GERM
00:00:09.440 – 00:00:11.560
Konnichiwa. My name is Germ.

WORM
00:00:11.560 – 00:00:13.360
I’m Worm.

GERM
00:00:13.480 – 00:00:26.400
Welcome to episode 116 of the Germ and Worm travel health podcast. Joints on a Jet. What not to do. It’s a big planet.See it in good health. I’m Dr. Paul Pottinger, also called Germ. I’m an infectious diseases specialist at the University of Washington.

WORM
00:00:26.400 – 00:00:32.190
I’m Dr. Chris Sanford, also known as Worm, a Family Medicine Doctor, also at the University of Washington.

GERM
00:00:33.470 – 00:01:29.570
Chris, this is our pleasure to answer questions from listeners across the country and around the world. Questions about how to stay safe and healthy when they travel.

Some of the questions we will answer today include, is it legal to take marijuana on a jet in the United States? How can I protect my eyes if I choose to view an eclipse? What are top considerations when you’re choosing a trail to trek on?

And people with Alpha Gal allergy can’t eat meat, but what medical products should they also avoid? These questions and more. A reminder to our listeners, please do contact us with your questions, your tips for success, or your stories.

We would love to hear from you. Send us an email germandworm gmail.com or see us online. Germandworm.com as always, our medical disclaimer.

This podcast is designed to inform, inspire and entertain. But before you travel, please see a qualified healthcare professional for recommendations specific to you and to your itinerary.

Chris, where are you coming to us from today?

WORM
00:01:29.570 – 00:01:42.310
I am in a little town in Washington state called Cle Elum, actually a neighborhood outside of it called Teanaway, and my wife and I have rented a cabin and we are just hanging out amongst the Douglas firs.

GERM
00:01:43.590 – 00:02:09.500
What an amazing thing. Cle Elum, the town that is “Mule Elk” spelled backwards.

I love Cle Elum and Teanaway I like as well because gadzooks, they got a lot of black bears up there. Be careful. The black bears will come and try to eat your liver. Just kidding. They don’t want to eat your liver, they just want to eat your garbage. But it’s beautiful up there. And the other thing about that area of our state, Chris, it tends to burn in summer. How’s that going?

WORM
00:02:09.580 – 00:02:18.620
You know, today it’s better, but yeah, actually the skies have been really smoky most of the week, so that’s been the only downside of a lovely week in the woods.

GERM
00:02:20.060 – 00:04:16.790
I’m in Seattle now and I just got back from a super fun family vacation to Europe. We had a week in Mallorca, really my second time to Mallorca. But my first real time there.

We spent a week as a family just enjoying the food and the customs and, you know, everybody over there was happy it’s their summer vacation and lovely, lovely time. But gadzooks, it was so effing hot, I gotta tell you. It was. I mean, you wouldn’t think mid-90s is that hot.

It’s just something about the fact that it’s a sun, a cloudless sky, and just the sun that’s up there cooking you. So we really. I would emerge like a crepuscular creature of the night.

Like, I come out at dawn and dusk, but in the day, unless you’re in a car with air conditioning, I think I. I think I just wasn’t quite up to it. But super beautiful. And I do recommend Mallorca. And it was a chance for us to see the solar eclipse, or at least part of it.

It was a funny eclipse because it was very quick, just 90 seconds long for totality. And it was at sunset. It didn’t even occur to me. You can actually get a sunset eclipse.

Well, that just means that as you look out over the water, there were some low clouds and that sort of blocked our actual favorite time, which is totality. So that part was a bit of a bummer. But I’ve seen totality before. And again, the main point was to see a new place and meet. Meet new friends.

And anyway, that was great. And then off with my lovely wife to Dublin for a few days. Our first time in that city. It’s like a beautiful, tiny little London.

People from Dublin listening to this podcast will not be happy for me to say that, but it was manageable, friendly, and I really recommend Dublin. It’s. It’s a very. I was by far the oldest person in the entire city. I mean, it’s a young person city.

That was great energy for me to partake in great cult culture and a very progressive nation. I mean, they’re doing a lot of things, I think, right with their government and their society. So learned a lot about Ireland and then a few days in London to see old friends and make new friends and anyway, a very nice time overall in Europe.

WORM
00:04:16.790 – 00:04:33.390
That sounds lovely. But one thing I wanted to touch on today, and this just came out in the News yesterday on the 26th of August.

And I know, Paul, you’ve spent time in Nepal. There is this terrible story and awful videos coming out on the China, Nepal border of this flash flood.

GERM
00:04:35.790 – 00:08:13.630
Yeah, this is a true catastrophe. It just has happened. And, you know, a friend sent me this news alert.

It Came to me as something on the socials, if you will, and I actually could not believe what I was seeing. As you said, Chris, right at the border between Tibet and Nepal, it looks like there was a collapse of a high hanging glacier.

More than a serac, an entire glacier moat that fractured. Whether this is because of global warming, some other factor we don’t know, does not seem to have been prompted by an earthquake.

But this of course led to a huge rush of water, ice and ice that then triggered, you know, a bigger landslide that then led to tremendous surge of water, a true flood down on the Lende Khola. And you know, this has led to devastation of everyone living along those communities and people visiting.

As of right now, we have at least 3,000 people missing and several hundred confirmed dead. That number will certainly rise.

The devastation is inconceivable and these communities have now been buried under tons upon tons of mud, flow and rock. It’s just extremely discouraging.

You know, to our listeners who are wondering how we might advise them to support this community which is so terribly afflicted, I think there’s a number of ways to do this. First of all, in terms of giving and your charity, thank you for considering that.

There’s a number of wonderful nonprofits that you might consider or look into further to see whether their goals and ethos aligns with your own. The World Central Kitchen is one, of course, that I think has done great work elsewhere in the world and seems to be involved here as well.

There’s a nonprofit called Direct Relief that is active in this space. They seem to be a good organization. Likewise, Global Giving, another nonprofit, and one called Humanity and Inclusion among a number of others.

Save the Children, of course, is one that’s very well established, has a good track record and might be considered here as well.

No doubt you’ll find within your own local communities, close to where you live, a number of GoFundMe projects that may be created by the Nepal society in your local hometown. And that’s worth looking at as well.

You know, in the past, the disaster relief arm of U.S. agency for International Development would be really at the forefront of, of the response that’s been closed by the current federal administration. And so I’m really sorry to say that they’re not going to be a part of that response.

So now more than ever, if you’re thinking about making a donation, I think that more than ever it may make a difference. That’s in the short term. I would just also like to plant the seed for our listeners in the Longer term, please consider visiting Nepal.

It’s a beautiful country. I’ve had the privilege to visit it three times. It’s amazing. I recommend that people go.

I’m saying that because so often there’s that post catastrophe enduring problem in areas like this where people have a bad vision of a place because it has been through a catastrophe and makes it less palatable to visit. I think this may be the reverse.

I’m not saying you should run to start volunteering in the rubble, although if you’re qualified, that’s worth looking at.

No, no, I’m saying as a tourist, as a concerned citizen and a curious human being, if you’re ever thinking about visiting Nepal, please put it onto your travel itinerary now. Not to visit presently, but again, once the dust settles, literally from this huge humanitarian crisis, they will be looking forward to hosting you.

Tourism is a big part of their economy and I think that’s an important thing that we should consider. It’s not a direct way to offer relief, but it is something that I think would be appreciated in the long term.

WORM
00:08:13.630 – 00:08:16.710
Images just are something out of a science fiction movie.

GERM
00:08:18.000 – 00:08:34.160
The human side, what you and I think about as doctors is just inconceivable. So for those who are following the story, if you have friends, family who are affected by this, reach out to them, share your concern with them.

That kind of human contact so that people know that you’re thinking of them. Take it from me, that can really go a long way.

WORM
00:08:34.160 – 00:08:58.540
Some catastrophes, I can point to the behavior of the people involved.

You know, if someone is hiking an active volcano, well, you’re entering into a risky thing. But this just seems like a really cruel fluke of fate. And just like something can happen randomly at home, something can happen randomly on the road.

And you know, there’s chaos in the system and it’s hard to draw a moral from this.

GERM
00:08:59.900 – 00:09:09.100
Yeah, these are innocent people who’ve been devastated. And as often happens, some people with the least are the ones who are impacted the most. It’s very, very disconcerting.

WORM
00:09:15.670 – 00:09:34.150
Well, Paul, moving into our questions here, first one is for you. And this actually ties into your recent eclipse trip to Mallorca.

Everyone says don’t look directly at the sun, but you want to look at the sun to see the eclipse. What’s the best way to protect your eyes during an attempt at viewing an eclipse?

GERM
00:09:35.430 – 00:13:00.810
Okay, so thanks for that. And yeah, I’m no eclipsologist, but I do consider myself an umbrellist.

People who chase eclipses, Chris, are called umbrellas because we, we look for the. So look, there are lunar eclipses and solar eclipses. A lunar eclipse happens when the Earth gets between the sun and the moon.

And you’re looking at the moon, you’re looking at your own shadow. No special issues there. You’re looking at the moon, it’s nighttime. You’re not going to hurt yourself.

You’re just looking at a full moon that could look blood red, for example. So lunar eclipses, it’s never an issue? No, it’s. It’s the solar eclipse.

That’s where the moon comes between the Earth and the sun, and that’s what you’re looking at. And so what you said is correct. Here’s the issue. Solar eclipses have two completely different components. And this is confusing.

I didn’t really appreciate this until I recently, a couple years ago, went to Missouri to watch the totality of a solar eclipse and was transformed. It is the single most incredible natural side I’ve ever seen. And I’ve stood on top of Everest. I’ve seen the northern lights.

There’s nothing like totality. It is a thing. But totality is very different from, from the partial eclipse. So what’s a partial solar eclipse?

That’s when you have, well, incomplete blockage of the sun where the moon’s shadow does not cover the whole sun. And so if you were to look at that with your unprotected naked eye, you’d be looking at the sun.

I mean, take it from me, even when you’re at 95% shadow, the world is still bright as can be. It. It can still burn your retinas. So we would never look at the sun in our everyday life. And the same is true for a partial eclipse. That’s it.

You should never, ever look at the sun, eclipse or otherwise. It’s just dead simple. In order to do this safely, you can do right. So there are special glasses. They’re not regular sunglasses.

They are eclipse glasses. These are glasses that have a rating by ISO 123122. This is an international standard.

You should look for that marking for the ISO standard on the glasses themselves. And that’s the only time you could ever look directly at the sun.

Because I got to tell you, you’ll know if you have a counterfeit pair, Chris, because these legit eclipse glasses, you can’t see anything through them. It’s like you’re looking through a piece of paper.

It’s only the sun itself, which is so unimaginably bright where you can see the crescent looks like a Little Pac man that’s getting bigger and bigger mouth, if you will. And that’s what’s so fascinating about this, the partial eclipse.

If you have any doubt about the quality of the province, the origin of those glasses, get a different pair. And they can look cheap. They can look cheap as hell. A piece of cardboard with these little pieces of plastic in them, they don’t look impressive.

But when you actually hold them up to the light, you should not be able to see any light come through except the light of the sun. And that’s true for the partial eclipse. I have to tell you, the whole reason to do this, of course, is to see totality.

Totality is when there’s full shadow of the sun and then the glasses come off. That’s the whole point. As you look with your naked eye, it’s like you’re looking at the moon and it’s a transformational experience.

It looked to me like the evil eye at the center of the universe was staring down at me. It looked like something that was secret that I, as a human being, was not supposed to see. I’m not a religious person.

This is very, very impressive and it’s worth looking at. I won’t oversell it.

But I got to tell you, for me personally, it’s something that was so impressive that I would like to do this again and again as many times as I can while I’m alive. I’m not a big fan of those partial eclipses where you’re squinting through those glasses. It’s totality. That’s what you’re chasing.

And I have to tell you, if you get a chance to do it, please don’t.

WORM
00:13:00.970 – 00:13:05.770
Well, it sounds like no sunglasses or no combination of sunglasses are adequate.

GERM
00:13:06.970 – 00:13:43.300
You could put on–I don’t know the answer, Chris. I suspect you could put on three pair of regular sunglasses and still would not be enough. This is a very special coating. It’s a very special material. And again, the only time you should ever do it is if the only light that you can see through them is the light of the sun. If you hold it up to a TV or a light bulb and you can see it, you’ve got the wrong stuff. Okay, Chris, here’s a question for you from an anonymous listener, which is always fine. I’m going to have. You could go to either of us.

I’m going to have you answer this one. What are top considerations for. For you when you choose a trail?

WORM
00:13:44.020 – 00:16:08.250
Thank you. And I want to get your input after I give my preliminary answer. I think you’ve done more trekking than me, but what I’m big on is the day hike.

I love to go outside of Seattle into the Cascades and take a vigorous day hike up and down a hill or up or find the flats. Some things I think about, the first thing is how adventurous or how much do I want to huff and puff versus just have a pleasant stroll.

So I look at altitude and some days I’m up for going up a fairly steep hillside. Some days I’m just looking for flat ground. And so I look about the trail online.

There’s always something at a site you can read that’ll have the elevation and the difficulty. Also, I will look if there’s a destination.

In general, a downside of a destination at the end of the trail, such as a waterfall or a lake in my mind is that’s going to make the trail more crowded. But not always. I’d actually personally rather go on an empty trail with no lovely sight at the end of it than a crowded one to a waterfall.

But different people have different preferences. The other thing I will look at is safety. You mentioned there’s bear where I am now in CLE Ellum.

So if there’s been a recent bear attack and I’m by myself, I might avoid that terrain for a while. And that doesn’t apply to a lot of places, but it applies to a few. I also will consider how much stuff to lug.

You know, some days I’m willing to take quite a bit. Some days I just don’t want much more than some water bottles stuffed into my pockets.

And that’s going to argue for a shorter, more calm kind of hike. I would read up on it. In Washington State there’s this great series of books called the Mountaineers Guides.

And so they have the Guide to the North Cascades and the Guide to the next mountain range over. So I will read about it a little bit.

And if it’s in the middle of nowhere, if I’m in a foreign country, I don’t know the area, I have a real low threshold for hiring a guide. So when I hike, for example Pacaya in Guatemala, which is just a day hike, I certainly did not attempt that by myself. I joined onto a tour group.

So those are some of the things I like to hike. I like to go up a hill. There’s lovely ones like we were talking about before, the North Cascades in Washington State.

State are rather oddly undertouristed for how lovely they are. So that’s my take on it, Paul. But you’ve done more adventurous trekking than me, both for short treks and long treks.

What’s sort of your mental calculus when you’re picking a route?

GERM
00:16:09.610 – 00:18:57.470
Yeah, thanks. I mean, I think it just depends, right, what’s my, my goal? Am I going to be alone or with someone else? And I do sometimes go outside alone.

For me actually that’s very important part of my mental health and all that stuff. But I also love going out with friends and so it depends who’s available, depends whose schedule aligns with mine. I think that’s a big difference.

If I’m going to be alone, I need to have a very strong exit plan, a good communication plan, etc. Because I, you know, I got things to do, I’m busy, I got reasons to stay alive. I don’t want to die out there and just get lost in the wilderness.

So that’s a big feature of it. It’s true when you’re with friends, friends, but the safety feature is so much higher when you’re out with, with friends as well.

Alternatively, it’s also something I think about. It’s not just seeing a new place and all the new natural features. Learning about a new part of the world. That’s obviously what I want to do.

I want to know if I’m going to be alone or with other folks. Like as you said a moment ago, North Cascades, what a great example.

In the North Cascades, almost every year a small group of friends and I will do a week long traverse up there and it’s pretty stunning. This is high season, middle of the summer and every year it’s the same. I mean, knock on wood, my desk here is made of wood. I’m knocking right now.

We never see anybody. There’s not a single human being that we encounter at least for the six core days of those traverses. How can that be?

And I always turn to my friends and say, how can it be that we’re here, we live here in this state. I’m three hours from home by car and yet there’s not a single human being being for an entire week. It’s just unbelievable. And I think that’s great.

I’m not totally anti human, it’s just when I’m outside, I want to be outside. So for me that’s a big part of it. Chris the other thing I think about is why do I want to go outside?

I know that sounds obvious, but if it’s just a quick day hike, which I love so much, I can do it almost, almost anywhere. I think people go Outside for different reasons. You know, I chose a few years ago to hike Haleakala, which is the top of, of Maui.

It started at the beach and just walked to the summit. And that’s a difficult thing to do and most people aren’t stupid enough to do that.

But I wanted to go through that trial and tribulation as a way to just be alone for those 14 hours, whatever it was, and to help mourn some of the people in my family who’d recently died. That was a spiritual, you know, journey for me. So I had to go through the suffering in order to honor their deaths, for example.

That’s totally different from just going out for a day hike, something I might do with you or other friends.

So, you know, to our listeners out there, hey, if you have tips for how you’re choosing places to go that gets you beyond just somebody’s social feed, you’ve got tips for great places to go or reasons, different reasons that you go outside. We’d love to hear from you. Visit us online and let us know. Germ and worm.

WORM
00:18:57.470 – 00:19:14.830
You know, that is a whole interesting topic.

We really haven’t talked about much and we probably don’t have time to right now, but the whole relationship between meditation and your spiritual self and exposure to the outdoors and isolation and a difficult but achievable task.

GERM
00:19:16.510 – 00:19:48.500
Yeah, I mean, why do people go? You know, people have been going to outside. I mean, this isn’t just a John Muir thing. “The mountains are calling, I must go.”

I mean, he was not wrong. And I think sometimes it’s that pull like it’s your center of gravity, just pulls on your sternum. I’ve got to get outside.

If that’s how you’re feeling about being outdoors, I’m with you. And if that’s not how you feel about it, maybe you should try it.

Give it a try sometime and see about the different benefits and therapies that being outdoors can do it. Just please do it safely for. For goodness sake.

WORM
00:19:52.500 – 00:20:45.750
All right, Paul. On a different topic, the President of the United States earlier this month issued an executive order.

And in that he decreed a reduction in recommended childhood vaccines from 18 to 11.

And he also decreed that the MMR measles mumps rubella vaccine, which currently is a three in one vaccine, should be split into single vaccines given at different visits for reasons we’ve discussed. This is kooky. It is nutty, it is harmful. It is not based on science. It will result in the illness and death of more people.

It’s already starting to My question is, that’s all that’s a given. What’s the best way to fight back? Most people I talk to, virtually everyone I talk to, knows that this is insanity.

We don’t want to be passive with this. As citizens of the U.S. what can we do to make our opinions heard?

GERM
00:20:47.270 – 00:24:14.240
Yeah, thanks. This effing guy, I mean, he just. He just doesn’t know when to quit. What else did he do this week?

He started a trade war with Canada and he renamed Lake Ontario, Lake America. He just. He’s out of his effing mind. So here’s yet another example. And just so we’re totally clear, because some folks may not remember about mmr.

That’s one example. MMR stands for measles, mumps, and rubella.

It’s a real triumph of medical technology that we have three different viruses that we can provide protection for in a single immunization. That’s amazing to me.

We used to have them as individual components, right, Chris, in America, you could get your measles, your mumps, or your rubella separately. No one wanted this. Parents hated it, kids hated it, Doctors hated it.

So it was really a whole bunch of money and time and effort to put them to together and study them so that we know that they can be given together safely. It’s a huge triumph. It’s the way it’s been, I mean, for decades. And now, with some sort of writ, he decides to change this.

Number one, I think we’re in uncharted legal territory. It’s not clear to me what this executive order is actually going to do.

I think what he’s trying to do is intimidate and threaten and bully the new head of CDC, Dr. Erica Schultz, who he just, you know, appointed the real test right out of the gate for poor Dr. Schultz. Will she stand up for what she knows to be true, which is that this is bogus, or will she bend the knee and declare her fealty to King Trump?

So I feel for her, but, boy, Dr. Schultz, the eyes of the world are on you. You better stand up for what you know is right, otherwise it would be a violation of your physician’s oath, etcetera, much less your oath of office.

Anyway, you had asked how our listeners can put push back. Yeah, look, Germandworm. Our ethos, Chris, is that we want our listeners to be empowered with knowledge, but we can also get people empowered by.

By raising their voice. So, folks, let your. Let your Congress people know. I mean, to me, that’s very important.

I actually am lucky to volunteer to do some advocacy on behalf of our ID Society of America.

And so I have worked, been fortunate to have audiences with members of Congress, both Senate and House, on a number of occasions talking about these issues. You can do that too. You don’t have to be part of a professional society. You, they work for you, you are their boss.

And the way to find your member and reach out to them is right online. This is not a partisan thing. This is part of the US government. Www.congress.gov and then you can search for members and find your member that.

We’ll put that link in the show notes Chris. I’m happy to do that. So that’s a way for you to say here’s my zip code.

And they’ll tell you instantly who in the House of Representatives and in the Senate represents you if you send them a message. And by the way, it doesn’t have to be long, doesn’t have to be profane, profanity written that you can cite us if you want to.

Anything you want to say that’s on your mind, tell them you could have someone who represents you, who’s very science oriented, friendly and a good person writes to them anyway. Give them that encouragement and thank them for their hard work.

Alternatively, if you live someplace where you’ve got a bureaucrat who doesn’t know about science, who’s trying to make America less healthy again, you know, let’s change that. Please let them know, change it up. They should not be telling you what to do.

You should be telling them what you want and tell them that you listen to German work, that we’re telling you what to do and giving you that power. So I think, honestly, that’s a big part of it.

But Chris, for you, in addition to writing to members of Congress, what other things do you think our listeners could do that would empower them and make a difference?

WORM
00:24:14.400 – 00:25:09.440
A couple of the things come to mind. One is to make a donation. And it doesn’t need to be a huge amount, $25, whatever you have, but enough small checks will add up to significant money.

And unfortunately, in the US it shouldn’t be this way, but it is. Candidates need money to run an effective campaign and so give money. Also volunteer. There’s a lot of organizations out there.

You can join them, you can knock on doors, you can write postcards, and these things are effective in determining who wins an election. Lastly, supporting STEM in school. I hate to see math and basic biology and other courses cut in elementary school and in high school.

I think a well educated populace is more more likely to reject the nonsense that is being put forward by Trump and RFK Jr. So those are a few thoughts.

GERM
00:25:10.160 – 00:25:24.400
I think that’s right. Look, we got midterm elections coming. Just get involved.

Your involvement in this process makes a difference and thanks to this listener for asking about that. And let’s keep our fingers crossed that we can make some real progress here.

WORM
00:25:24.480 – 00:26:03.410
Yeah, I would say too, if you are ever going to be involved in your life in politics, this is the time. I mean these are unprecedented times.

Paul and I wrote an op ed recently and we noted that presidents of both parties forever have supported vaccines, starting with George Washington in the Revolutionary War, Democrats, Republicans, everyone has supported vaccines until now. Until now. And so we have these non medical people who have all these wrong ideas who are trying to limit this life saving technology.

So if you were ever going to get involved, it would be now during these somewhat desperate, unique, unprecedented times.

GERM
00:26:11.250 – 00:26:20.610
Chris, question to you from Sean in Roanoke, Virginia who says hi, I have Alpha Gal allergy. I know what foods to avoid, but what about medical products? Thank you.

WORM
00:26:21.170 – 00:28:07.280
Thanks Sean for asking. First, briefly, overview Alpha Gal allergy. This bizarrely is a tick bite transmitted meat allergy.

So how this works is, and you may be familiar with this is your normal and you can enjoy meat like any carnivore, but then you get a tick bite. This is more common in the southeast of the US and it’s getting common and after that you are allergic to red meat, so mammalian meat.

So if you have a hamburger with beef from a cow, you will break into hives, maybe even if your luck is bad, have a life threatening reaction. So that’s Alpha Gal allergy and we’re going to talk about that again when TikTok rolls around next year.

But your question is what about medical products? So the main thing everyone knows about with Alpha Gal is that you can’t eat mammalian meat.

But unfortunately Alpha Gal is also present in a large number of medical products.

So you need to tell your doc and your hospital and your hospital record that you are Alpha Gal allergic and remind them if they don’t know about some things that have Alpha Gal in it. This includes some immunizations including some preparations of measles, mumps, rubella and rabies and zoster which is shingles.

Many snake antivenoms and other antivenoms have Alpha Gal and you should not take them.

Both gelatin and glycerin, this makes up the coating of some pills have Alpha Gal, heparin which is a blood thinner, some preparations of thyroid hormones, specifically Armor thyroid has Alpha Gal. Some monoclonal antibodies, some heart valves, like pig heart valves, have Alpha Gal. Some surgical meshes and then some other animal products.

So and then Paul, can you add to that a little bit with this recent story that’s coming out about blood transfusions?

GERM
00:28:08.000 – 00:30:18.690
Yeah, this. Forget medicines, what about blood? Can you actually be allergic to blood because you’ve got this Alpha Gal syndrome.

So there’s a story which is really interesting to me, A study published in JAMA Internal Medicine in which it turns out that it’s looking at a very large number of people who had received platelets. Those are the clotting cells of blood or plasma. That’s some of the proteins in blood, not red blood cells, but platelets or plasma.

That those people who had received these products, platelets or plasma, if the recipient was a type O blood and the donor was a type B blood, they tended to have more allergic type reactions. Not a transfusion reaction. It’s not a red cell thing, it’s an allergic reaction.

But this experience of an allergic reaction in a type O recipient of platelets. Yep. It was happening in parts of the country where there’s a lot of Alpha Gal and not elsewhere, including other parts of the world.

So by association the suggestion is, hey, it may be that Alpha gal is also sensitizing us.

If we are type O people, I happen to be one of those, that we may actually end up having an allergic reaction if the donor happens to have a different blood type. Please don’t be confused. Some of the lay press on this I think is wrong.

It says if you get a blood trace transfusion from type B to a type O person, you can get a reaction. Hell yeah, that’ll kill you. That’s a transfusion reaction. Type O is the universal donor, but not the universal recipient. So it’s a little confusing.

But for those allergic reactions, Chris, the suggestion is that these tick borne issues of Alpha Gal, it may also impact your ability to receive platelets or plasma. And these are important medical therapies. So what’s this mean?

It may mean that if you live on the east coast of the United States, for example, other parts of America, including the southeast Texas where there’s a lot of Alpha Gal, they may start having to match your plasma donor to your blood type. We don’t have that yet as an official thing from Red Cross, but this could be a change that’s coming that’s really interesting.

WORM
00:30:18.690 – 00:30:21.210
That’ll make something complicated even more complicated.

GERM
00:30:21.530 – 00:30:25.690
As is true with politics and our crazy hot hot world.

WORM
00:30:33.220 – 00:30:58.600
You know, speaking of politics in our hot, hot world, that’s a nice segue to our next question. So we have just experienced in the US this huge outbreak of cyclospora, which causes this miserable, horrible diarrhea.

Can you, Paul, comment on the recent cuts in the federal workforce at CDC and how that might be linked to this large cyclospora outbreak and how it got so very big?

GERM
00:30:59.400 – 00:33:18.940
You know, thanks. We’ve talked about this a little bit. Cyclospora parasitic infection.

It comes from the feces of human beings and we get sick when we eat those little microscopic germs. This happens typically when we have food from the ground, especially lettuce, cilantro, etc.

And as we’ve talked about in pretty gory detail, thanks for sticking with us, folks. We talk about all this diarrhea, but man, this can be a bad case of diarrhea and tenacious. So how did this happen? Cyclospora has always happened.

It’s part of the human American food experience. But that is something that we actually have not seen much over the years. The 80s, the 90s, the 2000s, the 2010s.

If we had 2,000 cases in a year, it would be a lot. The last big year was 4,000 cases. 2019. Well, here, here we are 2026, and we have, you know, well above 10,000 infections just in Michigan alone.

The explosion of explosive diarrhea. And how did this happen?

It’s not a coincidence that that’s happening under this particular president and his minions, because one of the things they have done as part of their so called doggy department or doge, this Department of Government Efficiency, I think it’s Department of Government Evisceration is what I call it. And they have slashed to the bone the food safety network that is housed within our Centers for Disease Control and Prevention.

So, you know, that doesn’t mean that it’s necessarily the reason that this contaminated food got into the US but just seems perfectly clear to me that if you slash these departments in the hopes of saving money, what you’re really doing is cutting away public health and that investment that it takes in prevention, man, the people who are running to the toilet. By the way, you can’t even get toilet paper in America because apparently it all comes from Canada. And now there’s a 50% tariff on the toilet paper.

So it’s the worst time of all time for to have fricking diarrhea is right now 2026, a literal shit show. And so there it is: I think this particular perspective in the journal the American Medical association is correct. This was a mistake.

The people who have paid for it are in many cases the people who voted for, for this president. And I hope that they will see the light as they see the toilet bowl and that they can make a change in their behavior. CDC is people.

They’re brilliant, hard working people. We really admire them. And let’s, let’s let them do their damn job to keep us safe and healthy.

WORM
00:33:19.660 – 00:33:42.470
Yeah, I agree 100%. And a dollar spent on public health will spend, will save so much money on treatment after people get ill.

So this is definitely a case of where a ounce of prevention is worth a pound of cure. But we’re choosing instead to let a lot of people get sick, which is tremendously worse than preventing all this in the first place.

GERM
00:33:42.869 – 00:33:56.080
100%.

Chris, a question to you from Anonymous of Ohio usa. Very straightforward, straightforward. Is it legal to fly with marijuana in America?

WORM
00:33:56.400 – 00:35:09.680
You know, this is confusing because there’s many, many states in the US now, including Washington state, our home state, where marijuana is legal. And the answer is no, it is not legal to fly with pot.

And I would recommend that you not do it because enforcement can be difficult to predict, as are the penalties. But definitely bad things could happen, including fines and jail time.

The reason is even though pot is legal in many states under federal law, it’s illegal. Recreational pot is illegal in the United States under federal law. And it’s the feds. Here’s the key point.

It’s the feds who control air traffic and jet traffic and what is legal and not legal on a jet.

So if you are at an airport and say you’re from a state such as mine where pot is legal and you have, have whatever amount and they find it, it will not be an effective defense to say, hey, I’m from Seattle, it’s legal. I bought this legally. Here’s the receipt. They will say fine, that can be exhibit B, your court trial. So the bottom line is no, it’s not legal.

And I really don’t have more to say about it than that other than I would not attempt to transport it when you travel by jet.

GERM
00:35:10.080 – 00:36:26.330
Well, yeah, and that’s true. Even if it’s legal at both your origin and destination. I agree with you.

And if you think traveling with marijuana is a risk, man, what if people try to use on the plane?

Now this happened not long ago on a JetBlue flight where somebody lit up or fired up their, their e cigarette, whatever you call those things, they were vaping marijuana in the lavatory. This is a bad idea. It’s completely illegal. And in fact it was such a disaster because it wasn’t a real disaster.

But the pilot heard about this happening and said that he was turning around.

They were so worried as professional aviators that they could get a contact high, that they might be randomly drug tested when they landed, and that they could inadvertently bring in marijuana into their bloodstream that they would get well, they’d lose their career because they were flying while they’re high. Medically speaking, that is not a thing.

But that poor pilot didn’t know that and I don’t blame them for making that decision, even though it wasn’t medically necessary. So the entire plan plane was screwed.

Everybody missed their flights and their connections because one person just needed a why couldn’t they even done an edible? What the hell is wrong with people anyway? I didn’t say that, but this was a bad idea for a bunch of reasons.

Do not mess around with with dabbing, smoking, vaping or using by mouth. That would be a bad idea.

WORM
00:36:26.810 – 00:36:31.450
So on a jet, what I’m hearing is that even one toke is too many tokes over the line.

GERM
00:36:31.530 – 00:37:12.650
I have to I have to agree. Thanks everyone for joining us here on episode 116 of Germ and Worm. As always, we welcome your questions on travel health.

Send them along or your tips for success suggested corrections. We’d love to hear from you.

Send us an email germandworm@gmail.com or visit our website germandworm.com. If you have enjoyed this episode, please subscribe. Rate us favorably on your device. Spread the word with friends, family and on the socials. Those are free ways to support this podcast. I’m Germ.

WORM
00:37:12.650 – 00:37:15.290
I’m Worm. It’s a big planet, seed and good health.

GERM
00:37:15.690 – 00:37:38.090
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 belong to Dr. Sanford and Dr. Pottinger alone and do not necessarily represent the opinions of the University of Washington or UW Madison.