First Korean teen MERS patient confirmed

Seoul confirmed five more MERS-affected hospitals, one death and 23 more cases Monday, bringing the nation's total number of cases to 87 and the death toll to six.

Among the newly confirmed patients was a 16-year-old, the first Korean teenager to be diagnosed.

The number of cases in Korea is the second most in the world, after only Saudi Arabia, which has reported more than 1,400 cases and 428 deaths since it confirmed the first-ever case in 2012. Following Saudi Arabia and Korea is the United Arab Emirates, which has reported 84 cases and 10 deaths.

Among the 23 newly reported patients, 17 of them ― including the teenager ― were infected at the emergency room of the Samsung Medical Center in Seoul, where they stayed with the 14th patient from May 27-29. The remaining six are connected to the 16th patient, who stayed at two medical facilities in Daejeon ― Dae Cheong Hospital and Konyang University Hospital ― from May 22-30.

The five newly confirmed MERS-affected hospitals are: Im Hong-sub Internal Medicine Clinic (1010-4 Goejeong 3-dong, Saha-gu) in Busan; Cha Min Internal Medicine Clinic (724-2 Hwaseo-dong, Paldal-gu) in Suwon, Gyeonggi Province; New Seoul Clinic (148-5 Anjeong-ri, Paengseong-eup) in Pyeongtaek, Gyeoggi Province; Kyung Hee University Hospital in Gangdong-gu, Seoul; and Konkuk University Medical Center in Seoul.

President Park Geun-hye, meanwhile, visited the headquarters for MERS countermeasures and said the government was putting its best efforts into combating the disease in collaboration with municipal governments, civil experts and volunteers.

Park also announced that she would entrust medical experts on preventive measures against epidemics with full powers so they can make prompt decisions as the current situation progresses.

"We are creating a system where all health care workers can share the names of all affected hospitals and suspected patients," she said. "We are also making sure every suspected patient has a monitoring agent who is responsible solely for that patient."

Park added that experts working with the government should have the full authority in decisions and that "(all) measures, not just the preventive ones, should be carried out at a pan-national and pan-governmental level."

Dr. Kim Woo-joo, who is now the leader of the government's MERS task force, said the primary goal was to research and monitor MERS-affected hospitals. Among 87 confirmed cases, 37 infections took place at Pyeongtaek St. Mary's Hospital in Pyeongtaek, Gyeonggi Province, and 34 occurred at the Samsung Medical Center in Seoul. The cases related to the two facilities account for 81 per cent of all cases.

"South Korea has shown different signs from MERS cases that took place in Saudi Arabia, as it is highly populated and is a country with high-level medical services," Kim said. "So far, all confirmed MERS cases are hospital-associated. By tracing all contacts of infected people and placing them under quarantine, I believe we could bring an end to this outbreak."

On Tuesday, a 16-member joint mission team from the Korean government and World Health Organisation will start its investigation. The team is jointly led by Dr. Keiji Fukuda, assistant director-general for health security at the WHO, and Dr. Lee Jong-koo from the Seoul National University College of Medicine. The mission is scheduled to end on June 13 and a press conference will follow the same day.

"(The team's) planned activities will include: discussing epidemiological investigations into the confirmed cases and infection control, visiting the hospitals that have confirmed cases or are keeping isolated patients, and analysing the characteristics of MERS-CoV in Korea with the Korea Center for Disease Control and Prevention," the Health Ministry said in a statement.

In spite of its latest efforts, both Cheong Wa Dae and the Health Ministry have been under fire for their handling of the outbreak. The government released a list of MERS-affected hospitals Sunday, three days after Seoul Mayor Park Won-soon abruptly revealed that more than 1,500 Seoul residents may had been exposed to the virus. The Health Ministry and Dr. Kim had been standing firm on their decision not to share the names of the affected hospitals until Sunday, claiming doing so could cause "unnecessary fear and stigmatization."

Cheong Wa Dae claimed on Monday that President Park in fact had ordered the authorities to release the names of the facilities on Wednesday, the day before Mayor Park held the late-night press conference to reveal the possible community transmission of the disease in Seoul. However, it was also on Wednesday that Dr. Kim and Hyun Jung-taik, the senior presidential secretary for policy coordination, told reporters that sharing the names of the affected facilities could "cause more harm than good."

When asked if Hyun and Dr. Kim had misunderstood the President's order on Wednesday, presidential spokesman Min Kyung-wook said, "I don't know how (the two) interpreted, but the President for gave out the order (to release the name of the hospitals)."

On Sunday, the Health Ministry had to release the list of the hospitals twice as the initial copy had a number of factual errors. One of the listed clinic turned out to be non-existent. During the regular press conference on Monday, CDC officials could not answer a lot of questions, including how many of the newly confirmed patients were under quarantine.

The nation's first confirmed teenage patient was diagnosed with the virus at the Samsung Medical Center on Sunday. The teen underwent a surgical procedure ― the Health Ministry did not reveal what his pre-existing medical condition was ― on May 28, the day after he was admitted to the hospital's emergency room where the 14th patient was present at the time. His surgery went well, and he is in stable condition, said Jeong Eun-kyung from Centres for Disease Control and Prevention at the Health Ministry.

"We can confirm that the teenager didn't have any lung or kidney-related diseases," Jeong said.

The sixth MERS death was also confirmed Monday morning. The deceased was diagnosed with the virus Sunday, becoming the 84th confirmed patient in the country, and died at Dae Cheong Hospital in Daejeon on Monday morning.

The 80-year-old had been staying as an inpatient at the same hospital since March for pneumonia. He is believed to have been infected from the 16th patient from May 25-28.

The deceased started showing symptoms of MERS on Saturday, just a day before his diagnosis and two days before his death. He had been scheduled to be quarantined at a government-certified facility Monday afternoon, but died at 8 a.m. the same day, as his condition abruptly deteriorated, the Health Ministry said.

The CDC also confirmed that the 76th confirmed patient visited two medical facilities in Seoul prior to being diagnosed with MERS on June 7. The 75-year-old, who was exposed to the virus at the emergency room at the Samsung Medical Center from May 27-28, visited the emergency room at Kyung Hee University Hospital in Gangdong-gu from June 5 to 6 and Konkuk University Medical Center's emergency room on June 6.

The CDC said it hasn't figured out why the 75-year-old patient visited two emergency facilities in two days.

When asked if she had been illegally rejected by the hospitals for having previously been exposed to the virus at Samsung Medical Center, the CDC said that more investigation was needed to verify the facts. Korean law stipulates that any health care worker who refuses to treat a patient without offering a valid reason can face imprisonment of up to five years, or a fine of a maximum of 50 million won ($45,000).

The government is urging those who visited the two Seoul-based facilities from June 5 to 6 to report themselves to the authorities. They can do it by calling 129 (The Health Ministry) or calling the closest of three municipal governments. Seoul government can be reached at 120, Daejeon at 042-120 and the Gyeonggi Provincial government at 031-120.

A total of 1,970 schools, kindergartens and colleges across the country have cancelled classes as of Monday afternoon. Seoul and Gyeonggi Province ordered all education institutions in MERS-affected regions ― including Gangnam-gu in Seoul and Pyeongtaek in Gyeonggi ― to cancel classes.

Also Monday, the fifth confirmed patient became the second to be fully-recovered and discharged. The patient, only identified by his surname Choi, is a medical doctor who treated the nation's initial patient in early May.

"The symptoms weren't as bad as the flu," he said during an interview with the media. "I think the disease isn't something to be too afraid of if one doesn't have any pre-existing health conditions and gets diagnosed early."

To date, the virus has killed 6 people, infected 87 and pushed health officials to quarantine more than 2,500 others. Authorities said June 12 is the last day of the incubation period of those who stayed with and may have been infected by the 14th patient at the Samsung Medical Center's emergency room from May 27-29. "We expect the number of diagnosed patients to decrease after that," said Kwon Deok-cheol, an official from the CDC.

"And we can now say that cases related to the Pyeongtaek St. Mary's Hospital, where the index patients stayed from May 15-17, are less likely to occur from now on."