Intro: It's Your Health Radio, a special podcast series presented by Henry Mayo Newhall Hospital. Here's Melanie Cole.

Melanie Cole, MS (Host): Welcome to It's Your Health Radio with Henry Mayo Newhall Hospital. I'm Melanie Cole. And today, we're talking about infectious diseases and summer travel, how to keep you and your family safe if you're going on some trips this summer. Joining me is Austin Haberman. She's the Manager of Infection Prevention and Control for Henry Mayo Newhall Hospital.

Austin, thank you so much for joining us today. So, we all love to take our vacations. We all love to go places. But one of the things, and me in particular, whenever I'm about to travel, I'm so worried about getting sick, either right before the trip or on the plane, and then it ruining my trip, or wherever I happen to be. So, I'd like you to start with your best advice. When we're planning a trip and we're packing our stuff, what should we be thinking about in terms of infection prevention?

Austin Haberman: Thank you for having me on the show. Really, a key takeaway here for the best travel illness prevention is really just doing the basics, making sure that you're hydrated, getting enough sleep at night is very important, hand washing practices, and just limiting germs overall in crowded spaces.

Melanie Cole, MS: Okay. So when we're thinking about packing, not a lot of people are wearing masks anymore. My daughter, we take sanitizer, especially through the airport. And, you know, things are filthy in different places and everybody's got something going on. Is there anything specific we should be packing? Should we be carrying sanitizer and that sort of thing around?

Austin Haberman: I would say so, yes. Hand sanitizer is one of the best methods to prevent illness in any format. I mean, if you're in a hospital, if you're in a restaurant, especially if you're on a plane, for example. Doing appropriate hand hygiene with alcohol-based hand rub like Purell hand sanitizer, for example, or any off-brand hand sanitizer works as well because that has that alcohol base—and and that helps kill 99% of the germs that you come into contact with—are effective with hand sanitizer because of that alcohol content. So if you pack yourself some hand sanitizer, it's pretty effective. Definitely, if you're in areas that tend to be overcrowded, wash your hands frequently, you know, if you tend to touch a lot of high-touch surface areas like railings for example, things like that. So, I would say packing some hand sanitizer is good.

They also have some wipes that you can pack that tend to have like some Lysol component. you can pack those, and those are sometimes good to wipe, like if you're going in a plane, for example, you can wipe the front table behind the seat that you have, your armrests for example, those things. Those are all really good preparations to bring in case that you're traveling, and you pack it in your bag.

Melanie Cole, MS: We think of places that we're all going, and one of the things that's kind of getting common now is cruises and disease outbreaks. So, it seems like a lot of those kind of outbreaks take place on cruise ships. And the hantavirus we mentioned before we got on the air is just one example. So first of all, why are we seeing those kind of outbreaks so often on cruise ships, and what is hantavirus?

Austin Haberman: Well, honestly, we're seeing more of those outbreaks on cruise ships because we have people living in closed quarters. Unlike the norovirus, hantavirus can be common on cruise ships because there's a lot of people living in a closed area that they don't have a lot of space in between.

So,how do you get hantavirus? Most infections, although they're rare, occur after exposure to rodent droppings or urine. So, that's often from time spent in dusty cabins, sheds or campsites, or in hiking, camping, or hunting areas where rodents could be present. You would hope that your cruise ship, of course, doesn't have rodents. However, you know, that's why it is kind of rare. There's only a small number of reported cases that occur in the US each year.

I will say that in terms of hantavirus, human-to-human spread is extremely rare. You can't just get it from passing somebody in the hallway or breathing the same air as them, for example. And there's typically only one strain that's been detected in South America that's been known to cause human-to-human transition, and that requires a significant exposure to infected body fluids. Or like I said before, you can have dusty cabins, places that maybe rodent droppings or urine has contacted that you also come into contact with. That's how you would tend to get hantavirus exposure.

Melanie Cole, MS: So, another thing that we hear about on cruises is foodborne illnesses. And so, how do you know if you're on a cruise, if that's going to happen, if the food is bad? Because sometimes we've heard, "Oh, 100 people got sick," or, you know, and that's one of my worst nightmares, is that kind of illness, because that takes you down. You're out for the count on that one.

Austin Haberman: Right. Most of the time, illnesses that occur on a cruise ship is going to be primarily norovirus. That spreads easily on cruise ships or other, like, foodborne illnesses spread on cruise ships due to closed quarters and shared dining. That's going to be the biggest bulk of your risk of infection. And you also have large groups of travelers that could be coming into contact with the food, and maybe not doing hand hygiene, for example.

Some of the most common risk factors for going on a cruise ship and being exposed to a foodborne illness is, like, shared buffets and dining areas. You can avoid this by, like, making sure that the food that you're eating hasn't been sitting out for too long. A lot of cruise ships tend to have those salad bars or big buffets. So, you should be cautious with food and water sources. Make sure that what you're drinking out of doesn't come from, like, a shared poured pitcher, for example. Things like that can really help.

And then, also, make sure that you're washing your hands with soap and water. That's going to be more effective than using just hand sanitizer, because a lot of GI organisms, like pathogens that are in your GI tract, are spore-forming bacteria. I say this because alcohol alone most often doesn't kill spore-forming bacteria because of the spores. You want to use soap and water for that. So, that's why in the instance of before you eat, for example, you want to make sure you're washing your hands with soap and water. Of course, if you don't have that, the alternative is hand sanitizer. But if we're talking specific to cruise ships, you should have access to a sink with soap and water. And in that case, I would utilize that to prevent any kind of foodborne illness on a cruise ship.

Melanie Cole, MS: Another one that we're hearing a little bit about in the media is Ebola. I mean, is that really going around other scary diseases? What is that? And tell us a little bit about it.

Austin Haberman: Ebola would be the most deadly of the diseases we've talked about today. But that also only spreads through direct contact with body fluids, not through the air. So, you can't catch Ebola through casual contact or just by simply being near someone in the public.

Transmission would require broken skin or mucus membranes, like you have a cut in your skin, you touch someone who's infected, and then you rub your eyes, your nose, or your mouth, or you come in contact with, like, infectious fluids like blood or saliva, maybe vomit, things like that.

I will say that I'm not aware of any Ebola being in the United States at this time. But the CDC does keep an updated list, like an updated report on current Ebola cases and locations. So, you can also go onto the CDC website. It should be a quick Google search to see where Ebola's at right now, and be able to avoid going into those areas.

Melanie Cole, MS: Okay, I want to jump back for a second about cruises, because I wanted to ask you if we do feel sick on a cruise, you know, you're out in the middle of the ocean or you're on some island somewhere, what should we do?

Austin Haberman: If you develop symptoms, do you know what symptoms to look for? That would probably be where I would start. If you develop any kind of vomiting, diarrhea, fever, respiratory symptoms, you know, you should probably limit your contact with others, and let the crew staff know, of course, as well, that, you know, you have these symptoms. And probably, they'll want you to isolate until your symptoms subside.

If you're out, like, on an island and you're not going back to the cruise ship, the best thing that you can do, honestly, is try to stay hydrated, especially in hot climates. Staying hydrated really is essential because if you're hydrated, it fuels your critical immune defenses. It makes sure that your body can circulate white blood cells. That's what keeps your body protected against pathogens and infections by keeping your mucosal barriers moist, like your nose, your eyes, your mouth. When you have moist mucosal barriers by drinking enough water, for example, those barriers are naturally in place to trap pathogens. So, that will allow your body to have its own defense mechanisms. It also makes sure that your body can transport appropriate white blood cells and antibodies throughout your bloodstream and lymphatic fluid to make sure that you can stay safe by circulating immune cells.

Melanie Cole, MS: Well, this is all very great information that you're giving us. Now, let's talk about summer travel in general. What steps can we take to keep our family and ourselves safe? We've talked about hand sanitizer and packing, you know, hand washing, making sure that we're doing those things. When we're cruising around, maybe we're taking a road trip, is there anything that you want us to know or any places, red flags you'd like us to think about where maybe we shouldn't go, or if we are going to go, we make sure to check out what's going on there before we go?

Austin Haberman: You can always look on like a local public health website, and it has a dashboard actually that's really convenient to use that'll tell you what is going on in the area at any given time. Like, let's say I'm going to go and visit Yellowstone National Park for example. If you look up Department of Public Health for Wyoming, national parks websites also have it so that you can see what is like being identified in the area.

Most importantly, really, I would say that you should focus specifically on your daily water intake goals. And then, also make sure that you have the appropriate sleep hygiene. Sleep plays a big role in preventing illness as well.

The last thing that I would say really just to limit your exposure to germs in crowded places, carry hand sanitizer with you and make sure that you're doing enough hand washing in between.

Melanie Cole, MS: That's all such important information. Is there anything we didn't touch on, Austin? Any parts of the world we should avoid? Anything you want to tell people? Your best advice here for summer travel, infectious disease, the expert that you are, what would you like us to know?

Austin Haberman: Yeah. Honestly, I think that if people are practicing the appropriate hand hygiene that they have, if you're sick, you stay home, so that you don't spread any kind of other contagious organisms or pathogens to anyone else out there in the community.

If you do have any kind of symptoms of everything, you know, make sure that you kind of avoid travel, and that you're staying up to date with your sleep, your water intake and then, of course, hand hygiene.

Melanie Cole, MS: Really great advice, Austin. Thank you so much for joining us, and we want to let everyone know to have a safe summer and travel smartly. Listen to Austin, share this show with your friends and your family, because that's what's so important, so that we can all have a great trip. and not go anywhere and spread things around if we're sick, stay home, or get something that ruins our trip that we've planned and gotten so excited for. And for more travel safety tips, you can visit library.henrymayo.com and type the word travel into the search box.

That concludes this episode of It's Your Health Radio with Henry Mayo Newhall Hospital. Please always remember to subscribe, rate, and review It's Your Health Radio on Apple Podcasts, Spotify, iHeart, and Pandora. For more health tips and updates, follow us on your social channels. I'm Melanie Cole.