It’s not an official recommendation, but some Northwest doctors, including a University of Washington expert, are warning pregnant patients to think twice about travel to places in the U.S. where Zika virus may spread soon.

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Zika virus hasn’t yet reached the U.S. mainland, but some Northwest doctors already are quietly warning pregnant patients to think twice about travel to places in America where it’s almost certain to spread.

Dr. Kristina Adams Waldorf, a University of Washington expert in infectious disease and pregnancy, said she has counseled more than a dozen patients since January to reconsider trips to locations such as Texas in coming months because of the risk of severe birth defects linked to the virus.

“Knowing what I know about Zika and the frightening degree of fetal injury that we have seen in the scans from the babies in Brazil, I feel obligated to discuss travel history and to think about upcoming travel,” said Adams Waldorf, an obstetrician-gynecologist. “And to ask whether these trips are really necessary.”

Ways to avoid Zika if you must travel

No vaccine exists to prevent infection from Zika virus, which is spread through the bite of infected Aedes mosquitoes and by sexual contact. Pregnant women who must travel to places with Zika spread should take the following precautions:

• Wear long-sleeve shirts and long pants

• Stay in places with air-conditioning or use window screens and doors to keep mosquitoes outside.

• Use insect repellents registered with the Environmental Protection Agency (EPA). When used as directed, they’re safe and effective, even in pregnant and nursing women.

• Treat clothing and gear with the chemical permethrin, or buy items treated with permethrin.

Centers for Disease Control and Prevention (CDC).

Adams Waldorf isn’t alone, said Dr. Scott Lindquist, the state’s epidemiologist for communicable disease. He’s heard about other doctors offering similar warnings to pregnant patients, but Lindquist thinks such advice may be coming too soon.

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“It’s kind of premature,” he said. “I’m much more comfortable to wait and see if we’re going to have any local transmission in the U.S.”

Officials with the federal Centers for Disease Control and Prevention (CDC) have advised pregnant women not to travel to 38 countries and territories where Zika virus is spreading.

Agency officials emphasize that no cases of “local transmission” — Zika virus spread by local mosquitoes — have been reported in the U.S. But they also said the CDC could warn Americans to stay away from places with local transmission in the future.

“It wouldn’t be out of the question for CDC to issue travel guidance for pregnant women pertaining to the U.S. should a ‘hot spot’ for transmission emerge,” CDC spokesman Tom Skinner said in an email.

An analysis published this month by the National Center for Atmospheric Research found that conditions favorable for a Zika outbreak could converge in late spring and summer, putting cities including Houston, Miami and Orlando at high risk for transmission. That’s based on factors that include climate, mosquito populations, air travel from Zika-affected counties and poverty.

A study earlier this year found that about 200 million Americans, more than 60 percent of the population, live in areas of the U.S. conducive to Zika spread.

Texas health officials said that while pockets of local transmission of Zika virus are indeed possible, travelers needn’t avoid the state.

“People should talk to their doctors and be aware of what’s going on with their travel destinations, but there is no reason to avoid making travel plans for Texas,” said Carrie Williams, a spokeswoman for the Texas Department of State Health Services.

Adams Waldorf, a UW researcher and clinician, said she’s had a pregnant patient ask about going to a friend’s wedding in Texas in late May, for instance, and she’s had others ask about various trips this summer. She acknowledged the advice she’s giving is just a precaution.

It may be “a bit of overkill” to recommend avoiding travel to the Southeast U.S. until there’s evidence of transmission, she said. But, she added, she feels an obligation to her patients, who often bring up the issue themselves.

“As an obstetrician, my job is to do everything I can to protect a mother and her fetus from whatever dangers I can,” she said.

Adams Waldorf is also critical of members of Congress, who adjourned for Easter break without voting to appropriate any of the $1.9 million requested by the Obama administration to fight the spread of Zika.

“The lack of funding for Zika will delay critical work in this area, and that’s a mistake,” she said.

Zika virus exploded across Latin America and the Caribbean last year, after being introduced to Brazil. The CDC has issued travel advisories for nearly 40 countries, including the U.S. territories of Puerto Rico, the Virgin Islands and American Samoa.

At least 273 cases of Zika infection have been detected in people who traveled to areas where the virus is spreading and then returned to the U.S., including 19 cases in pregnant women. Six of those were sexually transmitted. An additional 286 cases, mostly local transmission, have been reported in the U.S. territories, the CDC said.

Worry exists because Zika has been strongly linked to catastrophic birth defects, including a severe form of microcephaly, a condition in which babies are born with smaller than normal heads and other devastating problems.

Zika also has been tied to cases of Guillain-Barré syndrome, a condition that causes paralysis.

CDC officials were quick to note that even if Zika reaches the continental U.S., the spread of the virus is likely to remain limited. Conditions here are vastly different from countries that experience wide local transmission, said Skinner, the agency spokesman.

Despite such assurances, one Seattle woman whose baby is due July 3 has been carefully mapping her travel plans to avoid Zika virus. Sarah Rose, 31, said she and her husband, Eric Rose, had planned to return to Nicaragua for a “babymoon” vacation before their child arrives.

When Zika virus started spreading there and across Central and South America, they turned their attention to the U.S., finally settling on a trip to Sedona, Ariz., at the beginning of May.

“I have a friend who gets briefed on Zika, and she said it would be fine,” Sarah Rose said. “We’re already being so careful about everything else, I just couldn’t take the risk.”