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Thomson and First Choice have joined Thomas Cook in waiving amendment fees for pregnant women wanting to switch holidays away from Zika virus-affected countries.

Cruise companies including MSC Cruises, Carnival, Norwegian and Royal Caribbean also adopted a similar policy as the head of the World Health Organisation warned that up to four million people could become affected across Latin America.

The mosquito-transmitted virus is reported to be present in 23 countries across the region.

Public Health England and the National Travel Health Network and Centre have urged pregnant women to think carefully about travelling to the affected areas.

Zika has been linked to birth defects in children by causing a form of infant brain damage called microcephaly. There is no known cure or vaccine.  

WHO director general, Dr Margaret Chan, said Zika had gone “from a mild threat to one of alarming proportions”. A Zika “emergency team” has been set up following the “explosive” spread of the virus.

Thomson and First Choice said in a statement: “The Foreign and Commonwealth Office has updated its travel advice for a number of countries in Central and South America, some Caribbean islands and Cape Verde to reflect the health advice of the National Travel Health Network and Centre (NaTHNaC) following a small number of cases of the mosquito-borne Zika virus.

“The Foreign Office is advising people, particularly if they’re pregnant, to refer to the advice of NaTHNaC.

“Customers due to travel with us to Mexico, Barbados, Dominican Republic, Cape Verde, Panama, Colombia, Honduras and Martinique, who would like to amend to an alternative destination, and have a doctor’s note confirming their pregnancy, can do so without incurring an amendment fee.”