00:01 John Daub: Welcome to Tokyo. If you're watching this, you're probably one of the people that are worried about STSS, which is streptococcal toxic shock syndrome, which is something that has been on a lot of people's minds since the media has been reporting on this over the last several months, in particular since June when the numbers came out that we passed the total number of patients who suffered from this the entire year 2023, and we're only halfway through 2024. So of course the media is onto something, especially when there's flesh eating in front of it, which is a very concerning word.

00:36 John Daub: And should you be concerned? The answer is, well, yeah, you should be concerned about every single disease that you could possibly get when you're traveling to a foreign country. And it is not without reason to be watching this video and trying to understand exactly everything that you need to know. But the thing is that there's not a lot that you really need to know because there's not a lot that's known about how this has caused why people— why this is increasing. There's some theories out there, but the bottom line is anybody who's traveling to anywhere in the world, there are a couple of pages that you need to bookmark before you leave that will be your source of information so that you are ready in case there are really bad situations.

01:21 John Daub: One of them is, you know, the embassy's websites here, this is the one for the US Embassy. So for Americans in particular. The thing with the embassy pages here, they actually have places where it sends alerts for U.S. citizens. In this case, they would have an alert for you if it were to be something that you should be seriously concerned about. There's no alert for this right now. So there's an alert for something right now as an ambulance goes by. But there's no reason for you to worry about STSS right now because there's no warning from the State Department for Americans traveling to Japan.

01:58 John Daub: In fact, I checked online, there's no alerts on for any places for this. This is something that's been around for a while. It's not something that is a brand new disease by any means. They've been tracking it since 2010. You can see the numbers have continuously gone up. Right before the— you know, that era where we couldn't travel anywhere, it started to decline mainly because people stopped traveling. A lot of people stopped going out, but it didn't go away. And here it is, it's starting to increase.

02:29 John Daub: We're only halfway done through 2024. And that yellow line shows that we've already reached the totals from 2023, which is more than 2019. So what is STSS? The best way to get an understanding of this is to see what the media is posting about it. Now keep in mind, whenever you see the media posting stuff about it, everything should be taken with a grain of salt because they kind of want you to— you know— be worried about this too. So this comes from the Washington Post. It's somewhat— well, I guess you guys could— when it comes to this kind of— we could trust the newspapers perhaps.

03:06 John Daub: A rare deadly bacterial infection is on the rise in Japan. When you see "rare, deadly" together, it just scares you, right? STSS, Streptococcal Toxic Shock Syndrome kills up to 30% of its patients and is highly associated with flesh eating infections. Symptoms include fever and a red rash. So I mean, the newspapers went through this. They show a very scary image that brings us images of the era that we just all lived through when we started to get to know viruses and bacteria and stuff like this.

03:36 John Daub: But the image says it's a digitally colorized image, depicts a group a streptococcus bacteria on the surface of the human white blood cell. So a record number of cases of STSS in Japan this year has focused attention on the rare and potentially deadly bacteria infections. There have been 1,019 cases of STSS. I'm just going to pause for a second. Just 1,000 of them. It's not something that's as rampant as the era we just lived in. The National Institute of Infectious Diseases warned of a rise in cases in March— three months ago— after 77 deaths from the illness were recorded.

04:11 John Daub: That's significant. The majority of the cases at the time were people above the age of 50. I'm 50, so I agree. I'm still reading. The United States reported 145 cases of STSS in 2021 according to the latest data. So, you know, it's sort of on par with the cases. It's just on the increase here. What is it exactly? STSS is a severe illness caused when a group a streptococcus bacteria spreads into the blood and deep tissues. So that's a pretty basic explanation of it. So it's something that really has to get deep into your blood, into your tissue in order to be impactful.

04:45 John Daub: So that means it's kind of rare for this to happen, I guess. We're going to look at some of the reasons why— writing here. So GAS is common— common bacteria found in— just went by— really fast— in general, often causes sore throat, skin infections and are at large of a public health— at KFF Health News and infectious disease— blah blah blah. Blood, lung and flesh eating infections are less common. Well, that's good to know. Open wounds or sores, diabetes and alcohol usage are factors that can increase the risk of contracting STSS.

05:17 John Daub: According to the CDC, 3 out of 10 STSS patients are likely to die. That is worrying. So I mean the news is kind of latching on to the most— you know— like troubling aspects of this. I think when you're traveling around Japan, there are certain things that you should really do before you— should get used to doing. When you come to Japan, one of the things you could do is to make sure that you're always washing your hands. So I asked— let's just get to the point here. I asked ChatGPT, which knows more than this about all of us, how to avoid getting STSS in Japan or anywhere for that matter.

05:53 John Daub: And I wrote in what you can do here. So let's go over here. So it's a serious bacterial infection caused by these. Here's how you would stop it. Good hygiene practices. No brainers. When you're traveling abroad, you're not used to— you know— the things in the air, the water, the food. There's bacteria particles that your body is always fighting off because you're in a new environment. So always washing your hands is something that you should be doing anyways no matter where you're traveling. In fact, even if you're at home, good hygiene is going to keep you safer all the time.

06:28 John Daub: You don't have to use alcohol, just make sure you're using soap. Very good thing. So this is something that can help stop the spread of this wound care. This is something that we saw in the news in Japan. Here, if you have an open wound, make sure that it's disinfected. Make sure that it's cleaned properly. This is how bacteria can get into the deep tissue, into your bloodstream. Keep wounds covered. When clean, make sure that nothing can get in there. Seek medical attention for any wounds that show signs of infection, redness, swelling, pus.

07:01 John Daub: I always say when you're going into a hotel that the housekeeping staff— I want to give them the benefit of the doubt that they did a pretty good job. But that doesn't mean that you shouldn't be washing— wiping down surfaces and places. The beds are probably going to be okay. I always just wipe down surfaces and stuff, especially the toilet. This sounds weird, but I always alcohol wipe the toilets because I've seen— I used to teach, I used to make videos for a company that taught housekeeping housekeepers by using video because turnover rates for housekeepers at international hotels is very high.

07:37 John Daub: So I helped make a video series that taught housekeepers how to clean toilets rooms. One of the things that I noticed while I was doing this, the natural instinct for the majority of housekeepers was to put the toilet brush in the toilet and use the brush to clean the outside— the top of the toilet seat. So they're using whatever was in the toilet to clean the toilet seat, basically. Look, I am suspect of any toilet or bathroom despite how good the cleaners are. So it would be a good idea for you to clean places like that with alcohol wipes and just be safe with that.

08:11 John Daub: I always do that anyways, which makes me a little weird. But I think— I've already seen what's happening in the kitchen there. Seek medical attention if you have any wounds that show signs of infection. This is something that doctors are now kind of looking at if you're here in Japan as well because it was hard to diagnose. Avoid sharing personal items. Do not share personal items such as towels, razors, toothbrushes that can spread bacteria. I think for most people, they're not doing it. Another reason why this thing isn't spreading to like 10 or 20,000— ChatGPT.

08:45 John Daub: What else should we be doing? Stay healthy. Maintain a good immune system. This is really important. Make sure you get a lot of rest on that flight. If you possibly can, make sure you're not drinking too much alcohol on that. That's hard to do for some people. Make sure you are— you know— getting enough vitamin D. Maybe take those vitamin D supplements two weeks before your trip. Take zinc supplements. These are things that are scientifically proven to help you with your immune system. But the best thing you can do is have a really good diet and make sure you get some sunlight.

09:20 John Daub: You know, don't try to stay inside. In the digital age, in particular, during the last few years, humans have stayed inside maybe a little bit too much. We're not getting enough vitamin D, which is important for our immune systems to help to fight this off. So the common sense stuff— be careful with food and water as you travel. Always be careful with food and water. Even in Japan. Ensure that the food is properly cooked and water safe to drink. I'd say the first couple of days, maybe— I don't know— depending on your age and how good you are with eating food in other international places, always be a little careful the first 48 hours. Whenever you travel to a country, you might not want to go get some street food. Probably the highest chance of having an illness. I'm probably going to be okay from it. But you have not seen the stuff that's hanging around this country, so might be something that's unique and give you stomach problems.

09:50 John Daub: Seek medical attention if you think that you have a fever, rash, severe pain— anything like that— you've had a cut in the— or you've used somebody else's razor or something. These are all signs that maybe you should go check— check this out. Really quickly because it does escalate really fast. STSS which is rare to get it moves and progresses very, very quickly. How quickly? I knew you were going to ask that. Michael Susano, quick stop to say aloha. Thank you, brother. How quickly? Well, we can go take a look at the next article here. I think this is— this comes from NHK, the National Institute of Infectious Diseases here in Japan.

10:55 John Daub: Here's the image. When you see stuff like this, it just scares you. I don't know. STSS cases in Japan hit record high. One of the things about this article in particular, I'll put a link in the description if you guys would like that. It's local and has a lot of information. Japan's National Institute of Infectious Diseases says the preliminary number of cases in the country since the beginning of the year reached 977 as of June 2. It's now over a thousand. There's a 2.8-fold increase in the same period last year.

11:27 John Daub: Again, these kinds of numbers the media has loved to latch onto. Some of the symptoms include swelling of body parts and high fever. That's kind of good to know. Just— you know— I don't think anyone's going to catch this traveling. But again, you should be concerned. And any knowledge on this is certainly power here. Just people to call an ambulance immediately if swelling spreads rapidly. This is true and Japan knows that this is spreading. So doctors might be looking at this a little bit more. Properly diagnosing stuff is the most important.

11:59 John Daub: This man in his 40s was one of the patients who got STSS. Let me just go over what NHK reports on his symptoms. Last November, he developed a fever and fatigue after finishing work as a beautician. The following day experienced swelling and pain in his right shoulder. He visited several medical institutions, but they were unable to figure out the case. I'm really glad that he went out to look for medical help right away. On the third day, his kidney function started to deteriorate. Three days. That is really quick.

12:31 John Daub: I began to experience nausea as well as stopped urinating. I thought I might die. When swelling spread and the pain got worse. When the swelling spreads and the pain gets worse— you know— and it's time to go to see a real doctor. On the fourth day, he visited a university hospital where they do this kind of— these kinds of tests— and was diagnosed with STSS. The infected tissue was necrotic. He underwent an operation immediately, saved his life again. 30% die from this. If I'd stayed at home to wait to see how things went— again.

13:04 John Daub: Seek medical attention if you start to feel bad and think you might have it again. The swelling was pretty telltale sign and stopping urination. Tabata says he asked his doctors the cause of the infections, but they said they were not able to determine as if there was no apparent injury. They weren't looking for anything. It's hard to find something— similar to Lyme disease, which I know a lot of people who have had in the past. Although the reason for the rapid rise of STSS cases in Japan is unclear, Professor Kikuchi says it may have to do with people's weakened immune systems.

13:40 John Daub: Again, there's just hypothesis on why this is spreading because there's not a lot of information on it and the numbers seem— no, we're not getting anything from the United States State Department saying that this is something that you should worry about. They would know. They have people that are on top of this and they want to make sure that travel is safe for you and for them. They don't want this either. Nobody wants this. It's true story. Vasily is here. John Daub is my hero. Well, thank you, Vasily.

14:10 John Daub: I just want you to have a happy and worry-free trip here in Japan. Bottom line, make sure you wash your hands when you touch stuff, especially on the subway. I'll be honest with you. I've learned to balance on a subway. I don't touch anything. I'm somewhat neurotic in that case. I don't like to touch anything. I don't touch my face. I might do this, but I made it a habit not to touch my face. I don't pick my nose, particularly in public or during a live stream. Just little things that I noticed watching other people.

14:42 John Daub: They touch their face like a thousand times a minute. It might be something that you could work on as a habit where you stop to do something like that. But that's probably where a lot of this stuff comes from. You don't even know it but you're scratching, you're touching, and this stuff gets into your system. There's other things that you could do. Having the hand wipes is really good. Now being a slave to alcohol is not something— like as a sanitizing thing. That's not really a good thing for your skin or for your body.

15:13 John Daub: It's natural to get sick and build up an immunity to stuff. But when you're traveling, this is the one time you don't want to get sick. So if you're staying here for a two or three week holiday, do whatever you can to stay safe. Again, I think it takes some time before you can get used to the local bacteria, local stuff— bugs around that I probably have an immunity to, but you probably don't. It's still a really clean country, you probably have a less chance of getting it. But whenever you go to a country that is a new environment for you, you have to consider— consider these things.

15:49 John Daub: And you know, I'm glad that we get a chance to talk about this so that you could possibly prepare for it. But again, you know, the cases are on the rise. I think it's good that you— you know— keep an eye out not just on this but all the other stuff and the place to do that— you know— not ChatGPT, AI— but make sure you're— you know— following this is on X. I follow the US Embassy in Tokyo. Make sure, you know, there's stuff that I really don't care about. But there's a lot of stuff like the warnings that I think are critical for every American citizen or worldwide citizen.

16:24 John Daub: You can follow your embassy here in Tokyo. Information that they need to know. Following the CDC also kind of a good idea. You don't have to follow everything but— you know— you want to know about this stuff and if you ask questions, you come up with answers. You know, sometimes it's not the best answers. Sometimes it's a lot of fake news out there. Which I think is why you really need to do your due diligence. Talk to your doctors— talk to your— before you go to any trip, there's shots and make sure you have your vaccines up to date.

16:56 John Daub: There's Japanese encephalitis which has "Japanese" in it. I don't hear a lot of cases of Japanese encephalitis in Japan in particular the countryside. But if you do go hiking in the woods, you know, it's a mosquito-borne illness and I did an episode on whether or not you should get vaccinated for that because I get a lot of questions about that as well. But you should get— make sure your tetanus shots are up to date. Make sure that you're healthy when you go out to travel, make sure that you get enough sleep, make sure that you are sound in body and mind and you'll have a great trip.

17:31 John Daub: But I don't think it's anything to worry about. Calm down. I'm following the story. If this really gets bad or we start to hear people that are getting seriously ill from this, I will let you know. There's an uptick in that— you know— the 19— you know— that is coming around. So that's sort of— that's on the rise globally right now. But nobody's really talking about it because we all have pretty much built up immune system. So it makes a lot of sense to just be good with personal hygiene— making sure that you wash your hands before you eat.

18:04 John Daub: Making sure that you try not to touch everything. I was like— I got a child who's three years old, he's not a baby anymore, but he loves to touch everything. So before he eats, I'm kind of watching, making sure that he can stay as healthy as he can. In particular because we're going on a flight to go to the US really soon and we all want to be healthy to do that. Any questions? I will take some questions for you later on tonight. I'm going to be doing another news story that's really big— right before the opening of the climbing season in Mount Fuji, three climbers who did this before— and they were professionals.

18:41 John Daub: Three climbers who climbed to the summit before the climbing season started were found dead at the summit of Mount Fuji. I'll talk about that tonight in a story. There's some things that you really have to consider when you climb Mount Fuji. And every time something like this happens, it's a good chance to look back and reflect and— like, I don't know— most people don't need to climb Mount Fuji. You do it because it's a beautiful thing and you like to conquer stuff. But it is not for everybody, seriously.

19:11 John Daub: And it's good to think about the risks before you— and think about the rewards before you go ahead and do something like this. It's not a normal tourist attraction. Hiking a 3,000-meter summit is something that requires some sort of skill or physical conditioning. Despite the fact that some people can do it. Okay. The weather always changes up on the top of a mountain that high fast and it's something to be concerned about. But there's a— in general though, like Japan's a pretty safe place. You know, we just got volcanoes, earthquakes, landslides, typhoons, tsunamis, and flesh eating bugs that— you know— make everybody kind of question whether or not Japan is as safe as it really is.

19:52 John Daub: But it is because I've been here for 26 years, I'm pretty healthy. I'm probably healthier now than I was 26 years ago. And you can thank maybe my wife for that. Thanks, G' day. Alright everybody, I hope this is informational for you. The new currencies are coming out in just a couple of days. I will show you those new banknotes as well. They look pretty cool here. They come out on July 3rd, which is just four days from now, which is super cool. I did an episode on that just a few days ago. So there's a lot of good information coming for those that are coming to Japan that you really need to stay in touch of and this channel is one of those places where you can do that.