Author’s Response to Letter to Editor on “Characteristics and Outcomes of Middle East Respiratory Syndrome Coronavirus Patients Admitted to an Intensive Care Unit in Jeddah, Saudi Arabia”

I agree with Dr Wiwanitkit that patients with Middle East Respiratory Syndrome Coronavirus (MERS CoV) often present with acute respiratory illness that can progress to respiratory failure, with worse outcome in patients with comorbid conditions. This has also been confirmed by other investigators. Although early diagnosis remains important and combination therapy with interferon a-2b combined with ribavirin has been shown to improve survival at 14 days, however, this effect was not noted at 28 days. Despite promise from invitro studies, the mainstay of treatment remains supportive. Having said that, our practice remains to have a low threshold to test patients with symptoms for MERS CoV and to treat patients with MERS-CoV with combination therapy as soon as possible. In Saudi Arabia, as of May 30, 2015, there have been 1016 cases reported with 447 deaths (44% mortality). Given the relatively high mortality, emphasis should remain on preventing human to human transmission, especially among health care workers. However, as the recent experience from South Korea shows controlling the spread of MERS CoV remains challenging even for developed nations.