Just as peak summer season was gearing up, Koreatown travel agent Chris Chang began receiving dozens of calls from travelers concerned about an outbreak of Middle East Respiratory Syndrome in South Korea.
MERS, a severe, flu-like illness, was diagnosed in a patient in Seoul last month and has since spread to 138 people and killed 14.
Chang, manager at Hana Tour USA, said the company is still operating its South Korea tours on schedule, but he gives nervous customers the option to cancel. He estimated that 20% to 30% had canceled flights and tours because they feared contracting MERS.
"It's their choice. It has to do with safety, so we're not going to tell them they are or aren't going to get the disease," Chang said.
Despite the anxiety about MERS, health experts say, Americans are unlikely to contract the illness, even if they're traveling to South Korea. All infections so far have been associated with healthcare facilities visited by the original infected patient and haven't spread to the outside community. Plus, numbers of new cases appear to be peaking.
"You're not going to get it," said Laurene Mascola, chief of the acute communicable disease control program for the Los Angeles County Department of Public Health. "Go about your business. Eat Korean food. Visit Korea."
MERS, a virus thought to have come to humans from camels, was first detected in a patient in Saudi Arabia in 2012. Characterized by fever, respiratory problems and kidney disease, it is most likely spread through close contact with infected patients, such as coughing.
A South Korean businessman who returned home from Saudi Arabia last month is believed to have contracted the virus that began the Asian outbreak, the largest ever outside the Middle East.
Since MERS was detected there have been two cases in the United States, one in Florida and one in Indiana. Both patients were infected in May 2014 and had recently traveled to Saudi Arabia and recovered after being hospitalized.
In Los Angeles County, there have been 10 suspected cases of MERS over the last three years, but all were negative, Mascola said.
She said that because of the recent outbreak, airline workers are keeping an eye out for patients with signs of the illness traveling on the six direct flights between Seoul and L.A. each day.
Angel Lee, owner and pharmacist at Woori Pharmacy in Koreatown, said many jittery customers came into her store looking for masks and hand sanitizers in preparation for trips to South Korea. Many told her they had canceled their trips because of the disease; those who couldn't postpone for business or family reasons bought disposable masks in bulk, buying enough for each day they would be there, she said.
"They're asking what they need to bring, what they need to do," she said. "It's worrisome."
Lee said that since last week, the store had sold several hundred masks — the pharmacy normally sells fewer than 10 a year. She said she was concerned about people visiting South Korea and bringing the disease back with them.
Jeff Lee, director at the Korean American Federation of Los Angeles, said the group was forced to cancel its annual trip for second- and third-generation Korean Americans to visit South Korea.
The group of 50 teenagers was set to depart in early July for a cultural and historic immersion program, but when the MERS outbreak began to intensify, panicked parents called in droves to cancel. The parents said their relatives in the country advised them not to send their children, Lee said. When more than 30 families pulled out, Lee said the group had to cancel the trip.
"It was disappointing, but we had no choice," he said.
Dr. Robert Quigley, regional medical director and senior vice president of medical assistance at International SOS, said MERS tends to cause panic because of its similarity to severe acute respiratory syndrome, or SARS, which killed more than 700 people in the early 2000s.
"That really was a scare for many, many countries in Asia and even Canada," Quigley said. He said that though both SARS and MERS are coronaviruses, MERS does not appear to spread as easily as SARS and isn't likely to spread much more than it has already in South Korea.
"We're really not seeing it transmitted in the community," he said. "They're washing their hands, they're wearing masks, they're covering their mouth. Those simple practices … can often be the difference between contracting a viral disease and not."
The U.S. Centers for Disease Control and Prevention does not recommend that Americans change their travel plans because of the outbreak.
Hospitals, which have been given special guidelines by the CDC for screening patients with MERS, are more prepared than ever to handle a disease outbreak because of the recent scares of measles, Ebola and pertussis, Mascola said.
Dr. Hares Najand, an ER physician at Good Samaritan Hospital in Westlake, said hospital staff know that if patients show up with a high fever and respiratory symptoms, such as a cough or pneumonia, they should take a detailed travel history to find out if they recently visited the Arabian Peninsula or a healthcare facility in South Korea. So far, the hospital has had no suspected cases, he said.
"Should the Koreans in L.A. County be worried from people coming back from visiting Korea? No," Mascola said. "Are we prepared to handle a case? Yes."