10 Things To Know About Immunizations And Medications Before You Travel

You’ve booked a hotel, you’ve got your passport, and you found a great rate on a flight. Now, you’re counting the days until your adventure begins. There’s just one problem: If you haven’t thought about healthcare, that trip might not happen.

To travel responsibly, you need to think carefully about immunizations, prescriptions, and other medical necessities. If this is your first time leaving the country, that can be overwhelming. Fortunately, it’s actually a pretty easy process, provided that you start planning early.

We spoke with physicians to find out what travelers need to know when going abroad–and what they can do to enjoy their trips with total peace of mind.

1. Know Your Travel Destination

This might seem obvious, but if you’re traveling internationally–or even domestically–you should know the likelihood of contracting serious diseases at your destination. Fortunately, the Centers for Disease Control and Prevention (CDC) make that process fairly easy.

“Beyond just what tourist destinations to visit, you want to know if there is anything medically going on in the area,” explains Frank Illuzzi, M.D. Illuzzi is a practicing board-certified physician in emergency medicine and is currently the Chief Medical Officer at CityMD, a network of urgent care centers.

“Before traveling, I visit cdc.gov, which has a section on traveler’s health,” he says. “It will let you know if there are any health advisories or outbreaks in that country–such as Zika, malaria or Ebola outbreaks. It will even tell you if there is a seasonal illness, such as the flu, or a heat wave, in which case you should be aware. The CDC also lists prior immunizations you need before going visiting. This is helpful because you’ll need to get any vaccinations a couple of weeks before you go.”

In particularly dangerous circumstances, the CDC will issue Level 3 warnings. Travelers shouldn’t visit an area given this designation unless it’s absolutely necessary. Level 2 warnings from the CDC are less extreme, but still quite serious. The CDC instructs travelers to “practice enhanced precautions” before traveling to these regions.

Finally, there’s Watch Level 1, which is applied to any place in the world where health risks are at normal levels. While the CDC website is an essential stop in the vacation-planning process, other sites can also provide helpful information for the health-conscious traveler.

“The other website I recommend is travel.state.gov,” says Illuzzi. “It has a tab for international travel and will give you an overview of the country–any advisories, political situations, as well as a list of major hospitals, English speaking doctors, and so on.”

2. Give Yourself Enough Time

Don’t assume that you’ll be able to get your immunizations in the week before you travel. Depending on where you’re going, you might need several weeks to get up to date.

“The hepatitis A vaccine is two doses, so you need to have time to fit both in before you travel. Malaria prophylaxis often starts before you leave as well,” says Monica Wood, M.D. Wood founded SectAway, a mosquito repellent system. She’s passionate about managing disease exposure–particularly malaria. “It may take time to see a travel specialist and order certain vaccines,” she says.

In theory, you could take immunizations and medications after you arrive at your destination, but that’s not always a safe plan. Antimalarial meds, for instance, should always be purchased in the United States. The CDC notes that in some countries with malaria risks, counterfeit or substandard medicines are relatively common, and they may not be effective for limiting risks.

To further complicate the matter, the CDC also recommends different antimalarial medications for different countries (you can find their current recommendations here). That’s because some strains of malaria are resistant to certain medications.

3. Remember, Some Vaccines Might Not Be Available In Your Area

Kelly Hayes-Raitt is an author who travels full time. On a recent trip to Mozambique, she realized that medications aren’t always accessible–even for a person with decent insurance.

“There is a global yellow fever vaccine shortage, so I had to rearrange my travel itinerary to ensure I didn’t travel through a country with yellow fever, or I would have been denied entry into Mozambique,” Hayes-Raitt shared. “And there are several different anti-malarial prophylactics depending on your destination. Not all of those medications are available.”

“For example, I was travelling from Mexico to Mozambique, but could not find mefloquine anywhere in Mexico! I had to make arrangements to have it brought to me from the States. Luckily, I had started researching these medications several weeks before my trip. Had I waited until the last minute, I would have been stuck.”

The takeaway is clear: To stay safe, you need plenty of time. Talk to your physician immediately after–or even before–planning your trip.

4. Get Help Weighing Your Risks

Let’s be clear: For the most part, immunizations are a good thing. However, understand that your physician will look at a variety of factors when making recommendations, including your age and medical history.

“Some recommendations vary with age,” Wood explains. “The yellow fever vaccine has increased risk with age and has to be balanced with the relative risk of contracting yellow fever while you travel. A fellow physician friend went to the Amazon recently, and he opted out of yellow fever [vaccination] because the risk of infection was low and the risk of a vaccine reaction was high.”

That doesn’t mean that you should head into your doctor’s office with a list of vaccinations that you will or won’t take–you simply need to find a physician with experience in travel vaccination schedules who can accurately explain the risks and benefits of different options. That way, you’ll be able to make educated, appropriate decisions about your medical care.

5. Don’t Assume That You’re Already Up To Date

You visit the doctor regularly and you’re pretty sure you’ve been vaccinated against common diseases. You’re in the clear, right?

Not quite.

“The family that started the measles outbreak in Vancouver lost track of the fact that they had opted out of measles vaccines years before,” Wood says. “My biggest piece of advice is to compile your vaccination records to make sure you are up to date on all the routine ones–MMR, TDaP, Hib, flu, rotavirus, and so on. There’s no sense preventing yellow fever and malaria if you bring home whooping cough!”

The CDC compiles a list of immunization recommendations by age, which is a great starting point for checking your routine vaccinations. For adults, the CDC recommends seasonal flu (influenza) and TDaP (whooping cough) vaccinations. Past 50, you should add the zoster vaccine, which protects against shingles and complications associated with the disease.

If you’re 65 or older, you’ll also need pneumococcal vaccines, which protect against infections in the lungs and bloodstream. Once again, talk to your physician; assumptions can put you at risk, and vaccination records can be checked with relative ease.

6. Know Your Medications

Once you’ve sorted out your immunizations, make sure that you’ve got your other prescriptions sorted out.

“If you have a complicated medical history, write it down so it’s easy to translate,” Illuzzi suggests. “I have family members with heart problems and recommend they take a photo of their most recent EKG and shrink it down to a wallet size.”

That way, if a foreign physician needs to see the EKG, it’s ready. Illuzzi says that a bit of preparation can go a long way if you somehow lose your prescriptions overseas.

“Write out your medication list and put it on your phone, including the generic name, which is helpful in other countries,” he says. “Make sure to also include allergies to medications and foods, along with the name, number, and email of your primary care doctor. I like when my patients tell me they are going away so I can help troubleshoot if they have issues while abroad.”

Finally, don’t assume that your planned travel time will be your actual travel time.

“If you have medications, bringing enough prescriptions on the trip for several extra days,” Illuzzi says. “Assume your plane will get delayed on the way back, or you’ll get snowed in while [in] Paris or Rome.”

7. Know Your Insurance

If you need to see a doctor while you’re traveling internationally, you might have to pay for the privilege. Some insurers cover out-of-country expenses, but unless you’ve checked, you shouldn’t assume that your insurance will work anywhere.

“Keep both your insurance information handy as well as an emergency contact state-side,” Illuzzi says. “Go online or call your health insurance provider and find out what is covered. Some plans will not cover anything that happens outside the U.S.”

If your insurance carrier doesn’t cover international claims, consider other means of coverage.

“Some homeowner or umbrella policies have international or medical coverage, and some of the higher-end credit cards also offer international medical insurance,” Illuzzi says. “Once you know what is and is not covered, you’ll need to make a decision whether to purchase travel insurance.”

Travel insurance policies can be inexpensive–basic plans often cost less than $100–and they’re usually a worthwhile investment.

“Ask yourself: Do you have medical problems? Are you hiking in the Andes and may get hurt?,” Illuzzi says. “If you do, there are companies that offer medical insurance abroad. Just know that there are different types of travel insurance, and you want to see what the line item is for medical insurance.”

8. Know How You’ll Pay For Medical Treatment

If you do need healthcare in another country, you’ll need to keep good records.

“Generally, you have to pay upfront,” Illuzzi says. “Save the receipts, and [your insurer] will reimburse you when you get back.”

That said, Illuzzi emphasizes that “you need to be prepared to have enough money accessible in case of an emergency,” and that preparation will differ from country to country. “Some may have socialized medicine, and you may never get charged.”

Once again, the CDC’s Travelers’ Health site is a great resource for checking healthcare access in your destination country.

“In most places in the Western world, it’s easy to access medicine,” Illuzzi says. “You can often speak to the concierge at your hotel who can direct you to a clinic or hospital. If you are in a more remote area, it will be more challenging. Lean on your resources, such as your travel or hiking guide.”

Of course, you don’t want to find yourself thumbing through the Yellow Pages (or your destination country’s local equivalent) when you’re having a medical emergency. Through travel.state.gov, you can find the locations and contact information for your local U.S. embassy or consulate, which can be vital information.

“I recommend that my patients and family members print that information and keep [it] with their wallet or passport where it can easily be accessed,” Illuzzi says.

9. Know Where To Find The Best Care

If you come down with a cold or a minor flu, you can probably head to any local physician for help. If your situation is more serious, however, your quality of care matters.

“If I’m in a remote destination or a developing [area], I like to know where the teaching hospitals are, because they often have the most advanced equipment as well as English-speaking providers or other international providers,” Illuzzi says.

“Some countries have hospitals just for foreigners. When I was in China, there were two hospital systems: the public hospital system and foreign hospitals, which were staffed with international physicians.”

The CDC recommends checking the qualifications of health care providers. Foreign health care facilities often have different standards than facilities in the United States, but accrediting bodies like Joint Commission International, DNV International Accreditation for Hospitals, and the International Society for Quality in Healthcare can help you find reputable facilities throughout the world.

10. Don’t Rely On Immunizations Alone

You’ve got your immunization records, you’ve got your prescriptions renewed, and you know where to go for medical care. Now what?

“Prevention isn’t just vaccines and medications,” Wood says. “Simple things–like proper hand washing, using filtered water, fully cooking food, wearing a mask [as needed], and using protective clothing and repellents against insects–can also reduce your risks.”

Wood emphasizes proper hand washing because, well, most people don’t wash their hands correctly. The CDC recommends scrubbing your hands with soapy water for at least 20 seconds (as opposed to simply lathering and rinsing).

Depending on your destination, buy filtered water or boil your water when necessary. Avoid going barefoot, particularly on beaches that might be hiding parasites or animal waste in the sand. Supervise young children at all times, and make sure they’re practicing proper handwashing, too.

So, how dangerous is traveling abroad? By one estimate, about 8 percent of travelers working or vacationing in developing areas become sick enough to seek medical care either while abroad or shortly after returning home. Most of those problems are mild, however, and risks vary greatly by destination. Fewer than 1 percent of travelers are hospitalized abroad, and preventative measures greatly limit your risks.

Stay safe, but don’t let health concerns discourage you from taking the trip of your dreams. By planning ahead–and making sure you know what to do in the unlikely event of an emergency–you can enjoy yourself without worrying.

Photo Credit: noppawan09 / Shutterstock

Do Not Travel: 13 Dangerous Places Where Travel Is Strongly Discouraged

In January 2018, the United States Department of State created a new travel advisory system. Individual countries are ranked as follows:

Level 1 (blue): Exercise normal precautions.
Level 2 (yellow): Exercise increased caution.
Level 3 (orange): Reconsider travel.
Level 4 (red): Do not travel.

The State Department recommends that travelers refrain from visiting the 13 countries in the red. Below, we’ve highlighted these 13 countries and explained why the State Department has singled them out.

1. Afghanistan

Reason for advisory: armed conflict, terrorism, crime, and civil unrest

In Afghanistan in recent years, there have been many incidents of kidnapping and hostage-taking, as well as suicide bombings, military combat operations, and terrorist and insurgent attacks, including attacks using explosive devices, suicide vests, and grenades.

The State Department reiterates that the U.S. Embassy has limited ability to provide routine and emergency services to U.S. citizens in Afghanistan, especially outside of Kabul.

It encourages those who travel to Afghanistan to draft a will, share important documents with loved ones, and establish a personal security plan with their employer.

2. South Sudan

Reason for advisory: crime and armed conflict

Since December 2018, South Sudan has been on the State Department’s advisory list, since foreign nationals have often been victims of rape, sexual assault, and armed robberies.

Violent crime has been increasing exponentially in South Sudan, and there have been many carjackings, shootings, ambushes, assaults, robberies, and kidnappings in the country. There is ongoing fighting between various political ethnic groups throughout the country, and cattle raiding often leads to violence.

The U.S. Department of State advises that travelers to the area exercise extreme caution and avoid border areas as well as demonstrations and public gatherings.

3. Haiti

Reason for advisory: crime and civil unrest

On February 14, 2019, the State Department ordered all non-emergency U.S. personnel and their family members to leave Haiti, due to unpredictable demonstrations throughout the country, especially in Port-au-Prince. These unpredictable demonstrations happening throughout Haiti are violent, and protests, tire burning, and road blocking are frequent.

If you are traveling to Haiti, you should arrange airport transfers and hotel stays in advance, make sure you are not being followed when leaving the airport, and avoid physically resisting any robbery attempt.

The Iranian flag. — Borna_Mirahmadian / Shutterstock

4. Iran

Reason for advisory: arbitrary arrest and detention of U.S. citizens

According to the State Department, Iranian authorities continue to unjustly detain and imprison U.S. citizens, including students, journalists, business travelers, and academics. Charges include espionage and posing a threat to national security, and counselor access to detained U.S. citizens is often denied.

Those traveling to Iran should review their personal security plan and enroll in the Smart Traveler Enrollment Program (STEP) to receive alerts and make it easier to be located during an emergency.

5. Iraq

Reason for advisory: terrorism and armed conflict

According to the State Department, U.S. citizens in Iraq are at high risk for both violence and kidnapping. There are currently numerous terrorist and insurgent groups active in Iraq, and these groups target both Iraqi security forces and civilians. There have been a number of attacks involving improvised explosive devices in Baghdad, though this has occurred in several other regions of the country as well.

Travelers headed to Iraq should visit the State Department’s website and review both the High-Risk Area Travelers page and the Traveler’s Checklist page.

6. North Korea

Reason for advisory: serious risk of arrest and long-term detention of U.S. nationals

North Korea is the only country on this list where travel is legally prohibited. Individuals cannot use a U.S. passport to travel to, in, or through North Korea without special validation granted by the State Department.

The U.S. government cannot provide emergency services to U.S. citizens in North Korea, since diplomatic or consular relations with North Korea do not exist at this time.

Libya on a map. — TonelloPhotography / Shutterstock

7. Libya

Reason for advisory: crime, terrorism, civil unrest, and armed conflict

U.S. citizens and other westerners have been kidnapped and held for ransom in Libya, and crime levels in the country are increasing.

Terrorist groups and violent extremist activities remain common throughout the country, with outbreaks of violence between competing arms groups occurring with little warning. Hotels and airports frequented by U.S. citizens and other westerners have been caught in the crossfire between these arms groups.

If traveling to Libya, make sure to carry proof of citizenship and valid immigration status at all times, and make contingency plans to leave.

8. Mali

Reason for advisory: crime and terrorism

Violent crime, including kidnapping and armed robbery, is common in northern and central Mali. Local holidays and seasonal events in the capital city of Bamako, its suburbs, and other southern regions can also be dangerous.

Terrorist and arms groups may attack with little to no warning in Mali, targeting many areas where tourists can be found, including nightclubs, restaurants, hotels, and places of worship.

9. Somalia

Reason for advisory: crime, terrorism, and piracy

Kidnapping, murder, and illegal roadblocks are common throughout Somalia, especially in Puntland and Somaliland. Terrorists plot attacks against airports and seaports, government buildings, hotels, restaurants, shopping areas, and other areas where large crowds gather and where U.S. citizens and other westerners can be found.

Many schools in the area act as “rehabilitation centers” without licensing and oversight and have been reported for physical abuse and for holding people against their will.

In the waters of the Horn of Africa, pirates are active, particularly in international waters near Somalia.

A Syrian flag. — ART production / Shutterstock

10. Syria

Reason for advisory: terrorism, civil unrest, and armed conflict

The Syrian Civil War has been ongoing since 2011, and according to the State Department, no part of Syria is safe from violence, including kidnappings and the use of chemical warfare, shelling, and aerial bombardment. Hardship throughout the country has increased due to the destruction of infrastructure, housing, medical facilities, schools, and power and water utilities.

Those traveling to Syria should develop a communication plan with family and/or employers before traveling through high-risk areas.

11. Venezuela

Reason for advisory: crime, civil unrest, poor health infrastructure, and arbitrary arrest and detention of U.S. citizens

Ongoing political instability and crisis throughout Venezuela caused the State Department to include the country on its advisory list in January 2019. The State Department ordered non-emergency U.S. government employees and their family members to leave the country.

Political rallies and demonstrations are common throughout Venezuela due to the socioeconomic and political crisis that began in 2010 under Hugo Chávez and has continued under Nicolás Maduro. Demonstrations bring in large police and security forces that use tear gas, pepper spray, water cannons, and rubber bullets against civilian participants. These clashes can also result in looting and vandalism.

12. Yemen

Reason for advisory: terrorism, civil unrest, health risks, and armed conflict

The Yemeni Crisis began with the 2010-11 revolution against President Abi Abdullah Saleh, who led Yemen for more than three decades. The crisis in Yemen has its roots in the failure of a political transition after the revolution that was supposed to bring stability to the country.

Terrorist groups in Yemen tend to target public sites, including transportation hubs, markets, shopping malls, and local government facilities. Employees of western organizations may be targeted for attacks or kidnappings.

13. Central African Republic

Reason for advisory: crime and civil unrest

The Central African Republic Civil War has been ongoing since 2012, primarily involving the government, rebels from the Séléka coalition, and Anti-balaka militias.

Violent crimes are common throughout the Central African Republic, and large areas are controlled by armed groups who kidnap, injure, and kill civilians regularly.

The U.S. Department of State strongly encourages travelers heading to the Central African Republic to appoint one family member to serve as the point of contact for hostage-takers, the media, U.S. and host country government agencies, and members of Congress.

Strange Airline Rules And The Reasons Behind Them

Flying isn’t as simple as it used to be. It’s still one of the safest, quickest ways to get where you’re going, but airlines impose a lot of rules that may seem arbitrary to first-time passengers.

For instance, you’ve probably heard flight attendants tell you to keep your trays and seats in the upright position. You’ve certainly had to endure the latest TSA security protocols. You might have wondered why you have to put your phone in airplane mode — and what “airplane mode” even means.

The truth is, there are good reasons for each and every one of these bizarre requirements. Airlines don’t always have time to explain themselves.

Here are some of the most common rules you’ll have to follow on commercial flights, along with the reasons they exist in the first place.

First, though, a quick word on airline safety. The rules discussed below exist out of an abundance of caution. They’re there for the one-in-a-million incident. You’re far safer on a commercial flight than you are on a train, ferry, or car (and don’t even get us started on motorcycles). According to one estimate, reaching your vacation destination by air is 100 times safer than doing so by car.

Listen To The Flight Attendant’s Speech

It must be lonely to be a flight attendant. When they’re in the spotlight, no one pays attention. Still, they have to give you that pre-flight safety briefing — it’s the law.

In the United States, federal regulations insist that “all passengers are orally briefed by the appropriate crewmember” on key safety issues. Globally, the International Civil Aviation Organization (ICAO) recommends similar briefing materials. The demonstration will cover things like the location of emergency exits, use of seatbelts, and what to do if the oxygen masks deploy.

But what are we saying? You’ve heard all of that stuff before. The good news is that, while the ICAO requires all demonstrations to include the same basic information, it allows airlines to decide how to present that info.

These days, you’re just as likely to get your safety information wrapped up in a much more entertaining package. Airlines are recording high-quality videos, some of them star-studded, to hold your attention while they deliver the boring details. It’s the spoonful-of-sugar approach.

While the pre-flight demonstration doesn’t make for great entertainment, it’s still important, so pay attention. Should something go wrong, knowing what to do with the oxygen mask will be well worth a moment of your time.

Keep Trays And Seats In The Upright Position

What possible difference could an unlocked tray or a reclined seat make during a catastrophe?

Actually, quite a bit. Many airline safety rules are designed to speed up the (highly unlikely) process of an emergency evacuation. An upright seat creates a few more inches of space for the people behind you. If they need to bolt for the exit, those few inches could seriously slow them down. Besides, as CNN reports, if the plane gets a jolt, it’s far safer to be sitting straight up.

That still leaves the question of why we only have to forego our trays and recliners during takeoff and landing. Though airline travel is extremely safe, the accidents that do happen tend to occur during takeoff and landing.

In other words, lean back and enjoy your tray during the flight, but follow the rules when you’re close to the ground.

Open The Window Blinds

When you sit in the window seat, your flight attendants will ask you to make sure the shades are up during takeoff and landing.

Again, this is all about shaving precious seconds off an evacuation. During an emergency, crew members need to see the conditions outside. They don’t have time to open every window.

Keeping the windows open also provides another safety benefit. It makes every passenger into a safety observer at crucial times during the flight.

“There have been cases where passengers have noted technical problems by looking out on the wing or engines for instance. Of course, it happens very rarely,” airline pilot Kare Lohse told The Independent.

Finally, in the rare event that something goes wrong, it’s helpful to have your eyes adjusted to the outside light. Vision takes time to adjust, and if you go from semi-darkness to sudden daylight, you might not see as well for a few important moments.

Of course, there’s another nice reason to keep your shades open, and this one has nothing to do with safety: you might get a peek at a beautiful sunrise to kickstart your adventure.

Put Your Own Oxygen Mask On First

If you’re traveling with children, you might think that you’d ignore this rule in an emergency. After all, it’s parental (or grandparental) instinct to help kids before saving yourself.

Still, this rule is important — and logical. If the cabin loses pressure, there won’t be enough oxygen in the air to keep you awake and lucid. If you don’t put your own mask on first, the lack of oxygen might keep you from being able to help others.

Just how quick does hypoxia (the medical term for low oxygen levels in the body) take effect? At high altitudes, you might have as few as 30 seconds to make a decision before getting confused or losing consciousness. That’s why it’s so important to ensure your own flow of oxygen before doing anything else. Even if you only take a few seconds to place a mask on a child, those few seconds could make a difference.

Again, loss of pressure is very rare, and it’s certainly nothing to worry about. If oxygen masks do deploy, calmly place them over your mouth and nose and try to relax. The pilot will head for an altitude full of oxygen-rich, breathable air immediately.

Put Devices In Airplane Mode

Before your plane takes off, the flight crew will tell passengers to turn off all electronic devices or put them in airplane mode. To some travelers, that seems like overkill. If wireless communications really affected plane equipment, why would airlines offer in-flight Wi-Fi?

And if you’ve ever forgotten to put your phone in airplane mode during a trip, you’ve undoubtedly noticed that your plane did not, in fact, fall out of the sky. However, that doesn’t mean that the regulation is unnecessary.

Commercial aircraft are outfitted with sensitive equipment for navigation, and some passenger devices could potentially interfere with that equipment. That doesn’t mean that your iPhone is a dangerous weapon, but it could be a minor annoyance in some circumstances.

Even if smartphones don’t interfere with equipment, the Federal Aviation Administration would have to test every single phone, tablet, and computer individually before allowing in-flight operation. It’s much easier to tell passengers to turn their devices off.

On a more practical note, your phone won’t be able to get a cell signal in the air, since it will need to constantly connect to new cell towers. Leaving your phone on could conceivably cause issues for cellphone users on the ground, and the practice will certainly drain your phone’s battery.

In any case, you won’t be able to make calls, so go ahead and follow the crew’s instructions.

Meet The Emergency Exit Row Requirements

The emergency exit row offers some extra legroom, so if you like to stretch out when you travel, you might consider snagging one of those seats. Just make sure that you’re qualified for the job. Federal regulations require travelers to be able to locate the exit, comprehend the instructions for operating the door, and, if necessary, open the exit in an emergency.

Passengers in the row must be 15 years of age or older, and they must be able to comprehend the crew’s oral instructions (in other words, if you don’t speak the native language of the flight crew or if you have hearing issues, you can’t sit there). Additionally, if you’re disabled, you use an oxygen tank, or if you’re simply not strong enough to operate the exit, a flight attendant might ask you to choose another seat.

Don’t take that as an insult; they’re required by law to make sure that you’re up for the job. With that said, if you’re capable of handling the task, feel free to sit in the emergency row (and enjoy the extra space). Just understand that you’re taking on some responsibility.

Follow The Liquids Rule

The TSA’s liquids rule is frequently misunderstood, partly because it’s not very intuitive. Travelers can carry on 3.4-ounce containers of liquids, gels, aerosols, creams, and pastes, provided that all of those items fit into a 1-quart resealable bag.

To some, the requirement seems arbitrary. Why 3.4 ounces — why not set the standard at 4 ounces or 3 ounces?

For a time, the rule was 3 ounces. You can blame the metric system for the change, since 3.4 ounces is roughly 100 milliliters, which is the international standard used by the European Union. The TSA’s original guidelines set the limit at 3 ounces but later changed the rule to accommodate international travelers.

If that’s not complicated enough, the TSA allows some liquids in larger amounts, provided that they’re completely frozen when they’re assessed at a checkpoint. The administration also admits that certain products — for instance, toothpaste — could have different standards, but the 3.4 rule allows officers to work more efficiently.

“As you could imagine, taking weight into consideration would be a wrench in the spokes,” the TSA’s official blog notes. “I’m sure the public doesn’t want our officers using scales or conversion charts, etc.”

That’s probably a safe assumption. For more information on the TSA’s liquids rule, check out this page.

Don’t Wear Gel Inserts

If you wear gel shoe inserts, you may have learned about this rule the hard way. For years, the TSA warned travelers to leave their gel inserts at home. The reason? The inserts often contained more than 3.4 ounces (or 100 milliliters) of liquid.

That has changed in recent years, and the TSA’s website notes that gel inserts for shoes are currently permitted (Dr. Scholl would approve). Still, if you’re traveling internationally, you may want to switch to foam inserts to avoid an embarrassing situation during your check-in.

If you’re not willing to leave those inserts behind, try to get a note from your physician verifying that they’re medically necessary. Agents may ask to swab the shoes to check for explosives, but otherwise, you shouldn’t run into any issues.

Show A REAL ID-Compliant State ID

If you’ve flown recently, you’ve probably noticed some strange signs. They tell you that, beginning October 1, 2020, your state driver’s license or ID card must be “REAL ID-compliant” in order for you to board the plane.

Granted, this rule hasn’t taken effect yet, but it does raise some questions. This goes back to 2005, when the U.S. Congress passed the REAL ID Act. This law established minimum security standards for state ID cards. To find out if your state is already compliant with the REAL ID Act, check this page on the Department of Homeland Security’s website.

If your ID isn’t compliant by the deadline, don’t worry. You’ll just have to provide another TSA-approved form of identification.

Flight Attendant Rules Get Really Weird

At this point, you’re probably thinking that many of these rules are unnecessarily restrictive. If it’s any consolation, the airlines save their most obnoxious regulations for their flight attendants.

Passengers see the flight crew as the face of the airline, so many airlines have strict requirements for their attendants’ appearance. Qatar Airways, for instance, doesn’t allow employees to have any tattoos whatsoever, regardless of whether or not those tattoos are visible. Southwest Airlines reportedly doesn’t allow visible tattoos, while Jet Airlines reportedly requires its employees to have “a clear complexion (scars, pimples, and blemishes [are] not acceptable).”

Oh, and if you’re working for American Airlines, be sure to bring your clippers. Their flight attendant guidelines are said to state that “noticeable hair in nostrils and in/on ears or underarms must be cut or otherwise removed.”

Some other requirements are more practical. Most airlines require their flight crew to pass basic fitness tests and maintain a certain body mass index (BMI) in order to work, and shorter applicants are often refused outright, since they won’t be able to help passengers get their bags into the overhead compartment.

The takeaway: passengers might have to follow a few apparently arbitrary rules, but things could always be worse.

Understanding The Rules Before Your Next Flight

Most airline rules make sense, once you understand their intent. They’re also designed to be simple; each day, about 2.6 million people fly, and that’s in the United States alone. Complex regulations wouldn’t serve much of a purpose, since most travelers would simply ignore them.

With that in mind, you shouldn’t obsess about the rules before your next flight, but make sure that you understand them. If you’re traveling internationally, look up the flight rules of your destination country, particularly if you’re traveling with prescription medicine or if you’re planning on bringing any exotic souvenirs back to your home country.

Otherwise, listen to the flight crew’s instructions and enjoy your flight. If you’re doing something wrong, someone will let you know — just don’t expect a lengthy explanation of the rationale behind the rules.

Breakfast On Broadway: A Visit To Ellen’s Stardust Diner

Whenever I visit New York City, I HAVE to have an egg cream. The frothy concoction of soda water, milk, and chocolate syrup is a sweet and fizzy delight and, while it’s curiously free of both eggs and cream, it’s 100 percent full of New York spirit. Truthfully, I can’t even say that I absolutely adore egg creams — it’s not a flavor I’d go for every day — but there’s just something about the beverage that’s so New York that I can’t resist ordering one every time I’m in town. When it comes to getting my fix, I always head to a classic New York establishment: Ellen’s Stardust Diner. It makes a decidedly fine version of the egg cream — and is the perfect spot for a New York stopover.

Ordinarily, diners that exist solely to appeal to the Big Apple’s tourist trade rarely make my list of enthusiastic food recommendations, but while the overwhelming majority of Ellen’s clientele are out-of-towners like me, the diner has plenty of local soul. That’s because Ellen’s is a SINGING diner! And not just the occasional “Happy Birthday” here or there — I’m talking full-on, top-notch, blow-your-hats-off show tunes. Hello, Broadway!

This is a diner staffed by Broadway hopefuls and past performers — and it’s even located on Broadway! Your bacon and eggs (with an egg cream on the side, obviously) come with a side of nonstop artistic production. While you down coffee and buttered toast, the incredible waiters, bartenders, and busboys belt out hits from The Lion King, Les Misérables, and Cats.

I am a rather shy traveler, and the idea of patronizing an establishment that combines food with song would normally make me break out in a cold sweat. The mere thought of karaoke makes me want to vomit, and dinner theaters make me anxious (What if there’s audience participation?!). Introverts, take heart. This is a safe place! You don’t have to sing out your order to get your food! You’re a member of the audience, one who’s lucky enough to have easy access to club sandwiches and Denver omelets. All you have to do is relax, eat, chat with your friends, and enjoy the stunning raw talent letting those show tunes fly.

And fly they do. This isn’t amateur hour. All the staff are on the cusp of getting their big break, and there’s plenty of training behind their powerful pipes. I love how they sing both current and classic Broadway tunes and some slightly lesser-known numbers as well as the crowd-pleasing chart-toppers. It’s a nice combination that keeps the Broadway geeks happy and also ensures that those with a more cursory interest are equally entertained.

In between sets, there’s some cheesy banter between the day’s master of ceremonies and some of the talent/waitstaff. Sure, at times some of the jokes are groaners — but it would be a little disappointing if you went to a singing Broadway diner and you didn’t experience a few moments of corniness. The walls are awash with NYC- and Broadway-themed memorabilia, and all the staff members are upbeat and helpful in between their sets.

But while it satisfied my egg cream craving and allowed me to say that I went to see a show on Broadway (Hey, who cares that it was in a diner?), did Ellen’s measure up to my usual foodie expectations? If it were an ordinary diner with zero singing and nothing but platters of bacon and eggs, it would be average. The food is hot and the menu satisfies with comfort food, even if it’s not particularly inventive. But no one is going to write home about the pancakes or the Reuben sandwich. Are there better, cheaper, more authentic delis and diners and breakfast joints in town? Absolutely. But this is Broadway, steps from Times Square, and Ellen’s may just be the best bang for your buck in an area swamped with chains and tourist traps. Due to its proximity to the theaters, to many tour bus meet-up locations, and to the main tourist strip, it is well positioned to pull people in — it certainly has worked its charm on me! It would never make anyone’s list of best food in the city, but it’s on my list of favorite places to eat.

Maybe I really do like egg creams more than I realize, and I’m just coming back for the tradition. Or perhaps I’m secretly thrilled that I get a “free” Broadway show at 9 a.m. whenever I’m in town. Or maybe it’s that there’s a touch of New York in many of the otherwise ordinary recipes — like the famous rainbow bagel, part of the Brooklyn Pride breakfast platter. And it definitely doesn’t hurt that my visits always seem to correspond with a heavy dose of jet lag following an early morning flight. The corned beef hash has just the right amount of grease and flavor to wake me up, and the constant upbeat performances always have me humming in spite of myself.

Practical Information

This is an ideal spot to start or end a New York City layover and to get a taste of some of the best things the city has to offer: a brief look at Times Square to see the foolishness, a chance to have a bit of a Broadway moment, and the opportunity to slurp an egg cream!
Ellen’s is open seven days a week from 7 a.m. to midnight.
No reservations are accepted, but don’t be dismayed if you see a line out the door. Shortly after we entered the line, we were pulled out to be seated. If you’re with a large group, consider volunteering to be seated in tables for two — there’s a lot more selection that way.
In true diner style, the tables are close together. And naturally, each time I visit, I always have my big backpack with me. Sorry, folks! If you’re in a similar circumstance, be aware you might need to straddle your bag beneath your chair.
Visitors to North America should remember that a tip isn’t included in the bill and usually averages about 15 percent. You’ll also hear the entertainers announce that they’re “passing the bucket” for contributions if you enjoyed the day’s entertainment. The bucket funds cover career-related costs like acting lessons, voice lessons, and headshots.
The menu includes some gluten-free, vegetarian, and vegan options. You’ll pay about $6 for sides and small items; $14 to $17 for appetizers and salads; $16 to $30 for sandwich platters, burgers, and main courses; and $15 to $22 for breakfast (not including coffee). An egg cream will set you back $4.95.

10 Free Museums in London

With its rich selection of world-famous museums, London is a museum lover’s delight. Even the casual visitor is sure to find something of interest. And, delightfully, many of the museums offer free admission to their regular galleries.

Inside the British Museum in London. — Giovanni G / Shutterstock

1. British Museum

The British Museum is dedicated to human history, art, and culture. Numerous galleries on two floors contain a vast collection of art and artifacts dating from the Stone Age to the 20th century. The museum, founded in 1753, was the first national public museum in the world.

Its founding collection of 71,000 books, antiquities, and natural specimens was bequeathed by Sir Hans Sloane, an Irish physician, naturalist, and collector. Since then, the collection has expanded to include over eight million objects. Egyptian mummies, African textiles, Ming porcelain, Greek and Roman sculptures, samurai armor, and European clocks are just a small sample of what is on display in galleries that explore the culture and history of civilizations around the world.

Inside the Natural History Museum in London. — elRoce / Shutterstock

2. Natural History Museum

When Sir Richard Owen, curator of the British Museum’s natural history specimens, became frustrated with the lack of space for his ever-growing collection, he convinced the museum’s board of trustees that a separate building was needed. The Natural History Museum opened in 1881.

Located on Exhibition Road in South Kensington, the Natural History Museum, with its ornate terra cotta exterior, is sure to impress. The Romanesque building was designed by Alfred Waterhouse to reflect Owen’s vision of a “cathedral to nature.” Inside, you’ll find an equally impressive collection of artifacts as you “uncover the history of life on Earth, from the smallest insects to the largest mammals.”

You’ll find fossil trees, a meteorite, gems, a Neanderthal skull, objects melted by lava flow, lichens that live for over 10,000 years, and much more. The tranquil Wildlife Garden, open from March to November, contains thousands of British flora and fauna.

Inside the Victoria And Albert Museum in London. — pio3 / Shutterstock

3. Victoria And Albert Museum

Across Exhibition Road from the Museum of Natural History you’ll find the Victoria and Albert Museum, often referred to as the V&A. It houses the world’s largest collection of decorative arts and design. The V&A started out as the Museum of Manufactures in 1852 and was founded to instruct the public on all matters relating to good design. The museum soon outgrew its space on Marlborough Road. In 1899, in her last public ceremony, Queen Victoria laid the foundation stone for a new building. At that time the name of the museum was changed to the Victoria and Albert Museum.

An 11-meter Chihuly blown-glass chandelier hangs in the main entrance rotunda. Other artifacts found throughout the museum include stained glass, medieval tapestries, a 16th-century harpsichord, sculptures from various periods, ceramics, paintings and drawings, tiled chimneys, Islamic carpets, Leonardo da Vinci’s notebooks, and Shakespeare’s First Folio. A courtyard with a garden café and a lawn area offers a peaceful spot to stop for refreshments.

Inside the Science Museum in London. — Tupungato / Shutterstock

4. Science Museum

The Science Museum is also located on Exhibition Road. Founded in 1857, it is one of the city’s major tourist attractions, attracting 3.3 million visitors annually.

The Science Museum aims to inspire visitors with objects and stories of incredible scientific achievement. Exhibits on four floors offer opportunities to learn about flight, clockmaking, mathematics, genetics, robotics, the history of computing, and the role of steam in propelling British industry.

Although the museum is free, some exhibits, such as the flight simulator, are not.

Inside the National Gallery in London. — andersphoto / Shutterstock

5. National Gallery

The National Gallery in Trafalgar Square tells the story of European art, masterpiece by masterpiece. The National Gallery houses over 2,300 works, including one of the largest collections of paintings in the world. You’ll find Western European works of art dating from the 13th century to the 20th century. Artists with works on display include Leonardo da Vinci, Vincent van Gogh, Paul Cézanne, Claude Monet, Thomas Gainsborough, Rembrandt, John Constable, and J. M. W. Turner.

Inside the National Portrait Gallery in London. — Alex Segre / Shutterstock

6. National Portrait Gallery

Beside the National Gallery, you’ll find the National Portrait Gallery. Portraits in the gallery feature royalty, entertainment icons, and historical figures. Examples include King Henry VIII, Sir Isaac Newton, Shakespeare, Winston Churchill, Judi Dench, Elton John, Malala Yousafzai, and Princess Diana.

The gallery includes more than 11,000 portraits. Of these, about 4,000 are paintings, sculptures, and miniatures, 60 percent of which are regularly displayed. The 7,000 light-sensitive works on paper are displayed on a rotating basis of about 300 items per year to avoid excessive light exposure and minimize deterioration and fading. This means you may see something different with each visit.

The Imperial War Museum in London. — vitormarigo / Shutterstock

7. Imperial War Museum London

The collections at the Imperial War Museum London cover war and conflict from World War I to the present day, focusing on personal experiences and the way conflict has shaped our world. The museum invites you to “see war through the eyes of the people who lived it.”

Displays include weapons, uniforms, a recreated World War I trench, diaries, art, and the world’s largest collection of Victoria Crosses. Visitors discover stories of bravery and explore what it means to be a hero.

Inside the Tate Britain in London. — Philip Bird LRPS CPAGB / Shutterstock

8. Tate Britain

Tate Britain is home to works of British art dating from the 1500s to the present day. It contains the largest collection of works by the celebrated painted J. M. W. Turner. Two rooms are dedicated to the works of sculptor Henry Moore. The Walk Through British Art collection is arranged chronologically by decade, starting with the 1540s. As they stroll through time, visitors can view stunning art and observe the changing styles.

The Tate Modern in London. — Alex Yeung / Shutterstock

9. Tate Modern

Housed inside a former power station, the Tate Modern features international modern and contemporary art. Its collection includes world-class paintings, sculptures, photographs, mixed media pieces, and performance art. Works are grouped by theme, and each display features art from different time periods and by a variety of artists.

The National Maritime Museum in London. — goga18128 / Shutterstock

10. National Maritime Museum

The National Maritime Museum, located in Greenwich, covers the history of exploration by sea. Visitors can view more than 1,000 objects related to the emergence of Britain as a maritime nation in the 16th and 17th centuries, reflect on the legacy of European exploration, explore how human identity has been shaped by our relationship with the sea, and follow Pacific explorers such as James Cook and polar expeditions such as that of Robert Falcon Scott and Ernest Shackleton.

The National Maritime Museum is part of Royal Museums Greenwich, which includes the Royal Observatory, the sailing ship Cutty Sark, and the Queen’s House art gallery, home to a world-renowned art collection. The National Maritime Museum and the Queen’s House are the only two that offer free admission, however.

The list of free museums in London doesn’t end here. Other museums with free admission include the Museum of London, Sir John Soane’s Museum, the Guildhall Art Gallery, the British Library, the Royal Air Force Museum, and the Museum of London Docklands.

10 Amazing Outdoor Getaways If You Love The Snow

This winter has been a weird one…. If it’s not 60 degrees out and raining, it’s sub-zero and sunny. It’s hard to get a real winter vibe when you’re walking around in shorts one day, then hanging out in front of the fireplace shivering the next.

For those who love frolicking in the snow and making the most of winter getaways, there’s no shortage of places you can go to enjoy the last breath of cold air before that spring thaw starts to hit. From viewing the Northern Lights to enjoying the ski slopes, winter doesn’t have to mean giving up on fun and adventure.

Steamboat Springs, CO

How many places can you go that have their own trademarked snow? Steamboat Springs, Colorado has just that – a light, fluffy, effervescent snow called Champagne Powder that experienced ski bums will love! Rub elbows with Olympians and other serious skiers, or head out to do some fly fishing in the morning. One thing to put on your agenda though is Sunset Happy Hour – head up to the top of Steamboat Ski and Resort to view the sunset and the valley while enjoying signature cocktails, tapas and live music.

Sugarbush, VT

Have some pancakes with fresh maple syrup before heading out to shredding the slopes covered in fresh powder. How much more perfect can you get for a winter getaway? Sugarbush, VT is home to all things winter. From snow shoeing, skiing, ice fishing and ice skating, to relaxing apres ski, it’s a veritable winter wonderland, and has been for the past 60 years.

A snowy evening in Duluth, Minnesota. — Lucas Payne / Shutterstock

Duluth, MN

Vacationing in the Northlands of Minnesota is a wonderful way to enjoy the wooded winter getaway of your dreams. Whether it’s enjoying the Nordic pasttimes popular in the area, like snow shoeing, skiing, ice climbing, dogsledding and ice fishing, or relaxing in some of the area eateries and distilleries, you can’t really go wrong. Try out a “hot dish”, one of Minnesota’s iconic casserole dishes, or some of the adult beverages from Vikre Distillery that handcrafts its own gins, vodkas and aquavit with water from the crystal clean Lake Michigan.

New Paltz, NY

Like a castle overlooking a vast frozen lake, Mohonk Mountain House in New Paltz, NY reminds one of a visit to a Game of Thrones set. Nestled in the Catskill Mountains, Mohonk Mountain House is a winter retreat like no other. If it’s outdoor adventure you crave, there are plenty of opportunities to get out in the fresh, albeit cold, air. But the resort has plenty of indoor activities as well. From spas to movies, lectures and live music, the resort gives you plenty of reason to stay inside too.

A skier on the slopes in Big Sky, Montana. — alexfe / Shutterstock

Big Sky, MT

The community that calls itself Big Sky, MT is known not only as a gateway to Yellowstone National Park, but also as being a winter sports haven. Big Sky is home to some of the most skiable land in America, so there’s plenty of room to get your winter playtime in. At Big Sky Resort, you’ll find dog sledding, bungee jumping, snow mobile tours, ziplining and plenty of other winter activities in addition to skiing. And after it’s all done, area lodges offer plenty of opportunities to cozy up with your travel companion and spend your evening with hot chocolate in front of a fire place.

Idllywild, CA

If you love the look of snow, but aren’t all that keen to get out into it, why not head to Idllywild in southern California? Just a few hours from Los Angeles and San Diego, Idyllwild has long been a secret getaway for Hollywood-types. There’s no smog, plenty of seasonal changes and in the winter – snow. Located in the San Jacinto Mountains, there’s also limited development and plenty of natural beauty. The area is known for its artsy culture and mix of ex-hippies, artists and weekend outdoor enthusiasts who love the mix of climbing and hiking available in the area. What you won’t find is skiers. The town has purposefully left skiing out of the mix, hoping to draw in other types of tourism instead.

Fairbanks, Alaska, during the winter time. — FloridaStock / Shutterstock

Fairbanks, AK

Fairbanks, Alaska is not only home to the Iditarod and the World Ice Art Championship, but also to some great views of the Northern Lights. In a place that gets snow from September through May, you’ll find plenty of time to enjoy in winter activities. From August through April, you’ll be able to spot the Aurora Borealis. As the days turn to spring, the days get longer though. From late-April until late-August, the area becomes the Land of the Midnight Sun where you can enjoy 20+ hours of sunlight per day.

Reykjavik, Iceland

Winter is coming! For Game of Thrones fans, Reykjavik, Iceland is a bucket list destination, as it has served as the backdrop for many scenes for the HBO series whose eighth and final season airs in 2019. Beyond its entertainment appeal, the town is an outdoor enthusiast’s dream with glaciers to hike and natural hot springs to soak in.

Nagano, Japan

For those interested more in the beasts, than the birds and the bees, a visit to Nagano, Japan in the winter is a must to catch a glimpse of the Japanese Snow Monkey. At Jigojundani Monkey Park, you may even be able to capture a picture of snow monkeys bathing in hot springs located in the middle of a snow covered mountain. The area also features ice trees during the winter, called Juhyo, as hundreds of covered trees take on the appearance of snow monsters climbing the mountains at Zao Ski Resort. All across the northern part of Japan, you’ll find snow events like Yunishigawa Kamakura Festivals, where snow domes in various sizes are lit with candles during the night.

Patagonia, Argentina

If you can’t get away until April, but you still want the taste of snow, head to Patagonia, Argentina. Located south of the Equator, Patagonian winter runs from June to August instead of December through February. Really, experts say, winter in Patagonia runs from April through September. Here you can enjoy hiking, glacier climbing and hot springs, as well as stunning views from the other side of the world.