Authors ResponseAuthors Response to Letter to Editor onCharacteristics and Outcomes of MiddleEast Respiratory Syndrome CoronavirusPatients Admitted to an Intensive CareUnit in Jeddah, Saudi ArabiaAli S. Wahla, MD1I agree with Dr Wiwanitkit that patients with Middle EastRespiratory Syndrome Coronavirus (MERS CoV) often presentwith acute respiratory illness that can progress to respiratoryfailure, with worse outcome in patients with comorbid condi-tions. This has also been confirmed by other investigators.1Although early diagnosis remains important and combinationtherapy with interferon a-2b combined with ribavirin has beenshown to improve survival at 14 days, however, this effect wasnot noted at 28 days.2,3Despite promise from invitro studies,the mainstay of treatment remains supportive. Having said that,our practice remains to have a low threshold to test patientswith symptoms for MERS CoV and to treat patients withMERS-CoV with combination therapy as soon as possible. InSaudi Arabia, as of May 30, 2015, there have been 1016 casesreported with 447 deaths (44% mortality).1Given the relativelyhigh mortality, emphasis should remain on preventing humanto human transmission, especially among health care workers.However, as the recent experience from South Korea showscontrolling the spread of MERS CoV remains challenging evenfor developed nations.References1. Zumla A, Hui DS, Perlman S. Middle East respiratory syndromepublished online June 3, 2015. Lancet. 2015;pii: S0140-6736(15)60454-8.2. Zielecki F, Weber M, Eickmann M, et al. Human cell tropism andinnate immune system interactions of human respiratory corona-virus EMC compared to those of severe acute respiratory syndromecoronavirus. J Virol. 2013;87(9):5300-5304.3. Al-Tawfiq JA, Momattin H, Dib J, Memish ZA. Ribavirin andinterferon therapy in patients infected with the Middle East respira-tory syndrome coronavirus: an observational study. Int J Infect Dis.2014;20:42-46.1Respiratory and Critical Care Institute, Cleveland Clinic Abu Dhabi, UnitedArab EmiratesReceived June 29, 2015. Accepted for publication July 10, 2015.Corresponding Author:Ali S. Wahla, Respiratory and Critical Care Institute, Cleveland Clinic AbuDhabi, United Arab Emirates.Email: aliwahlahotmail.comJournal of Intensive Care Medicine1The Author(s) 2015Reprints and permission:sagepub.com/journalsPermissions.navDOI: 10.1177/0885066615598721jic.sagepub.com by guest on November 16, 2015jic.sagepub.comDownloaded from