What are the Zika dangers for travellers – and the costs of cancellation?

The infection is now being locally spread in Florida by mosquito bites. Simon Calder has contacted the leading operators to the state to get their policies on switching destinations

Cases of locally acquired Zika virus are restricted to small area of Miami (Simon Calder)

As the virus spreads to Florida, this is what you need to know about the risks for travellers - and the options for people who decide to cancel their trips

What is Zika, and what dangers can it pose?

Zika is a mosquito-borne infection caused by Zika virus. It is spread by the Aedes aegypti mosquito, which is present in hot, humid locations. The infection was first identified in the Zika forest in Uganda in 1947. Sporadic outbreaks have occured since then. Since 2015 a large outbreak has been occurring in the Caribbean, Latin America, the Pacific, some parts of Asia and now the US state of Florida. On 1 August 2016, Governor Rick Scott announced another 10 locally transmitted cases of Zika in the state's largest city, Miami.

Only about one in five people who are infected with Zika virus develop symptoms, which include a fever, a rash and aching joints. There have also been isolated links with Guillain-Barré syndrome (GBS), a disorder in which the body's immune system attacks part of the peripheral nervous system. But the most serious concern, in terms of numbers and threat, is when the virus is caught by pregnant women. It may cause microcephaly, a condition where a baby is born with an unusually small head. It is a disability that causes life-long problems. That is why the World Health Organization deems Zika a “public health emergency of international concern”.

For people who are not pregnant and not likely to become pregnant, there’s no significant risk - just take precautions to minimise the chance of being bitten. The mosquito bites during the day, and indoors. To avoid mosquito bites, wear long sleeves and long trousers tucked into socks, and use Deet-based insect repellant on exposed skin. Women should avoid becoming pregnant while travelling in, and for eight weeks after leaving an area with active Zika virus transmission.

Q How significant is the Florida outbreak?

Until now the only cases in Florida have involved people who caught the virus elsewhere and brought it back. Miami is the aviation hub for Latin America and the Caribbean, and it was therefore inevitable that there would be such cases. But now there is local transmission - i.e. someone with Zika has been bitten by a mosquito which has then bitten someone else and passed on the virus. State officials say: "Active transmissions of the Zika virus are still only occurring in the one small area in Miami-Dade County, just north of downtown."

Nearly two million visitors from the UK go to Florida each year. I estimate that upwards of 10,000 people a day will be flying to the state in August.

Public Health England has added the US state of Florida to the list of locations where there is a risk of contracting Zika virus by being bitten by a mosquito.

The organisation has rated the risk as “moderate” (compared with “high” in Mexico, Brazil and most Caribbean islands), and says “Pregnant women should consider postponing non-essential travel” to the state. The key word there is "consider"; for high-risk countries, the advice is that pregnant women should definitely postpone travel.

Q What should pregnant women do immediately?

Talk to their GP. He or she should be able to advise based on the plans for the trip and the very latest information from the NHS. For example, someone planning to fly into Orlando or Tampa and then embark on a fly-drive trip to the north of Florida or the rest of the US may be considered to be at negligible risk. But someone booked to spend a fortnight in Miami could well be advised to postpone or cancel their trip.

If the GP says “don’t go”, get a letter explaining his or her recommendation, which you can then show to your travel company and/or travel insurer.

Q What are the travel companies saying?

I asked the three leading tour operators, who sell package holidays, and the two leading scheduled airlines, for their policies for customers who are pregnant and booked to travel to Florida.

The basic policy for each is the same: if you can provide proof that you are pregnant, you and your travelling companion(s) can switch to another destination without the usual charges.

Thomson says: “Customers who would like to amend to an alternative holiday offered by Thomson and First Choice, and have a doctor’s note confirming they have been advised not to travel to the affected areas due to medical reasons, can do so without incurring an amendment fee.” This also applies to its subsidiary First Choice.

Thomas Cook says pregnant women and their travelling companions planning to travel to Florida between now and the end of the year can have "free amendments to alternative destinations”. Thomas Cook’s customer service team is contacting customers due to travel to Florida to advise them of the situation. For women who are planning on getting pregnant and are concerned about a future holiday booking, the firm says they should call “so that we can support them appropriately”.

Virgin Holidays says: "Customers who are pregnant have the option to amend or cancel their booking free of charge. Passengers in the UK who are due to depart can contact our Customer Service Team on 0344 557 4321 for assistance."

Virgin Atlantic, like its sister company, is offering cancellation as an option. The airline will allow customers who are pregnant to cancel with a full refund, or postpone or change destination free of charge. Customers who are trying for a baby can postpone or change destination (but can't cancel).

British Airways is offering customers “the flexibility to rebook to a non-Zika affected destination of their choice".

Anyone who has booked car rental or accommodation separately - i.e. not as part of a package holiday - may not be able to get a refund for these elements, and should contact their travel insurer. The Association of British Insurers says if a doctor tells someone not to travel to a particular destination, then “most travel insurance policies will cover cancellation costs that cannot be reclaimed elsewhere.” Of course, this is provided that the trip and insurance were bought before the advice changed.

Q What's the advice for couples who are trying to conceive?

They can probably switch destination. For example, Thomas Cook says: “All those due to travel who are planning on getting pregnant and are concerned about a future holiday booking should call us so that we can support them appropriately.”

It’s important also to remember that the UK health authorities are concerned about the possible sexual transmission of Zika, and there’s a warning that men who have been in areas where Zika prevails should not have unprotected sex for a couple of months after they return - or longer if they have any symptoms of Zika.

Q What about other parts of the US?

The Aedes aegypti mosquito is abundant in Florida for much of the year. It also exists in a number of other American states, with a concentration in the extreme south-east. But so far there is no indication of any local transmission by mosquito anywhere outside a small area of Miami.