.850 – 00:05:14.650
All right, Paul, this is coming to you. And this is from Gina F. In Healdsburg, California. And Gina writes, I’m attending a wedding in a couple of months in India. What should I do to prepare?

GERM
00:05:14.970 – 00:08:43.250
I would just get stoked for the wedding. That sounds exciting. I’ve only visited India twice. I would love to go back.

It’s basically the most interesting place I’ve ever gone and there’s so much more that I need to do and to go back. So wonderful about the wedding. Happy that you’re going. Everyone should visit India if they have not done so to do it safely.

Yeah, there probably are some things you can do when you meet with your qualified healthcare professional.

And Gina F. Of Healdsburg, California, you will see a qualified healthcare professional because the answer is what you’re going to do and what your exposures are going to be. They may be very addressable with some simple, safe, cheap, affordable things. So most of our.

And I don’t know that this applies directly to you, but most of our listeners who are going to visit India would benefit from immunization against typhoid. That’s a bacterial infection that can give you very serious series of problems, not just traveler’s diarrhea. It can be worse than that.

And we have great vaccines for that. There’s an infection called hepatitis A. It’s a viral infection we’ve talked about here on the podcast.

Everyone alive today should be immune against hepatitis A whether they travel to India or never leave their home in Healdsburg, California. We should all be immunized against hep A, but the risk in India is dramatically higher than it is here domestically.

And then it’s also going to depend on what else you’re going to do, where you’re going, the time of year, et cetera.

For example, if you’re going to be exposed to the mosquitoes that carry malaria, then you should take medication to prevent the chance of catching malaria. And that depends on where you go and when you go. There’s a wonderful map on this at the CDC website.

You’re welcome to take a look at that, but that’s something you should discuss explicitly with your healthcare provider. Likewise, there are a number of other mosquito borders, viral infections. One of them is called chikungunya, for example.

We’ve talked about chikungunya here on the channel. We have a very safe, effective vaccine called Vimcunya.

It’s a virus like particle technology, and it’s not perfect, but it’s very good to reduce the chance of catching chikungunya. If you’re going to be in areas of aquaculture, rice paddies, a very rural itinerary.

I don’t know where the wedding’s going to be, but if it’s going to be out in the countryside, that’s where we tend to see people who get bitten by the mosquitoes that can cause a very serious viral infection called Japanese encephalitis. We have a wonderful vaccine to prevent Japanese encephalitis.

Depending what you’re going to do, you may need to get that regardless for all these bug associated infections. Yeah, you want to make sure you bring a mosquito repellent that you don’t mind putting onto your skin.

I like the idea that people would pre treat their clothing if they have a set of clothes, few pair of trousers, few pair of shirts, sets of shirts that they’re going to take with them outside, spray those with permethrin ahead of time so that that can also reduce the chance of getting sick from mosquito borne infections. I also think it’s reasonable to take some medications in case you get sick with traveler’s diarrhea.

Traveler’s diarrhea is one of the most common issues we do see in people returning from trips to India. And it’s manageable. It’s usually safe, benign and self limited.

You may not have time to let things pass on their own with your busy wedding itinerary. And so azithromycin is an antibiotic that your healthcare provider might choose to prescribe for you.

Like we’ve talked about here on the podcast, even a single dose of azithromycin can be highly effective in getting people back on track if they do catch a case of bacterial traveler’s diarrhea. Chris, what else do you think someone should do in this circumstance?

WORM
00:08:43.330 – 00:09:28.500
Well, first, I agree with you. This sounds super fun and I’m a little envious. We cannot give definitive advice on the podcast.

You didn’t tell us how long you’re going for or where you’re going. And of course we don’t know your past medical history and immunization history.

I certainly agree you should get all of the basic vaccines, including flu and Covid. But for things like Japanese encephalitis, as Paul alluded to, it depends. So the risk is lower if you’re urban in short duration.

The risk is higher if you’re rural and long duration.

So as Paul said, we can give you a few pointers, but you really have to see a health Professional at a travel clinic, spend the whole 20 minutes or whatever with them. Go through your whole itinerary to get the full spiel of what would help bring your risk down of illness.

GERM
00:09:34.660 – 00:09:44.980
Chris, a question to you from Anonymous. Silly question, but my first trip overseas is coming up. It will be to Germany and Italy. How reliable will the Internet be while I travel?

WORM
00:09:45.670 – 00:11:15.620
Good question. As a large general rule, with many exceptions, in high income countries, as you probably, probably already know, it’s usually pretty good.

So if you’re going to the countries you mentioned, or Japan or Australia, usually the Internet and electricity is reliable. Not always, but usually in low income countries. Actually, in my recent experience, it’s usually reliable too, but it’s more likely to fail.

If the power goes out, your Internet’s going to go down. And of course, if there’s something like a storm, an earthquake, any disaster like that, usually everything goes down.

The cell phones, the electricity, the Internet. A couple recent things that I saw in the news. Not that many people are going to Afghanistan now, although they do have a fledgling tourism industry.

But in late September, the Internet for the whole country just shut down abruptly. And it’s a little controversial if that was accidental or on purpose or there was just a few days ago a really big earthquake in the Philippines.

And when that happens, power goes down, the Internet goes down. So in a high income country like your itinerary, the odds are pretty good you’re going to have Internet.

But it would be good to have some backup electricity like a power pack for your phone. And also don’t 100% rely on the Internet.

For example, if your jet ticket is on your cell phone only, especially if you’re going to a low income country, you probably want to print out a old fashioned hard copy so that if you don’t have cell service, you can still get through the airport ticketing.

GERM
00:11:15.620 – 00:12:25.650
Yeah, totally agree. And what’s so interesting is how the world continues to shrink and shrink and shrink. Everything you said about the Internet is true.

If you’re thinking about the Internet as a form of communication, a way to receive emails, to communicate with home, for example, there are other solutions.

I mean, as an expedition member on mountaineering trips, I’ve often taken, you know, a satellite beacon with me in the past, a delorme, an inreach, this kind of device that is also now becoming old school, right? Because the new flavor of iPhones.

I’m not a big fan of Apple necessarily, but I am an iPhone user and all the new iPhones now have the ability to send and receive Texts through satellites, completely separate from the local infrastructure, 5G, LTE, Internet, whatever. So it’s just interesting how that’s happening. You can’t browse the Web, at least not yet, through one of these devices.

But in terms of being in touch with home, that’s something that’s becoming easier to do. That’s a burden and a blessing. And everybody has to decide their own degree to which they’re willing to detoxify and get offline.

WORM
00:12:25.810 – 00:12:46.390
Right. Some people actually enjoy getting away from the Internet, which I totally get.

But if you have something critical going on that you really have to be in touch, and especially if you’re going to be remote geographically, it might be worth your while to get, just as you said, Paul, an Iridium phone, a Starlink account so that you can use communicate anywhere on the planet.

GERM
00:12:46.390 – 00:12:47.230
Totally. Totally.

WORM
00:12:52.670 – 00:13:04.190
All right, Paul. Oh, good question. This comes from Anonymous. I keep Tylenol in my travel medical kit. I’ve never had an issue with it, but now with a linkage to autism. Should I reconsider?

GERM
00:13:04.270 – 00:14:39.320
Yeah. Thank you. So the quick answer is, no, you should not reconsider because there is no link to autism.

So I appreciate this question and I’m glad to help clarify this. When we receive information from federal sources, unfortunately, it’s now necessary for us to consider the source.

And in this case, the source is someone called RFK Jr and his cabal of morons who support him.

They’ve come up with some weird, dark narrative that somehow Tylenol, which is also called acetaminophen, it’s also called paracetamol, that this might somehow be related to the development of autism if it is taken by a pregnant person, that their pregnancy might result in someone who lives with autism. That’s not true. We have large amounts of data and, Chris, in a moment, I’ll ask you to give us some recent updates on the literature about this.

It’s just fake news. Why is it news at all? I’m not sure. This person came into office promising to find the cause of autism. Spoiler alert. There is no cause.

There’s a whole series of causes. That’s why we haven’t been able to pin something down, because there’s not one thing that does this. But into that mix comes the acetaminophen story.

Right?

If you look at large populations, and this has been done on multiple occasions, people have been trying for a long time to understand where autism comes from. Why does it happen?

And it’s true that there is a very slight association between pregnant people who have Taken acetaminophen and subsequent development of autism after delivery. But that doesn’t mean that it is the cause. It just means that there’s an association. I’ll give you an example.

Autism has been around for a very long time, indeed longer than we’ve had acetaminophen on the shelf. Before the creation of this drug, that condition was still with us.

So it might be that someone who has a fever, a high temperature takes acetaminophen to treat the temperature. Maybe it’s the body temperature itself that led to one of the risk factors for autism. I don’t know that that’s the case.

The key is that there’s a huge difference between a cause and effect and an association.

What we know, 100%, is that the American College of Obstetrics and Gynecology, American Academy of Pediatrics, you name it, all the brightest minds in medical science know that Tylenol is safe and effective for treating pain and fever in people who are pregnant. And much more so than, let’s say, what’s the alternative? Ibuprofen, the so called non steroidals.

We know that these are very dangerous in pregnancy and are contraindicated, meaning you should not take them. So I really appreciate the question. I would continue to keep acetaminophen in your travel kit. It’s not a perfect medication, right?

You can still have pain if you take it, the fever may not fully resolve. And if you overdose on it, it can be very deadly. That means taking more than 4 or 5 grams, 4 or 5,000 milligrams in a single day.

You can start to have toxicity in the liver, but that’s not what’s being purported here by RFK and his cronies. And it’s not a reason to avoid it in the medical kit.

I also keep this in my own travel medical kit, and I would advise the same for someone who’s traveling if they are pregnant. Chris, what would you like to add to this, please?

WORM
00:16:12.450 – 00:16:47.500
Yeah. Multiple large studies have come out and they show that there’s no link between taking Tylenol in pregnancy and autism.

One of the biggest just came out last year, it was published in JAMA, came out of Sweden, and it actually looked at 2.5 million people. And once again, they found no association between autism and Tylenol. And as you say, Paul, consider the source.

We had this recent news release, but the people who were talking were a former reality TV star and a lawyer. So once again, I recommend you get your health advice from medical professionals.

GERM
00:16:47.580 – 00:17:02.780
Agree, agree, agree. Chris, to you from one of our listeners called Mandy of Aurora, Illinois. What do you think of detox retreats in foreign countries?

WORM
00:17:02.940 – 00:18:44.010
Ooh, thank you, Mandy. Well, detox is a large word in terms of it has many different meanings to different people.

Now, if you mean digital detox, actually, I think that’s kind of not a bad idea at all. In fact, I kind of like that idea.

So the idea of getting away from your cell phone and the Internet and all the different little gizmos that buzz on your wrist or beep in your ear, I think it can be healthy to go to a place where you just kind of record your thoughts with pencil and paper and talk to people and look at nature and get away from all this electronic stuff that can be so distracting. But I think more people mean detox in the sense of doing something that purifies your body in some way.

And that actually is where doctors think about toxins differently, perhaps, than lay people.

To a doctor, a toxin is something that you can measure, and it does something bad that we know, and you can lower it, and then you can measure it again, and that reduces your risk of the bad thing. And an example would be lead. It’s toxic. There’s treatment for lead in your blood. We could measure it. We do something to make that level lower.

A lot of these detox places, abroad and in the US as well, are these regimens that detoxify you. They don’t measure anything. And it’s almost more philosophical.

And whereas, indeed, a high fruit, high vegetable diet is good for you, your liver already does a good job of detoxifying your body. And so I don’t really know that any toxins are lowered by, I don’t know, drinking fruit juice or whatever they do for some prolonged period of time.

So I don’t think most of them do any harm, but I don’t know that they’re really detoxifying you in a real way that I can identify. Paul, help me here.

GERM
00:18:44.010 – 00:20:13.910
Well, I don’t know if I can help, because I do agree, and I just, I love the idea that someone’s interested in traveling overseas for their own wellness and benefit. This is great.

And that is something that I try to do myself, whether it’s through cultural enlightenment or just broadening my horizons, seeing different parts of the world. Whatever it is, you’re doing this for the right reasons. And I think that inclination to detoxify is a good one.

But I am concerned that someone might sign up for something that, at the least, is unsubstantiated by science and at the worst might actually be dangerous. Chris, I do worry about that. I don’t know what herbal remedies are being given to someone, what chelators are being pumped into the blood.

Look, there’s a way to do a yoga retreat which would detoxify because you’re just relaxed and exercising and eating right and doing yoga. I mean, I’m all about that. As long as you don’t catch leishmaniasis when you get bitten by sand flies, like that’s all fine.

I really do worry about something that would be medicine adjacent. Someone who’s giving you a remedy that they have come up with. Please be skeptical.

I don’t mean that something that I don’t personally understand can’t be of benefit. Just be skeptical, do your homework and understand that if someone is pushing medications, IV treatments, that is a big red flag.

Whereas relaxation, sensible diet, exercise, etc. I think that’s a whole different detox, which I personally would support.

WORM
00:20:20.150 – 00:20:32.410
Paul, this is, this comes to you. This is from Anonymous. And Anonymous writes, I’m going to Clearwater, Florida to swim with the manatees.

But a friend recently told me about brain eating amoebas in the water. Really?

GERM
00:20:32.730 – 00:25:10.550
Okay, so there’s. There’s two parts to this question and I really do appreciate this. Number one, the manatee.

For those of our listeners who don’t know what manatees are, they are this the world’s most peaceful, benign, charming, delightful aquatic creatures. These are freshwater mammals and they look almost like a giant dolphin or something. What’s the right word for it? They look like a mermaid, but they’re designed to. To just munch on grass in the Everglades. And that’s what they do. They never hurt a soul. They’re quite harmless, although they are enormous and they’re charming and beautiful creatures. I was not aware that you were allowed to swim with them. If that’s being done in a sanctioned way and it’s above board, then that’s interesting.

I actually just have not tried to do that before.

So if you’re going to hang with the manatees, please do it in a way that is approved, legal and above board because these are critically endangered creatures. Because of course we’re turning all the swamps and Everglades of Florida into more housing developments. Pollution. This is the issue.

It’s habitat number two. What’s up with the brain eating amoeba? I hate these guys. So this is a true thing.

It’s not only true in Florida, but elsewhere in the United States, typically in areas of warm water and Warm, clear water. We see this in freshwater drainage pools in Arizona. It could be elsewhere in the Gulf States.

The concern is for infection of your body with a germ called Naegleria. Naegleria fowleri is the amoeba, a single celled, microscopically small organism.

It looks like one of those Gary Larson cartoons, you know, that sort of puts a piece of itself out there, then crawls into it. These are what amoeba are. And there are many free living amoeba in the water. They’re usually quite harmless.

But this one in particular, Naegleria fowleri, we worry about that one in this circumstance because, yes, in incredibly rare, very uncommon circumstances, these can crawl up through what we call the cribriform plate. That’s the back of your nose. And you know, the back of your nose is right next to the brain.

And there are well described cases, I have seen them myself, where people dive into fresh water, especially in Florida, especially where there is muck and a bed of rotting leaves at the bottom of the water. They kick up that water and these free living amoeba are just feasting on all the pond scum that’s in there.

They can then get kicked up, go in through our nose, and then burrow through the back of our nose and eat our brain and kill us. I mean, I’m sorry, but this is a very real thing. Again, incredibly, incredibly rare. We have treatment for this. The treatment is problematic.

Most people come through who. The handful of people who have survived have typically been substantially neurologically injured. This is a very deadly, dangerous situation.

You don’t want amoebas in your brain. How do you avoid this? Number one, stay out of the clear water in Florida.

Number two, if you do choose to swim in freshwater areas that are at risk, you could try plugging your nose. If you pinch your nose and reduce the amount of water that gets jetted up into your nose, that could make a real difference.

A lot of these are cases of people who’ve been diving a lot in the water or those who’ve had a big jet of high pressure water into their nose. A classic way to do this would be riding a jet ski or trying to water ski in fresh water. You wipe out, as you always do when you go water skiing.

Boom, in comes this big rush of water into the nose. So that’s something that you would also want to avoid. What if you actually do this? Anyway, you’re worried you may have gotten a brain infection.

You’ll know because these patients get extremely sick very quickly, too. Within a Matter of days, they’ll have a case of meningitis.

That’s fever and neck pain, neck stiffness, that then evolves into encephalitis, which is altered thinking. People can’t think or use their brain properly and they typically will then go on to die within a few days.

Certainly if you find someone who seems to have a case of meningitis or headache that’s otherwise unexplained after diving in fresh water in Florida, take them immediately to a doctor or at least reach out to them and say, hey, I’m worried about an amoeba situation here. These are rare infections. I’m not telling you not to go swimming in Florida. I am saying it’s a real thing.

And so be choosy about the amount of freshwater exposure that you have. And please know about this so that if you do get that exposure, you can deal with it promptly. Chris, have you had any experience with this disorder?

WORM
00:25:10.870 – 00:25:50.880
Not this exact one, but I saw a different free living amoeba in Peru or a case of it of ballamuthia in a 10 year old boy. The good news about this is that both in the US and worldwide, the number of cases of this is minuscule fuel.

The bad news is we really don’t have a good treatment for it. As you alluded to, most or at least many microorganisms we can cure with the right drug. So most bacteria, we have a drug that kills it.

Several viruses, we have drugs that can stop the infection. However, this is something that we have a drug that helps a small number of people. But a lot of people, despite optimal care, will still do poorly.

So this is something that’s better not to get in the first place.

GERM
00:25:52.230 – 00:26:02.870
Totally. Chris, question to you from Gregory of Virginia. What should I do if I get caught up in a riptide?

WORM
00:26:02.870 – 00:27:29.500
Ooh, thank you, Gregory. A better term for this is rip current, just because although it’s better known as a riptide, it’s not really a tidal movement.

It’s where you get this current away from shore into the ocean. That’s where waves come together from, from either side. And it’s dangerous.

People can panic, they can try to swim against the current and get exhausted and drown. One thing to do is learn how to recognize it. And for example, Noah has videos of what this looks like online. Few tips. One is to stay calm.

Just don’t immediately start swimming as fast as you can, but just kind of think, look around, decide on what your strategy is going to be. And also this will not pull you down it’s not an undertow, so it’s not going to pull you down, so it’s not immediately dangerous.

Stay calm, signal for help. If there’s a lifeguard on shore, start waving your arms around. And the traditional wisdom is to swim parallel to shore. So don’t try to fight it.

Don’t go straight for shore because these things can be much faster than you can swim. But go parallel to shore, then go back to shore at an angle.

And if you’re not able to do that, just let it carry you out a bit, but don’t exhaust your energy. If you’re not a strong swimmer and you’re going in the ocean, maybe wear a pfd. So nothing bad’s going to happen if you get tired.

But this is actually a problem. All over the world, it’s good to inquire about local conditions and to learn how to recognize what it looks like from shore.

GERM
00:27:29.980 – 00:27:55.070
What I’ve been so struck by with rip currents is how incredibly focused they are. Strong as hell, you can never swim against them. Physically impossible, but narrow.

And if people would just swim parallel to the shore, don’t try to get back to the shore, just swim parallel. It’s amazing how quickly they drop away and you can then make your way back to the beach.

That pearl is a true one, and I hope our listeners will spread the gospel.

WORM
00:28:04.360 – 00:28:15.000
Paul, this is for you. I’m planning a cruise to Antarctica this winter, Antarctic summer. And I hear the risk of sunburn is high due to the ozone hole.

Is that really a thing?

GERM
00:28:15.240 – 00:30:41.210
Oh, this is exciting. So I am also planning an Antarctic cruise this winter, which is Antarctic summer. Maybe I’ll actually be on the same boat as this listener.

This was anonymous, so I. Yeah, I’m curious who that person is, but that’s exciting. So one of the things that I’m looking for forward to is just going to a different part of the world.

I’ve been to Antarctica before, but not to the coast. So this is going to be super exciting for me.

One of the things I’m not looking forward to is the avoidance of ultraviolet radiation, because this is a real issue.

So if you’re planning to go to Antarctica, to the interior, the South Pole, to Union Glacier, climb Mount Vinson, the risk of sunburn is extremely high. Right? Antarctica, the highest, driest, whitestone, brightest continent of all of them, the UV light. In this time of year, the sun never goes down.

I mean, you will fry. This is where we really have to take UV avoidance very seriously. The ozone hole is part of that ozone Turns out to be a good thing.

We’re supposed to have ozone at the ice caps that protects us. It bounces some of that solar radiation back away into space.

We’ve had a hole develop seasonally over Antarctica, related in large part to the presence of chlorofluorocarbons, the old fashioned refrigerants that we used to put into home refrigerators, AC units, etc. And they’re brilliant refrigerants, but just these chemicals will chew away at the ozone layer, which was totally unanticipated.

People who built these chemicals did not realize that was going to happen. And lo and behold, it’s a true thing. The good news about the ozone hole is that it’s gradually getting better.

And because the Environmental Protection Agency, your federal government, has banned them. And the hole is now gradually healing over like a, like a scab or something.

So it turns out that the federal government, folks, it’s kind of a good thing. As we record this conversation early October 2025, we have no more federal government.

They’ve closed it because they can’t agree on all kinds of budgetary issues. Turns out the government’s a good thing. This is one of the many examples. If you’re on a cruise to Antarctica, I would not worry about the ozone hole.

There’s a lot of other things you could worry about. This is one that you can take care of. But again, regardless of the ozone question, you will be at high risk of a sunburn when you’re outdoors.

Very important to protect yourself. Chris, what strategies would you give to an Antarctic cruiser about avoiding sunburnt?

WORM
00:30:41.680 – 00:31:26.620
Well, I have a few. But first, just a little distinction. Ozone is good or bad, depending on its altitude.

What’s bad is ground level ozone like you have in a polluted city, causes asthma and other bad things. What’s good is this high altitude ozone, which, as you say, protects us from ultraviolet light.

And that’s the issue here with this hole in Antarctica and the basic sun protection, UV light protection things will work. They’re just more important, important. So you want to do sunscreen, high spf, wear a big old hat with a brim.

You want to get sunglasses and wear them that block UV light. And also try to avoid peak UV hours. So morning and late afternoon is better. Noonish is worse when you’re going to get more intense UV radiation.

GERM
00:31:27.020 – 00:32:39.630
Yeah, agree. And one of the creepy things for me about the Antarctic expedition that I did back in, what was it, 2014, you know, the sun never sets.

It just goes in a little circle up above you and it’s always sunburn time. Could be 3am, could be 3pm, didn’t matter. So that’s one of the fun and incredible freaky parts of being down in Antarctica to this listener.

I hope you have a great experience and would be super fun to travel with you.

Well everyone, that’s a wrap for episode 72 of Germ and Worm. As always, we welcome your questions on travel health.

Please send them to us or anything that you’d like us to discuss. Clarifications, Corrections we’d love to hear from you.

Just Visit our website germandworm.com where you’ll be able to submit questions but also search for prior answers episodes and binge this podcast to your heart’s content.

If you’ve enjoyed German Worm, please subscribe, rate us favorably and drop us a favorable review and spread the word with friends, family and on social media. Those are free ways to support this podcast. I’m Germ.

WORM
00:32:39.710 – 00:32:43.190
I’m Worm. It’s a big planet. See it in good health and we’ll.

GERM
00:32:43.190 – 00:33:04.070
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 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.