GERM
00:00:09.200 – 00:00:11.560
Semalat pagi! My name is Germ.

WORM
00:00:11.560 – 00:00:12.400
I’m Worm.

GERM
00:00:12.720 – 00:00:26.960
Welcome to the Germ and Worm Travel health podcast episode 76, Waymo” Is it Way Mo’ Safe? 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
00:00:27.310 – 00:00:35.150
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
00:00:52.030 – 00:01:25.930
Chris, we have the best job in the world because we get to answer super cool, fun questions from travelers across the country and around the world. Here’s a few of them for today’s episode. Myocarditis and Moderna Is the risk real mosquito borne infections in France? What travel apps do we recommend and how can I get my health insurance to cover pre travel office visits? These questions and more today.

Please contact us with your own travel health questions, stories, tips for success, or if you want a clarification on something we’ve said previously, just send us an email germandworm@gmail.com or visit us online. Germandworm.com

Finally, our disclaimer. 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 your itinerary.

WORM
00:01:27.050 – 00:01:42.970
All right Paul, first question is to you and this is something we got in our email inbox. You are both very pro COVID vaccine, but I remember there was an increased risk of myocarditis heart inflammation with one of the COVID shots.

Is this correct?

GERM
00:01:43.530 – 00:04:07.020
Yeah, thanks. So this is a great question. This goes back to the original experience with one of the manufacturers of the first generation of MRNA Covid vaccines.

That was the one made by Moderna. And it’s interesting this signal did not show up until the vaccine was widely used.

There was an extraordinarily rare but certainly real issue where young and adolescent boys, I call them the boys to men that these younger boys, when they received the Moderna formulation of their flavor of the COVID vaccine, that they were at increased risk of developing heart inflammation. That’s called myocarditis.

The signal was real, the numbers were small and based on this there was a relative recommendation to say that people might consider switching to a different formulation. For example, the competitor made by Pfizer in instead of Moderna if it was a boy and not a girl in that particular age range.

What’s happening here is two things.

First of all, although that side effect was rare it’s important to emphasize, and CDC was clear about this, that if you’re really worried about heart inflammation in boys of a certain age, that they should definitely get immunized against COVID 19, because Covid itself is dramatically higher risk for getting myocarditis than getting the vaccine. So even with this increase in risk from that particular formulation, it was still better at reducing the risk of myocarditis.

Number two, they’ve changed the formulation now over time, and the Updated version of COVID 19 vaccination made by Moderna no longer carries this particular risk.

We have a nice paper that came out just recently, that the Updated at least 24 to 25 MRNA vaccine from Moderna really does not appear to carry that same risk of myocarditis in young male adults that we saw with the first generation of vaccine. This was information that came out at ID Week, our big national and frankly, global meeting held in Atlanta, Georgia. I was there at that meeting.

It was a wonderful meeting. And here’s a perfect example of why we get high quality epidemiology and ID science communication.

Late breaking, not even yet published, although I promise you this will certainly be published soon. So I’m excited about that. And the bottom line for me is that everybody should get their Covid shot.

And I don’t care whether it’s made by Moderna or Pfizer or by novavax, any of those is totally fine. And that’s true regardless of age. And that’s true regardless of boys or girls, men or women.

WORM
00:04:07.420 – 00:04:36.300
And what this seems to be evolving into is a once a year annual recommendation for a COVID vaccine given at roughly the same time or the exact same time as the flu shot in the fall. And that’s for healthy people with intact immune systems.

There does appear to be a more frequent benefit of getting this if you’re immunocompromised, of getting it perhaps twice a year. This is all evolving, of course, but for right now, it appears, bottom line, get your Covid shot once a year in the fall.

GERM
00:04:36.380 – 00:05:11.450
Yeah, that’s right.

And if you got questions about the chaos that is our federal government, all the dark conspiracy theories, you know, just the nutty stuff that’s come in, unfortunately, out of previously trusted institutions, including Centers for Disease Control. Hey, just let us know, send us your specific questions. We’re happy to give you the best information as we have it and to point you towards sources of trust and truth rather than conspiracy and insanity.

Chris, a question to you from Anonymous. Waymo, Is it safe? And which cities are Using it now.

WORM
00:05:11.610 – 00:05:38.790
Ah, thank you, Anonymous. Is it safe? Well, I’m reading the stats and by everything I can read, I’m kind of leaning toward yes.

There have been some incidents when people take control. So, for example, when the passenger opens the door, they can catch a bicycle if they don’t look first.

Or they can even step into traffic, which is dangerous. That’s rare, but it’s. That’s occurred. But actually the Waymo itself, they’re not perfect, but the numbers are really good.

GERM
00:05:39.030 – 00:05:42.430
These are robotic taxis, right, for those who don’t know what Waymo is.

WORM
00:05:42.430 – 00:07:29.810
Right, right, right.

So it’s sort of like Uber without a person or you download app on your phone and this car drives up with nobody in it, nobody in the front, two seats. You get into the car somewhere and you can’t just open the door handle. I learned this recently.

You have to hit a button on your app that lets you open the door handle. You get in, there’s nobody in there but you. Some robotic voice says, hello, welcome to Waymo, and it drives you to whatever address you put in it.

I had an opportunity to do this recently for the first time in San Francisco when I was down there visiting my brother. And it worked really well.

We got in, it took us straight to his house, it drove really cautiously through what looked to me like fairly complex traffic, and even this was a little creepy. But it was interesting on his app, he had given it permission to access his Spotify playlist.

So as soon as we got in, it started playing a song off his playlist. It drove us there, no fuss, no muss. So it’s not really a game changer because already there’s Uber and other apps such as that. So is it safe? Yes.

Where is it operating? Well, in the US it’s operating in five cities currently.

San Francisco, part of Los Angeles, not all of Los Angeles, but between about Santa Monica to downtown Phoenix, Atlanta and Austin, Texas, coming soon, they say is Miami to Washington D.C. but I saw just a few days ago in Seattle a Waymo driving around with nobody in it. So they’re already expanding and I hear they’re going to be in Tokyo soon. So is it safe? Yeah, currently the numbers are good. Not perfect, but safe.

And it’s, I think, going to just take off and be more and more available. And at least in San Francisco, I think it was about 20% more expensive than an equivalent Uber ride.

GERM
00:07:30.520 – 00:08:29.760
That’s interesting. More expensive. So by coincidence, I had my first Waymo ride last week when I was in Atlanta and it was A good experience overall.

The part that freaked me out was getting in and getting out. I gotta say, the GPS that it has, it doesn’t seem to know when it’s in the curb lane versus the middle lane of a road.

So, folks, if you call one of these things and it stops for you in the middle of a highway, just let it go. I mean, do not force yourself to run across traffic like one of those chickens on a video game or something, getting splattered. It’s not good.

So that was the one part that I found to be aggravating. In Atlanta, there’s so much traffic, you can cross a couple lanes to get in. But I think they have a little bit more refinement work to do.

If there’s a problem and you want to pull over and stop, there is a way to do that. You can touch a button and call somebody. I guess they take over and drive or something. But I think it has a little bit more work to go.

But it’s kind of interesting, the fact that it costs more because there’s fewer people involved. That bugs me a little bit. But on the other hand, you’re less likely to catch COVID from your driver if your driver’s not there. So that’s good.

WORM
00:08:35.670 – 00:08:46.870
All right, Paul, coming to you now. Somebody read about some West Nile virus in France. Does this mean that everybody going to France should wear bug repellent?

GERM
00:08:47.350 – 00:11:19.370
Yeah. So what is West Nile virus? This is in that flavivirus, or yellow fever virus family, and it’s spread by the bite of mosquitoes.

And it’s an infection that a lot of Americans know about, because more than 10 years ago, we had a pretty explosive epidemic, epidemic of West Nile virus, unexpectedly. But this was not fake news. It was very real.

Starting on the east coast, centered in New York City, and then spreading from right to left across the entire nation. So a lot of Americans have either heard of or have personally had West Nile virus infection over time.

So this was no surprise to me that we’re actually seeing some reports of a significant increase in West Nile virus infection in France. How does this happen? Well, you know, this virus is pretty versatile. It does not just rely on human beings.

It can get into other species, including birds. And birds, of course, are masterful migrators of our planet’s airways. And, you know, they can migrate over tremendous distances.

Although we call it West Nile virus. That sounds like, you know, Africa. That’s true. But it’s no longer an African disease. That’s the point.

It’s quite cosmopolitan, and it can Also travel, I think, in unexpected times and unexpected ways. We’re still learning about the way that climate change impacts, the way that birds fly around and the mosquitoes that bite those birds.

So the bottom line here for me was, yeah, if you’re visiting France, that’s great. If you’re looking for an excuse not to go, you could try to use this with your partner, whoever you’re supposed to go with. But this is rare.

So we have, you know, reports of about 50 cases of West Nile virus in a couple of regions within France. That’s a substantial increase, a tripling over time. The absolute numbers remain small. So France is not being overwhelmed by West Nile virus.

Quite the opposite.

I do think it’s a good reminder that, hey, if you are traveling really most anywhere where there are biting mosquitoes, that’s usually in the spring or summer, could be fall in some cases, you know, it’s reasonable to wear insect repellent. That’s true for nuisance mosquitoes, the ones that bite you, suck your blood, but they don’t transmit anything.

But it’s also good to prevent these rare possibilities. I would travel to France if I had that opportunity. In fact, I am scheduled to go to Paris this coming winter and I’m stoked about it.

If I were there in the spring, I’d probably bring some bug spray, but I wouldn’t be too nervous about catching this relatively rare infection. Having said so, I got to say, West Nile virus infection, it’s often a mild issue, flu like illness.

In some cases it can be very serious with neurological implications. So it can be a bad deal. But. But it shouldn’t turn anybody off from going to France.

WORM
00:11:20.010 – 00:11:43.370
Yeah. In terms of whether you should or should not wear bug repellent, you could, especially if you’re going there in the summer.

If you’re going to a rural area where there’s a lot of mosquitoes, risk is low. So it’s hard to give a definite thumbs up or thumbs down. It’s one of those things of where it’s rare, but it could happen.

So I would say for long duration, for rural. For summer travel. Yeah, maybe consider once or twice a day, bug repellent application.

GERM
00:11:50.330 – 00:12:11.530
Okay, Chris, this is a question to you from me. And this relates to some of the changes that are coming up for people who are planning to head to Europe. I’m thinking about myself in person, so you can help me out.

But also our listeners who are going to go next spring, next summer, in Particular what’s going on with European vacations for Americans?

WORM
00:12:11.770 – 00:13:24.400
Yeah, the European Union has come out with some changes basically in how they process international travelers. Everyone can still go there, but there’s going to be a different process when you hit the airport.

So for one thing, they’re going to start fingerprinting, I think everyone. So this already happens in a lot of places around the world, but they’re going to get your fingerprints in a computer system.

And basically all of these changes are for security, just to make sure that you are who you say you are and that you don’t stay there for too long. So first expect to be fingerprinted and also this next change kind of bums me out. They’re going to stop stamping your passport.

I’ve always kind of enjoyed watching the stamps accumulate in my big fat passport, but that’s going to stop. And this is actually 29 European countries, so virtually all of them. Also they’re going to start tracking visitors with increased diligence.

So the rule is you can only stay 90 days. Within 180 day period they’re going to start tracking you between airports so that they can identify if you are going beyond this limit.

So bottom line, you can still go there. You still just take your pass like you did before. But there are increased security measures. And don’t be shocked when they fingerprint you.

GERM
00:13:24.640 – 00:14:18.850
I mean, all of this makes perfect sense. It’s all reasonable. It should make things faster going through. I gotta say, I just said hashtag sad when it comes to the passport.

I mean your passport’s gonna go away. Do we end up in a time when we’re just digitally facially recognized and the passport’s a thing of the past? The past port, if you will.

So I would actually welcome that only because I’m so nervous about losing my damn passport. There are these nightmare scenari. One of my relatives had that happen.

Had his backpack stolen in Europe and kind of ruined his vacation just this past summer. It feels primitive, but it also feels romantic. And at heart I am a romantic. So I, I don’t know, I have mixed feelings about it.

The fingerprinting thing, no big deal. Most people have been through that process. It’s not with ink, by the way. You just put your hand on a little computer screen, a little piece of glass and it digitally takes the fingerprint. So. And that’s okay with me. I’m not going to commit any crimes. I got no problem with that.

WORM
00:14:19.400 – 00:14:22.440
Paul, what country was your relative in when they lost their passport?

GERM
00:14:22.600 – 00:14:57.410
They were in either Spain or Portugal, as I recall, and it only delayed the return back to the States by a few days. It was just a hassle for that person. So, you know, it could happen to anybody. It’s nobody’s fault. Theft and pickpocketing and such is a thing.

It’s just a hassle. So I think there were some lessons learned in that particular case.

But the bottom line is, until passports become a thing of the past, please do as we’ve talked about here. Keep track of them, photograph them. So if you do lose them, it just makes it easier when you get to the embassy for them to issue you a new copy.

WORM
00:14:57.730 – 00:15:15.570
Right. What I hear you do when that happens is you go to the US Embassy, which is closest.

Ideally, you pull up the photographed image of it on your email, you show it to them, they’re reasonable. But it takes a few days and it’s a huge hassle. And sitting in this office for three days versus being a tourist is pretty darn boring.

GERM
00:15:16.320 – 00:15:17.440
That’s generally true.

WORM
00:15:25.120 – 00:15:32.720
Paul, question regarding leptospirosis. What’s going on with this around the world and is it more common than it used to be?

GERM
00:15:32.960 – 00:19:07.220
Leptospirosis. So what is leptospirosis? Leptospirosis, the Latin name of this bacteria, Leptospira interrogans. It means the left handed corkscrew with a question.

Leptospira interrogans is one of these funny bacteria related to syphilis in a way related to the germ that causes Lyme disease.

There’s a few of these corkscrew shaped bacteria and leptospirosis, yeah, this is one that our travelers need to know about because it is relatively common. We see this in our clinical practice. There was a case at my hospital just a couple weeks ago.

What happens is that as we travel, especially in tropical areas, although not exclusively, but often in areas of warmer weather, if we go swimming or wading or skinny dipping or whirlpool jumping or waterfall bathing, when we’re exposed to water, yeah, that water can be befouled, besoiled and besmirched with, sorry to say it guys, with the urine of rats or pigs or other animals.

Now that rat urine itself is no big deal, but this bacteria can be in the urine of the rat, which then gets into the water and that can come into us through our mucous membr. It can also go in through splashes and probably through microscopic abrasions in our ankles, in our feet.

It can actually burrow through your Very living flesh. It’s a pretty catchy germ. That’s a problem because once Leptospira interrogans gets into your system, it can infect you.

Most people have a relatively mild and nonspecific issue with fever, muscle aches. They may start to look a little bit jaundiced in the mirror, but usually not. And it tends to get worse and then better and then worse again.

What we call a biphasic or two phased illness. And then most people do fine. There is a dark narrative here called Weil’s disease, and that’s a severe form of this infection.

It’s not clear who’s going to have the bad outcome. It’s probably related to a particular bad match of a certain strain with a certain patient.

But the point is that some people can get very desperately sick with Weil’s disease. That’s a overwhelming illness. People looking sick as hell, requiring hospitalization, severe liver inflammation.

People have actually died this way, which is a shame because it’s actually very treatable and preventable. Like with all corkscrew shaped bacteria. The answer is doxycycline. Doxycycline can help to reduce the risk of catching this.

And when you do have it, it can also at least mildly reduce the course. So it’s treatable. We don’t have a vaccine, we don’t have a bug repellent that’ll keep it away. It’s really about avoiding freshwater exposures.

And I talk with my patients about this. If I know that they’re going to do humanitarian work, they’re going to work in typhoon areas.

This is one of those infections like so many of the ones we talk about. Right. That loves chaos, it loves man made horribleness. Internally displaced persons, refugees, unsanitary conditions, typhoons.

Anytime people are around stagnant water, that’s a problem. Because where there’s people, there’s rats and pigs and they tend to pee into the water. And cause this issue for my travelers.

They often want to go bathe in the waterfalls in Hawaii. It’s well known as an issue in several of the islands of Hawaii where this has been reported, but doesn’t have to be there.

Eco racing, adventure traveling, whitewater rafting. You will bathe in animal urine. And for that reason, Chris, we have some strategies to help reduce that risk. Right.

What do you advise your people to do if you think they’re going to be exposed to these freshwater sources?

WORM
00:19:07.300 – 00:19:51.720
Right. Well, a couple of risks that I think about. One is flooding. Outbreaks are often associated with flooding.

And you can imagine all that rat urine all over the plants being carried to the lake by the flood water. Another link, as you mentioned, is freshwater sports. So kayakers, for example, are at risk of this.

And you want to consider not walking barefoot on mud. That can bring your risk down a little bit.

Sometimes we put people on a drug such as doxycycline preventatively, and if they’re going to be in an area with malaria and they have a choice of different antimalarials, we will not give our usual standby, which is mallourone, but we’ll give doxycycline and we’ll get a twofer. It prevents malaria very nicely and also prevents leptospirosis.

GERM
00:19:51.880 – 00:20:59.100
I think that’s right.

And even if someone is not also requiring malaria prevention or for whatever reason, they don’t want daily doxy, this can even be given as a doxycycline dose, 200 milligrams once a week. And that’s how exquisitely sensitive the germ is to doxy.

There’s an interesting phenomenon called the Jarisch Herxheimer reaction, which we see for people who have established infection due to leptospirosis. When we give doxycycline, it is such a killer of this germ that all those germs can instantly die at the same time.

That can cause this issue of Jarisch Herxheimer, where people have a reduced blood pressure, they start looking worse because every germ has died at the same moment and belched out all of its antigens and caused, in effect, a kind of allergic reaction. That’s something for doctors to know about.

If you’re curious about leptospirosis, talk with your healthcare specialist before you go because they may have some good strategies to help make that prevention. And if you come home sick with a non specific flu like illness, tell your physician, hey, I was in the water. Could this be Lepto? That’ll help us to make the right call.

Chris, what are your favorite apps when you travel?

WORM
00:20:59.260 – 00:22:51.160
Hey, there’s several that I love. I’m not a real app head and I suspect there’s a ton of useful ones that I’m not using.

One that I love, that I use both domestically and overseas is Shazam. And Shazam recognizes songs. And I’ve been in the most obscure places and used Shazam.

I was riding with my wife in the Sahara desert in southern Morocco and there was this Moroccan song on our driver’s radio and I just turned on Shazam and bam. In three Seconds. It told me the name of the singer and the name of the song.

And of course from that I could go find out what the lyrics were in English, which was interesting. So I love Shazam. It’s free. The next one I use, also free, is called Merlin. You may already know this one. It recognizes bird calls.

I was in Tucson recently, I turned on Merlin and bang, I had 25 bird species within one hour. So it’s really good. It’s also good overseas.

It does help if it knows where you are and you can enter that in if it doesn’t pick that up automatically. The third one, and I have to pay a little bit for this, is called Picture this.

It recognizes plants, plants, trees, bushes, grass, anything like that.

The reason I pay a little, and I think it’s about $2.50 a month for Picture this is I did a compare and contrast between the free Google Image Recognize and Picture this and Picture this did much better. I actually found that the Google Free function made a lot of mistakes. So I paid a little bit for Picture this. A couple that I think I’m going to get.

There’s one that recognizes stars and planets. You just hold it up to the sky and it tells you where Venus is and what constellation you’re looking at.

Another one that looks really good that I’ve had friends who’ve used that like it is.

They’ll hold it up to a mountain range, a bunch of peaks, and it’ll recognize it and tell you the exact name of all of the mountain peaks that you’re seeing. So that looks super fun.

GERM
00:22:51.160 – 00:22:52.970
Peak Finder. That’s called Peak Finder.

WORM
00:22:52.970 – 00:23:11.810
Peak Finder. Thank you. So I want to get that one. I suspect there’s a ton of other ones.

One that I’ve looked for but I haven’t found is an insect sound recognition app. I want to know if it’s a cicada or a cricket or what have you. So if you know of one, please let me know.

Paul, do you have favorite apps that you travel with?

GERM
00:23:11.810 – 00:24:24.290
I mean, the one I’ve always loved, I still love traveling with is Google Translate, where you can hold up with the camera function. I can read ingredients, read menus, and stuff like this. It’s always a little sketchy.

It requires an Internet connection, so it doesn’t work everywhere. But that’s been what I’ve used a ton. And now what I’m looking forward to using in this upcoming trip is the feature with the Apple AirPods Pro.

This is if you add Apple Intelligence AI to your iPhone and then you are wearing your buds. You squeeze both bud stems at the same time. You enter interpretation mode. And so someone speaks to you in a foreign language.

You don’t hear their voice, it’s turned down, but you hear the voice of Siri telling you what they’re saying and you then speak back and Siri will display on your phone what you have said in their native language. If you’re both wearing earbuds, apparently you just talk to each other this way. I call it the Babel fish.

I don’t know if you remember that from Hitchhiker’s Guide to the Galaxy, but there was that funky parasite that would get into your ear and groove on the happy vibe of the universe and live there forever. Everyone could talk to everybody. It was a good way to get around that issue in that novel. This seems to be the real life version of that.

So I’m looking forward to trying that and let’s see how it works.

WORM
00:24:24.530 – 00:24:33.290
Well, who I saw use that very effectively was Captain Kirk, Scotty and Spock. And I thought that was many centuries away, but lo and behold, lo and.

GERM
00:24:33.290 – 00:24:41.110
Behold, the future’s here. Let us know everybody, what your favorite travel apps are. Just shoot us a message. Germandworm@gmail.com. we’d love to hear from you.

WORM
00:24:47.990 – 00:24:54.390
Paul. This is for you. Will my health insurance pay for my pre travel appointment and vaccines and medicines?

GERM
00:24:54.949 – 00:26:31.860
I mean, almost certainly not, but it’s possible. I think the key is you want to figure that out before you sign up.

We’ve talked about this before, that all Americans should have the right to high quality health care. That doesn’t break the the bank when it comes to this field of travel medicine. It’s an issue.

I mean, so many of the vaccines that we reach for are uncommonly used in the US and even if they’re commonly used elsewhere overseas, you know, that’s our current situation, isn’t it? If you’re sick, pay me, I’ll make you better. And if you don’t want to get sick, pay me even more.

It’s, it drives us crazy as the doctors, because of course we have nothing to do with what pharmaceutical companies are charging, etc. You know, we don’t get a kickback from them. It’s not like that. It just is a barrier to getting our patients the right care.

But this does come up and I think it’s important on two levels. Number one, you want to know that the doctor you see is not going to charge an exorbitant fee for that encounter.

The doctor’s fee, number Two, what’s the cost of the vaccines and the medicines that you may benefit from? There was this really crazy article in the Washington Post.

This is anecdotal, but I thought this was great of somebody who got their pre travel visit, had a good experience and then was charged 2,500 bucks just for that visit. That’s too much and should not be that much money. And it’s important for people to ask these questions ahead of time.

What’s this really going to cost me, doc? As for your health care insurance covering this, it totally depends on the plan.

I mean, most plans do not do this, although they damn well should, because if you come home sick, they’re the ones who are going to end up covering it. So it drives me crazy.

But it’s important to know what the details are of your plan and if you don’t, because most Americans don’t, give them a call and ask them so that you’re informed before you end up out 2,500 bucks cash money.

WORM
00:26:32.340 – 00:27:01.930
Yeah, who is not going to know in all likelihood is your health provider. There are so many plans that there’s no way we can keep in our heads what is covered and what is not.

So if you ask your doc, they’re probably going to say you should call that number on the back of your insurance card. It even can be difficult to find out then, but it’s probably your best bet.

But unfortunately a lot of plans don’t cover this and thus a very explicit discussion of the cost of vaccines. Vaccines and other expenses is something you should have with your provider so you don’t get surprised later.

GERM
00:27:02.010 – 00:27:24.430
The finances of American healthcare: opaque, byzantine, outrageous… the best we got.

Chris, a question to you. This relates actually to what we were talking about before. I like this. What is the easiest way to learn a foreign language?

WORM
00:27:25.230 – 00:29:10.130
Well, first, not to be cynical, but there is no easy way to learn a foreign language.

So the first thing I’d recommend is if you see an ad, and I see these all the times, speak like a native after one month, after three weeks, after two weeks. That’s snake oil. That is impossible. They will collect your money and you will not speak like a native after one month. So here are some ways.

One, be young, don’t be old, because children can learn quicker than older people. That is not to say don’t learn it as an adult, but it’s going to take more time if you’re not a child, as most of us are not.

A few other things that will help structure something regular over time, such as a class or a regular appointment with a tutor over many months, if not longer. Also consume media, so listen to songs in that language, watch TV shows in that language, listen to the radio in that language.

Also focus not on abstract concepts like in Spanish. My only language to an extent is Spanish and we spent an inordinate amount of time in high school on er, ir, et cetera, verbs.

Instead, your memory will be better for pragmatic things like where’s the bus station? Can I have cream for my coffee? Oh, what a nice short shirt you have on.

So actually having conversations about real things will stick in your mind better than abstract concepts. Also, you need to use it.

You need to not just go on a program like Duolingo where you interact with this little animated animal, but use it, talk to a person and listen to the person and also write it and also read it. So basically you want to go long duration, structure and multiple different forms of expressing the language.

GERM
00:29:10.610 – 00:29:54.360
I mean, I agree my lovely wife is a huge champion on duolingo. I think 900 days of French or something like this and she enjoys doing it. We’ll see how that works when we actually travel to France.

It’s just a different process. I think that interactivity and the real worldness, the need to do it is just so much exponentially better than anything else.

The only other thing I would add though is if somebody’s watching a movie TV program, do it in that language just to hear it outside of the Duolingo. Single sentence, single phrase. Just really hearing people having conversations. To me that’s helpful. And I’m terrible at foreign languages. Yeah.

But that is something that I have found to be useful in the past.

WORM
00:29:54.680 – 00:30:06.590
Yeah, I’m not anti Duolingo or other apps like that. I think that can be a helpful portion of learning it, but you shouldn’t rely on that alone.

You really need to speak it and interact with people and it’ll stick better in your brain that way.

GERM
00:30:06.590 – 00:30:52.970
Yeah, 100%. If listeners have ideas for things that have helped them before, please do share them.

Unfortunately, that’s all the time we have have today for episode 76 of Germ and Worm. As always, we would love to hear from you with any questions on travel health or travel wellness.

Just be in touch with us through our website germandworm.com you can submit questions to us that way and also find prior episodes and binge our content to your heart’s content. Please do. If you’ve enjoyed this episode, please subscribe. Follow us Rate us favorably and spread the word with friends, family and on the socials.

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I’m Germ!

WORM
00:30:52.970 – 00:30:56.770
I’m Worm. It’s a big planet. See it in good health and we’ll.

GERM
00:30:56.770 – 00:31:19.340
See you next time.

This podcast is designed to inform, inspire and entertain, but it does not establish a doctor patient relationship and therefore 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.