Traveling internationally is exciting, but it also requires a little extra preparation and education. Learning about the region and culture where you’re headed will make you aware of any nuances or practices specific to the area. Increased awareness makes you less of a tourist will lead to more positive interactions.

While cultures do vary, it will helps to learn the details. There are some general best practices to follow when going abroad. Americans tend to have a certain negative reputation outside of the United States. But, following these best practices will ensure that you represent yourself and the U.S. well and also enjoy your journey!

10. Respect the authorities.

This may come as common sense, but this recommendation is an important one. For example, don’t mistake your interaction with the foreign police as a robbery, as was the case with one of our US Olympic swimmers. Make sure to obey and respect local laws and public property.

9. Avoid any natural inclination to speak loudly.

Americans are one of the more loud and boisterous cultures. We are used to having to shout over drinks at a sports bar or while bumping along on public transportation. Resist the urge to yell to your friend on public transportation in other countries. Be aware of your surroundings and match your voice level to them. Maintain quiet tones in synagogues, cathedrals, museums, etc.

Remember that speaking louder to those that don’t speak English will not help them understand. You will seem rude and irritating.

8. Dress accordingly and appropriately.

A good rule of thumb when choosing your attire is to consider local customs, attitudes, and religious beliefs. You don’t want to offend others or draw attention to yourself as a potential target to thieves.

Americans tend to dress more casually than other countries. Consider packing on the conservative side, leaving out your neon yellow tank top. Choose instead muted, neutral hues. Be wary of being too immodest or flashy in your dress or jewelry, especially for that specific region. Sightseeing in Europe requires a different wardrobe selection than spending spring break in Mexico.

Be cognizant of your itinerary. If you plan to visit a cathedral or synagogue, make sure your attire is appropriate for a sacred place.

Consider leaving typically American apparel at home. This includes items like sports jerseys, college t-shirts, or “I love NY” shirts.

7. Be careful of where you keep your camera.

If your camera hangs from your neck as you walk up and down the streets of Spain or markets in Morocco, you brand yourself a tourist immediately and become a potential target for thieves.

General travelers should find a small bag that stores their camera or phone, but allows for easy access to snap a few photos when, for example, they find themselves walking toward the Colosseum.

6. Don’t complain.

This one should be easy. Focus on the fact that you are on an adventure — seeing new worlds, learning new cultures, and meeting new people.

Don’t complain about your meal. Don’t cry aloud that you wish everyone spoke English. Don’t complain that the weather isn’t like back home or that you hate the local smells. Embrace it.

5. Find a good travel bag.

Don’t use the typical tourist packs, like backpacks, fanny packs, and money belts. Using any of these items is another way to easily put a target on your back for thieves and make you stand out.

Unless you are backpacking, avoid carrying an obvious tourist bag. Instead opt for a comfortable cross body bag or small purse or satchel. These types of bags are also easy to keep close to you and covered while traveling on a crowded train or bus.

4. When in doubt, don’t gesture.

Some cultures find gestures with the left hand insulting.

Avoid pointing, as many cultures also find pointing offensive. Common American hand gestures, like a thumbs up can have very different meanings elsewhere.

In general, it’s better to avoid gesturing altogether. If necessary, motion with your right hand, palm facing up, to indicate direction.

3. Embrace the local eats and don’t drink too much.

Don’t go searching for the nearest McDonald’s or pine for Taco Bell. Embrace the local delicacies. Visit outdoor markets or sit down for a cup of locally brewed coffee. You may find something unexpected and delightful.

Avoid the inclination to drink more than usual because you’re on vacation. Drinking too much can be dangerous in foreign situations, not to mention unflattering.

2. Don’t go crazy with social media, pop culture, and selfies.

Don’t worry about finding wifi at every turn so you can post updates on social media. You can overload all your followers when you get to your lodging for the night. Instead, capture the photos and memories in the moment. It will be fun to think back later when you do post your travel photos.

Also, it’s fun to contextualize the places you visit by thinking of movies filmed or set there. But, don’t constantly ask the locals to help you find a specific site from your favorite film. Do the research beforehand and also, come to learn the history of the place itself.

1. Be happy and courteous.

You’re traveling abroad! Take everything in with enthusiasm and warmth. Don’t be afraid to try new things. If you show enthusiasm for, and interest in the culture, the local people will be much more welcoming.

Planning a trip? Don’t forget to visit your local Passport Health to make sure your healthy as you go. Schedule online now or by calling .

Do you have any other suggestions to add? Feel free to comment below or reach us on Facebook or via Twitter! We would love to hear from you!

Passport Health is pleased to announce that Dengvaxia®, the first WHO-approved dengue fever vaccine, is available in our Mexico clinics.

Dengue is a mosquito-borne disease that affects nearly 400 million people each year across the globe. Approximately a quarter of these individuals will die from the disease.

Symptoms of dengue include:

• Severe headache
• Joint, bone or muscle pain
• Mild bleeding
• Severe abdominal pain or vomiting
• Circulatory failure, shock and possibly death

The vaccine is as a potentially life saving item, especially in dengue-affected regions.

Dengvaxia® was first licensed in Mexico and is approved for use in people 9- to 45-years-old. Administration is in a 3-dose series with boosters at six and twelve months. It is not yet clear when, or if, re-vaccination will be required.

Passport Health’s Mexico clinics are its only clinics with the vaccine in-stock for travelers. The vaccine will become available in the United States once it has been approved. Subscribe to our blog to learn more.

Until the vaccine becomes available in the United States, health professionals recommend the following to avoid infection:

• Wear long sleeves or pants and treating your clothes with repellents like permethrin.
• Using EPA-registered mosquito repellents and mosquito nets when necessary.
• Avoiding areas with standing water especially during times with high mosquito activity.

To learn more about dengue and how to prevent it, see our dengue prevention page.

To learn more about the dengue vaccine, see our dengue vaccination page.

Are you planning a trip to a dengue-affected region? Schedule a travel consultation with your local Passport Health clinic by calling or booking online now!

The Zika outbreak in Brazil couldn’t have come at a worse time. The virus scared many away from participating in and attending the games in Rio this year.

Where are these concerns coming from? Where did this disease come from? And, what do we have to be worried about?

What are the symptoms of Zika?

• Fever
• Rash
• Joint pain
• Conjunctivitis
• Muscle pain
• Headache

According to the Centers for Disease Control, “Zika is usually mild with symptoms lasting for several days to a week. People usually don’t get sick enough to go to the hospital, and they very rarely die of Zika. For this reason, many people might not realize they have been infected.”

Zika is a mosquito-born illness, similar especially to diseases like dengue fever and chikungunya.

The Aedes mosquito is the main vector for the virus. But, Zika can also spread through sexual interaction, blood transfusions, and mother-to-fetus connection.

Where Did Zika Come From?

The honest answer? Nobody really knows.

The Zika virus was named after the Ziika forest in Uganda, where scientists first (accidentally) identified the virus in 1947. The scientists were looking for yellow fever in rhesus monkeys. What they found was Zika. While first identified in 1947, the virus existed in many forests all over East and West Africa and Asia years before that.

No one knows where the virus itself came from – where the rhesus monkey caught it.

In 1952, scientists discovered the first human Zika cases in Uganda and Tanzania. The virus remained in these regions for 60 years after the initial discovery.

But, in 2007, a Zika oubreak occurred on the island of Yap, part of Micronesia in the Pacific Ocean. It was the first outbreak outside of Africa and Asia.

The Yap outbreak was bigger than most others – it presented a looming question. How did the virus get all the way over there?

How Did Zika Get To the Americas?

Between 2007 and 2015, the virus spread throughout various islands in the Pacific. These new outbreaks and raised new concerns, specifically microcephaly. Associated with Zika infection, this birth defect causes smaller than normal head size and other symptoms. Many researchers saw a connection between Zika and microcephaly, but had little definitive proof.

In 2015, outbreaks of a mysterious rash-causing illness began spreading through northeast Brazil. These reports soon moved throughout other parts of the country. Doctors tested for illnesses like dengue and measles before finally testing for Zika. Results came back positive.

During this time, researchers had a clearer connection between Zika and microcephaly. Other birth defects and symptoms are now connected with the disease. This includes Guillain-Barre syndrome and arthrogryposis.

While not very dangerous for most people, these discoveries showed fetuses are at risk. If a pregnant woman become infected, serious birth defects could occur.

Where Can we Go from Here?

Zika virus has been labeled a “public health emergency of international concern” by the World Health Organization. Its rapid spread, link to serious neurological conditions and other factors make Zika a serious concern.

Public health agencies recommend we take extra precautions to avoid Zika including:

• Preventing mosquito bites- Use CDC-approved insect repellents while traveling in affected areas.
• Practice safe sex- Be sure to use a condom to avoid sexually-transmitted Zika.
• Protecting others- If you think you may have contracted Zika, avoid areas where mosquitoes are present to help stop the virus from spreading.

Have you traveled to a country recently that’s got a history with Zika virus? Learn more about the Zika virus here.

Do you need to make an appointment with a Passport Health Specialist for other travel vaccinations? Schedule your appointment today by calling or booking online now.

Do you have questions about the origins of Zika? What are you tips for avoiding the virus? Let us know on Facebook or via Twitter!

Written for Passport Health by Adrienne St. Clair

The Zika virus has been a hotbutton topic throughout the year. With the virus raging in Puerto Rico and reaching the United States, many are worried. One question still remains, does catching the Zika virus also provide immunity? Or can you get it twice?

Can I Get Zika Twice?

According to early research, fighting off the infection provides immunity. How long this immunity lasts is still under investigation.

It’s scary enough to get Zika once. But, the prospect of becoming re-infected is terrifying. Especially when considering the impact the virus can have on unborn babies.

Researchers at the University of Wisconsin-Madison are testing this immunity. By observing how Zika affects macaque monkeys, they hope to better understand the virus.

Monkeys infected with Zika were disease-free after 14 days. They remained free even after being re-infected with a different strain 10 weeks later. This could mean that immunity develops after encountering the disease for the first time. Like humans develop an immunity to varicella following a case of chicken pox.

But, researchers did observe an extended duration of infection in pregnant macaques. There is no pattern for the length of the disease in pregnant macaques. They are the only group that had longer than average infections.

This has raised the question of whether the fetus can reintroduce the virus to the mother. It would explain why infection extends in pregnant macaques, and ends with the pregnancy.

Could Fetuses Spread the Virus?

A recent case report detailed this scenario playing out in a 33-year-old Finnish woman. The doctors saw the disease duration extend, and then end with the pregnancy.

Researchers are seeing if a mother can receive Zika if the only source is an infected fetus. This may provide some more evidence about whether the disease can be spread back from fetus to mother.

At this point, these are just observations in a preliminary study. While these discoveries are meaningful, they are not concrete findings. The sample sizes have been small, and the results have not been reliably repeated.

How Can I Stay Zika-free?

Preventing Zika infection can be tricky. The CDC and WHO recommend the following precautions:

Pack a strong mosquito repellent. Consider traveling with permethrin-treated mosquito nets or clothing.

Loose, long-sleeved shirts and pants provide great protection at night when mosquitoes are active.

Zika can be sexually transmitted, be sure to use condoms if there is a potential for Zika infection.

If you are of child-bearing age and might become pregnant, avoid travel to affected countries.

You can become infected with Zika at any point in your pregnancy. Avoid travel to all Zika-infected countries and areas.

If you feel that you may have become infected while traveling, seek medical attention. Take all necessary precautions when interacting with loved ones. Preventative measures are the most effective as there is no treatment for Zika.

Traveling to a Zika country? Speak with a travel health specialist before you leave. Schedule an appointment by calling or booking online!

Have you traveled to a Zika country? What was your experience and how did you protect yourself? Share it with us on Facebook or Twitter!