While mainstream media coverage of the Zika virus has largely faded into the background, agents say that clients who are most at risk of negative side effects -- women who are pregnant or planning to become pregnant -- are still avoiding travel to areas where the virus has been locally transmitted.

In late 2015 and early 2016, Zika was confirmed in a number of countries in the Caribbean and Central and South America. The virus started to make headlines following a February 2016 declaration by the World Health Organization that Zika was a public health emergency, with proven links to serious birth defects. The virus eventually made its way as far north as Miami.

Zika is still present in dozens of those countries (see chart).

"Travelers looking to get pregnant or who are pregnant have to decide if they want to take that risk," said Darcy Allen, owner of Travel by Darcy in Epping, N.H. "I would say, largely, they are picking alternative destinations or making sure they are tested when they get home before trying to start a family."

About the virus

According to the Centers for Disease Control and Prevention (CDC), Zika is transmitted through mosquito bites or sex. It can also be passed from a pregnant woman to her fetus, and it is thought to also be transmitted through blood transfusions.

Most people infected with the virus will be asymptomatic or have mild symptoms, including fever, rash, headache, joint pain, red eyes and muscle pain among the most common. The CDC said symptoms last several days to a week and very rarely cause death or hospitalization.

The virus is particularly problematic for pregnant women. According to the CDC, infection during pregnancy can cause microcephaly, a birth defect in which a fetal brain malformation results in severe neurological defects, including a smaller-than-average head. It has also been linked to Guillain-Barre syndrome, a nervous system disorder in which a person's immune system damages nerve cells, which can sometimes result in paralysis.

There is no vaccine for Zika. According to the World Health Organization, progress is being made toward developing vaccines and therapies, but hurdles remain.

What agents are seeing

Margie Hand, an adviser with Andavo Travel in Birmingham, Ala., said most clients are unconcerned about Zika.

"In general, I don't think it's really affected bookings at all," she said. "I definitely am booking a ton of Caribbean. I think probably the biggest effect on Caribbean bookings has been the hurricanes from last year and availability."

While clients generally are not concerned with Zika, Hand said, the exceptions are those who are pregnant or trying to get pregnant. Within the past two or three weeks, she said, three clients in that at-risk population specifically requested Zika-free destinations.

"For that market, for those who are expecting or trying to get pregnant, that's still something that they think about," she said. "It's still something their doctors are discussing with them."

Angela Pierson, co-owner of Wallace Pierson Travel on Amelia Island, Fla., agreed that most general clients aren't talking about the virus anymore. "It seems like it's just kind of fallen to the wayside for a lot of people," Pierson said.

She speculated that the falloff in media coverage is playing a role in that, as is the resilience of well-traveled clients.

"I think a lot of them realize that our new normal is just a constant state of chaos, whether it's volcanoes going off or acts of terrorism or Zika; there's always something that seems to be happening," Pierson said. "I think people just got to the point where unless they really feel uncomfortable about a destination, if it's something that they wanted to do, we're just not seeing it change their mind."

Gretchen Macknight of Perfect Honeymoons and Getaways Perfected in San Diego, said Zika concerns are "still quite prevalent" among her clients.

"Very possibly, we hear the phrase more than some because a large part of our business is honeymooners and brand-new families," she said.

Agents are largely sending clients concerned about Zika to Bermuda or Hawaii.

To discuss or not to discuss

Legally, agents are under no obligation to discuss Zika with their clients, according to industry lawyer Mark Pestronk, Travel Weekly's Legal Briefs columnist.

"Agents should provide clients with, or have clients agree to, a disclaimer that states that, for health matters at destinations, go to the CDC website," Pestronk wrote in an email. "That discharges the agent's duty, in my opinion."

Some agents said they are still discussing the virus with clients, though.

"I do think it is our responsibility to [bring it up], gently and gingerly, with all respect," Macknight said, adding that she brings it up "carefully" with clients.

"It's not something [like], 'Oh, hey, are you pregnant?' There has to be a bit of sensitivity there," she said. For example, she might ask, "Is Zika anything that you have been concerned about? Are you guys planning on expanding your family anytime in the next couple of years? That is a gentle enough but direct, to-the-point-enough question."

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