Reply to “Statins may decrease the Fatality Rate of MERS Infection”

Since the emergence of Middle East respiratory syndrome coronavirus (MERS-CoV) on the Arabian Peninsula in 2012, there has been a steady stream of MERS cases geographically focused in the Middle East, indicating that either zoonotic transmission from camel to human or person-to-person transmission likely takes place on a frequent basis (1). As reaffirmed by the recent MERS outbreak in South Korea, highly pathogenic coronaviruses are capable of causing epidemics affecting hundreds of individuals as a result of sustained person-to-person transmission in nosocomial settings that can be linked to a single traveler who became an index patient (2). Currently, the best public health strategy to circumvent sustained coronavirus transmission in an outbreak situation is to quarantine individuals who have a history of contact with confirmed cases of MERS. In the most recent outbreak in South Korea, this led to the isolation and monitoring of more than 16,000 individuals, a feat that may not be economically or logistically feasible in future outbreaks (2). Due to the diversity and presence of prepandemic zoonotic coronaviruses in bat populations, we may expect the continual reemergence of highly pathogenic coronaviruses related to MERS-CoV, SARS-CoV (severe acute respiratory syndrome coronavirus), or other CoV strains to be a future risk to global public health (3, 4). There is clearly a need for coronavirus-specific medical countermeasure strategies against these respiratory pathogens, as studies indicate that general antiviral medications like interferon and ribavirin are ineffective in MERS or SARS patients (5, 6)