As more swine flu cases were reported Monday from Mexico to Spain and New York to New Zealand, cruise lines pondered itineraries, airlines shifted refund policies and South Florida travelers debated canceling vacations.

The death toll in Mexico rose to 159, and the U.S. State Department advised Americans to defer all nonessential travel there.

By midday Monday, agents at MK Tours in Miami had handled 40 calls from anxious travelers bound for Mexico, said company president Amelia Calchadora. Most of the people delayed trips or switched to beach destinations elsewhere in the Caribbean, she said.

At Travel Network of Kendall, president Elsa Cristobal said she fielded calls from three families that had requested a vacation and four-day cruise later this summer. "All called today and said they did not want Mexican ports on their trips," she said.

Callers included Andres Garcia of Hialeah, who is set to sail next week with 25 family members on a Caribbean cruise that includes a stop in Cozumel. They're hoping the cruise line will rework the itinerary to avoid Mexico altogether; if not, they may not take the trip, Garcia says. "We have children in our group. Our main concern is our health," he said.

If they cancel, his group likely will lose its trip payments. Several major cruise lines – including Carnival and Royal Caribbean – announced Monday that they will stick with itineraries that include Mexican ports. No cases of the swine flu have been reported on cruise ships.

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