Visi­tors to S. Korea can (mostly) breathe easy

The Washington Post Sunday - - TRAVEL - El­liott is a con­sumer ad­vo­cate, jour­nal­ist and co-founder of the ad­vo­cacy group Trav­el­ers United. E-mail him at chris@el­liott.org. CHRISTO­PHER EL­LIOTT

The in­fec­tious dis­ease du jour isMid­dle East Res­pi­ra­tory Syn­drome (MERS), a vi­ral res­pi­ra­tory ill­ness that’s leav­ing some trav­el­ers hy­per­ven­ti­lat­ing about their va­ca­tion plans.

For now, the month-old out­break— the largest recorded out­side theMid­dle East— is con­fined to SouthKorean health-care fa­cil­i­ties, which aren’t ex­actly pop­u­lar sum­mer des­ti­na­tions for Amer­i­cans. But, as usual, the fear is spread­ing faster than the dis­ease.

“My hus­band is wor­ried,” re­ports a woman who plans to visit Seoul next month. “But I think if we wash our hands all the time and stay away from hos­pi­tals, we should be fine. What do you think?”

Trav­el­ers can breathe easy: Their chances of con­tract­ing MERSin SouthKorea are min­i­mal. “We do not rec­om­mend that peo­ple avoid trav­el­ing toKorea,” says Lisa Rotz, the as­so­ciate di­rec­tor for global health and mi­gra­tion in the Cen­ters for Dis­ease Con­trol and Preven­tion’s di­vi­sion of global mi­gra­tion and quar­an­tine. “So far, all trans­mis­sion has been within health-care fa­cil­i­ties, so the risk to mostU.S. trav­el­ers is ex­tremely low.”

But med­i­cal pro­fes­sion­als say it’s im­por­tant to mon­i­tor the sit­u­a­tion closely. And if you de­cide to can­cel, it also helps to know your rights.

The CDC pub­lishes up­dates on the out­break on it­sWeb site, at wwwnc.cdc.gov/travel/no­tices/watch/mer­sre­pub­li­cofko­rea. You can also find MERSin­for­ma­tion on the WorldHealth Or­ga­ni­za­tion’s ( www.who.int/csr/dis­ease/coro­n­avirus_WHO) site: in­fec­tions. There is no ev­i­dence so far that this virus is spread­ing in the gen­eral com­mu­nity.

Lowrisk doesn’t mean no risk, notes Robert Wheeler, chief med­i­cal of­fi­cer atOnCall In­ter­na­tional, a travel riskman­age­ment com­pany. If you’re near the out­break, he says, you need to take “se­ri­ous” pre­cau­tion, be­cause there is risk of per­son-to-per­son trans­mis­sion of the virus if you have close con­tact with an in­fected per­son. This could hap­pen if some­one pro­vides di­rect care in the home of a per­son sick with MERS.

“Those with weak­ened im­mune sys­tems, chronic dis­eases and peo­ple of older age tend to be par­tic­u­larly at risk for more se­ri­ous ill­ness and fatality when in­fected, so it is vi­tal for these groups to be con­scious of their sur­round­ings and those they are in con­tact with,” he says.

The prob­lem with­MERSis the un­cer­tainty sur­round­ing it. It’s an in­fec­tious dis­ease es­pe­cially likely to be seen in trav­el­ers, says Joe Alton, a physi­cian and au­thor of the book “The Sur­vivalMedicine Hand­book.” The rea­son: Its area of ori­gin, Saudi Ara­bia, hires skilled work­ers in var­i­ous fields from all over the world.

“These work­ers, if in­fected, re­turn to pass the virus on to their com­mu­ni­ties,” he says. “The cur­rent out­break is trou­bling in that cases are com­ing in clus­ters, of­ten in the same hos­pi­tal. This pat­tern, along with the un­cer­tainty re­gard­ing MERS’s mode of trans­mis­sion, sug­gests that med­i­cal fa­cil­i­ties have not yet for­mu­lated an ef­fec­tive plan to pre­vent spread.”

The pre­cise na­ture ofMERS virus trans­mit­tal isn’t well un­der­stood, says Florence Comite, an en­docri­nol­o­gist based in­NewYork. Whatwe do know is that theMERSvirus has an in­cu­ba­tion pe­riod of five to six days, but that symp­toms can ap­pear as early as two days and up to 14 days af­ter an ini­tial ex­po­sure.

“MERS is be­lieved to spread from an in­fected per­son’s res­pi­ra­tory se­cre­tions; for ex­am­ple, through cough­ing or sneez­ing,” Comite says.

Howdo you pro­tect your­self from MERS? Ron­ald St. John, who founded the travel health and safety site Si­tata, says: the same ways you would min­i­mize your ex­po­sure to any res­pi­ra­tory agent, such as the flu virus. “These in­clude fre­quent hand-wash­ing, cough and sneeze eti­quette, main­tain­ing a one-me­ter dis­tance from some­one who has a res­pi­ra­tory in­fec­tion,” the physi­cian says.

One just as ur­gent ques­tion for trav­el­ers toNorth­east­Asia is howto pro­tect your trip in case the out­break wors­ens. In­sur­ance can help, but you have tomake sure you’ve pur­chased the right cov­er­age. Astandard pol­icy with named ex­clu­sion­s­may limit a claim you have tomake if there’s an out­break. In other words, you can’t can­cel a trip be­cause you’re afraid you might con­tract MERS.

A “can­cel for any rea­son” in­sur­ance pol­icy al­lows you to re­cover a per­cent­age of your trip for any rea­son, in­clud­ing a MERSout­break. But those poli­cies are usu­ally pricey. Travel in­sur­ance typ­i­cally sets you back by be­tween 4 and 8 per­cent of your trip’s pre­paid, non­re­fund­able cost. A “can­cel for any rea­son” pol­icy can cost 10 per­cent of the non­re­fund­able cost, or even more.

If an out­break hap­pens, then air­lines, cruise lines and tour op­er­a­tors­may can­cel their trips. In that case, you should be en­ti­tled to a full, no-ques­tion­sasked re­fund, although some com­pa­nies, no­tably tour op­er­a­tors, will try to per­suade you to ac­cept a credit. Re­fer to the terms and con­di­tions of your pur­chase to see what your re­fund would be. Don’t rely on the ver­bal claims of a com­pany rep­re­sen­ta­tive.

But if there’s a con­sen­sus among health pro­fes­sion­als, it’s that this isn’t the time to can­cel a trip toKorea, orNorth­east Asia. TheWHO­con­tin­ues to ad­vise that travel re­stric­tions for SouthKorea are not war­ranted.

“The risk for a tourist ap­pears to be very low,” says Jeff Goad, an in­fec­tious dis­eases ex­pert at Chap­manUniver­sity’s phar­macy school.

Just stay away from quar­an­tined ar­eas, take rea­son­able pre­cau­tions, buy the right travel in­sur­ance and have a good time.

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