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Author s Response 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 Ali S Wahla MD 1 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 condi tions This has also been confirmed by other investigators 1 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 2 3 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 1 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 References 1 Zumla A Hui DS Perlman S Middle East respiratory syndrome published online June 3 2015 Lancet 2015 pii S0140 6736 15 60454 8 2 Zielecki F Weber M Eickmann M et al Human cell tropism and innate immune system interactions of human respiratory corona virus EMC compared to those of severe acute respiratory syndrome coronavirus J Virol 2013 87 9 5300 5304 3 Al Tawfiq JA Momattin H Dib J Memish ZA Ribavirin and interferon therapy in patients infected with the Middle East respira tory syndrome coronavirus an observational study Int J Infect Dis 2014 20 42 46 1 Respiratory and Critical Care Institute Cleveland Clinic Abu Dhabi United Arab Emirates Received June 29 2015 Accepted for publication July 10 2015 Corresponding Author Ali S Wahla Respiratory and Critical Care Institute Cleveland Clinic Abu Dhabi United Arab Emirates Email aliwahla Journal of Intensive Care Medicine 1 The Author s 2015 Reprints and permission DOI 10 1177 0885066615598721 by guest on November 16 Downloaded from