The glow from a sun-filled trip to the U.S. Virgin Islands disappeared when two couples returned to Nebraska in January.

Omahan Marcy Kolkman is pregnant with her third child and in her third trimester. She hadn't heard the word "Zika" until after she returned home with her husband, Dr. Paul Kolkman. The virus, which is prevalent in the Caribbean and Latin America, has been linked to an increase in babies being born with brain damage and small heads, or microcephaly.

"I guess I'd say I was freaked out when I heard about it," said Marcy Kolkman, 31. "It's just kind of scary that there isn't anything — very much — known about it."

Her sister Jill Smith of Broken Bow, Nebraska, learned that she was pregnant upon returning from the Virgin Islands — around the time she started hearing about Zika.

Just as scientists admit there's plenty they don't understand about the virus, it's hard to predict the impact the disease will have on travelers and on tourism over the long haul. The travel industry so far reports modest effects from the Zika-virus outbreak in tourist spots in the Caribbean and Latin America.

Local travel agents and national organizations say they are receiving some inquiries and seeing a small percentage of cancellations from people who had booked trips to affected places, such as Mexico, Dominican Republic, the Virgin Islands, Jamaica and Brazil.

The Zika virus makes most people only mildly ill or not ill at all. The main alarm involves an increased number of cases of microcephaly in Brazil since the Zika outbreak there. Scientists are investigating whether there's a tie between Zika and microcephaly.

The disease is largely carried by mosquitoes, although there also have been reports of sexual transmission and infection through blood transfusions.

The federal Centers for Disease Control and Prevention recommends that pregnant women consider postponing travel to affected areas. Colombia and Ecuador have advised women to delay pregnancy for months, and El Salvador has even recommended women there not get pregnant until 2018.

The winter getaway and delayed honeymoon for Jill Smith, a Mary Kay saleswoman, and husband Jack, a large-animal vet, included scuba diving and cliff jumping for the adventurous. Jill Smith snorkeled and did stand-up paddle boarding. Her sister Marcy Kolkman, well along in her pregnancy, did yoga and played sand volleyball. There were seven in their group.

"We were just really enjoying the 80-degree weather every day," Marcy Kolkman said. "I would just say, 'Awesome.' "

The families returned to Nebraska on Jan. 7. The CDC issued an official Zika alert, involving several Latin American and Caribbean locations, on Jan. 15. The Virgin Islands were added Jan. 26 to the list of places pregnant women were advised to avoid.

For Jill and Jack Smith, expecting their first baby, the information about Zika came as an ugly surprise. "I wouldn't call it pleasant news when I found out about it," said Smith, 33.

Marcy Kolkman's husband, Paul, a Methodist Physicians Clinic surgeon, called with concerns about Zika to the Methodist travel clinic, which recommended that his wife get an ultrasound. The clinic also advised that they read through the CDC's information on the Zika virus.

Marcy Kolkman and Jill Smith have had ultrasounds and everything appears to be fine. Their doctors are monitoring them.

"There was a reassurance with that," Kolkman, a pediatric intensive-care nurse who now is a stay-at-home mom, said of the ultrasounds. She has had two since returning from the vacation.

"I wouldn't say we're over the worry," she said. "There still could be something. I'm still not feeling 100 percent in the clear."

Jill Smith recently had an ultrasound and her baby, now about 11 weeks along, looks good.

"I'm just going to trust that I'm in good hands," she said. "I'll say God's hands."

Sharalyn Steenson, a doctoral student at the University of Nebraska Medical Center, intends to go to Nicaragua, another Zika-affected country, next month with a group of students and faculty members.

"I think there's always that concern about the unknown," said Steenson, 33. Nevertheless, she said, she has no plans to get pregnant in the next couple of years and is eager to make the trip.

Area travel agents say they have heard from some clients but haven't been deluged with calls.

"There are a few that we have had that are pregnant, and they have canceled," said Michelle Holmes, general manager of Travel and Transport in Omaha. "But it's few and far between."

Christine Vogt, director of Arizona State University's Center for Sustainable Tourism, said the finding of a sexually transmitted Zika case two weeks ago in Texas is "alarming, because now it's not just about pregnant women" being at risk.

"And for some, travel will be canceled or postponed because the risks outweigh the benefits," Vogt said.

She said the Zika virus outbreak in Brazil may have a strong impact on the Summer Olympic Games in Brazil this year because Brazil already was straining over preparations for that huge international event.

For those considering trips to the Caribbean and Latin America, "I'd say 'Stay on top of the news,'" Vogt said.

Travel Leaders Group, a large American travel agency company, said Monday it surveyed more than 1,100 of its travel agents early this month and found "the vast majority" of clients are continuing with their original travel plans to destinations with confirmed cases of the Zika virus. Just over 20 percent of agents indicated that six or fewer clients had canceled their travel plans.

Clients in their 20s and 30s were the most likely to have canceled a vacation or altered plans.

National AAA said travel agents are seeing some people alter itineraries or push vacation dates back. But those considering a vacation this year could benefit, AAA said, because travel providers are responding to concerns by cutting prices, in some cases considerably.

Jennifer Michels, a vice president with the Virginia-based American Society of Travel Agents, said her organization early this month had a meeting in South Carolina and Zika was the buzz. "They're starting to see some concern from American travelers. They're starting to see members cancel trips."

This comes, Michels said, during a vacation season for which the travel industry has high hopes.

Julie Imgrund, owner of Bellevue Travel, said as of early February that she had only one cancellation involving Zika. The travel industry endures coups, tsunamis, terrorist threats and attacks, and other diseases, such as the 2003 global outbreak of severe acute respiratory syndrome, she said.

"There's so much of it that's out of your control that you just sort of have to have a thick skin on it," Imgrund said. "So we just have to roll with it."

The UNMC group, part of the Student Alliance for Global Health, plans to send more than 35 students to Nicaragua and more than 25 to Jamaica next month.

Nobody has dropped out of the planned trips, said Sara Pirtle, adviser to the group.

They intend to stay on top of CDC and World Health Organization recommendations about Zika.

The students expect to administer vaccinations against various diseases and perform fluoride treatments in Nicaragua. Steenson, a student in the College of Public Health, hopes to put together a report on mosquito infestation and mosquito control in that country.

Dr. Armando De Alba, an instructor in UNMC's College of Public Health and a supervisor on the trip to Nicaragua, said it's a chance for the students to observe and participate in a public health situation.

They will learn from it, he said, and carry their findings into the future.

Contact the writer: 402-444-1123,


Pregnant women in any trimester should consider postponing travel to areas where Zika virus is prevalent. Keep up to date on what areas are affected.

A pregnant woman who does travel there should consult her doctor and strictly follow steps to avoid mosquito bites during the trip.

A woman trying to become pregnant or who is thinking about it should talk to her doctor before traveling to those areas and follow steps to avoid mosquito bites.

Insect repellent is safe and effective. Pregnant women and women who are breast-feeding should choose an Environmental Protection Agency-registered repellent and use it according to its label.

To avoid being bitten by mosquitoes, the Centers for Disease Control and Prevention also recommends wearing long sleeves and long pants, staying in places with air conditioning or that use window and door screens, reapplying repellent as directed, avoiding applying spray repellent on skin under clothing, applying sunscreen before repellent.

Those who have babies or children should avoid using repellent on babies younger than 2 months of age. They should cover cribs, strollers and carriers with mosquito netting. They should not apply repellent to a child's hands, eyes, mouth or irritated or cut skin.

To apply to a child's face, an adult should apply it to his or her own hands, then apply to the child's face.

Treat clothing and gear with permethrin or buy items treated with permethrin.

Sleep under a mosquito net if you are vulnerable or outside.

Check for the latest developments.

Source: U.S. Centers for Disease Control and Prevention

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