Health authorities have added eight tropical destinations, including Samoa, to a travel alert about an illness linked with a severe birth defect and spread by mosquitoes.
The rapid spread of the Zika virus has prompted Latin American governments to urge women not to get pregnant for up to two years, an extraordinary precaution aimed at avoiding birth defects believed to be linked to the illness.
A seemingly routine public health problem for countries that are home to a certain type of mosquito has morphed into a potentially culture-shaping phenomenon in which the populations of several nations have been asked to delay procreation.
The updated alert by the Centres for Disease Control and Prevention brings the total to 22 destinations, most in Latin America and the Caribbean, where there have been outbreaks of the Zika virus.
The new locations are Barbados, Bolivia, Ecuador, Guadeloupe, Saint Martin and Guyana; Cape Verde, off the coast of western Africa; and Samoa