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The Centers for Disease Control and Prevention (CDC) added the British Virgin Islands, Cayman Islands, Antigua and Barbuda, Turks and Caicos and St.Kitts-Nevis  to its Zika virus travel alert list.

The level two warnings advise pregnant women to avoid travel to the area, and recommend other travelers protect against mosquito bites and practice safe sex.

Other Caribbean islands and territories already on the list include: Anguilla; Antigua and Barbuda; Aruba; The Bahamas; Barbados; Bonaire; British Virgin Islands; Cayman Islands; Cuba; Curaçao; Dominica; Dominican Republic; Grenada; Guadeloupe; Haiti; Jamaica; Martinique; the Commonwealth of Puerto Rico, a US territory; Saba; Saint Barthelemy; Saint Kitts and Nevis; Saint Lucia; Saint Martin; Saint Vincent and the Grenadines; Sint Eustatius; Sint Maarten; Trinidad and Tobago; Turks and Caicos Islands; US Virgin Islands.

The regional outbreak hit the Caribbean’s normally strong tourism industry—a report from travel research firm STR cited it as the cause behind a 3% decline in Caribbean hotel occupancy during the first four months of 2016.

Destinations are working to ensure travelers are properly educated.

In August the U.S. Department of Health and Human Services on Friday declared a public health emergency for Puerto Rico. The declaration will give the nation access to additional support and funding to combat the epidemic, which has risen to over 10,000 cases.

In addition, the Caribbean Tourism Organization is working with health officials to deploy prevention and control measures to both residents and visitors to limit the number of new cases.

Still, Shawn Fitzpatrick, manager of Marlin Travel in Ontario, said Americans shouldn’t rule out travel to the Caribbean. “If you look at the numbers of travelers to the Caribbean that caught the virus compared to the number of total travelers to the Caribbean, the percentage is minuscule.”

Many people infected with zika virus do not get sick. Among those who do develop symptoms, sickness is usually mild, with symptoms that last for several days to a week. People who do have symptoms have reported fever, rash, joint pain, and red eyes.

Current CDC research suggests that Guillain-Barré syndrome (GBS) is strongly associated with zika; however, only a small proportion of people with recent zika virus infection get GBS. Most people fully recover from GBS, but some have permanent damage. GBS is a rare disorder that can cause muscle weakness and paralysis for a few weeks to several months, is very likely triggered by zika in a small proportion of infections, much as it is after a variety of other infections. Most people fully recover from GBS, but some have permanent damage.

Travelers to areas with zika should monitor for symptoms or sickness upon return. If they become sick, they should tell their healthcare professional when and where they have traveled.