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Medusa's Ugly Head Again: From SARS to MERS-CoV

Trish M. Perl, MD, MSc; Allison McGeer, MD; and Connie Savor Price, MD
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This article was published online first at www.annals.org on 28 January 2014.

From Johns Hopkins University School of Medicine and Bloomberg School of Public Health, Baltimore, Maryland; Mount Sinai Hospital, Toronto, Ontario, Canada; and University of Colorado School of Medicine, Denver, Colorado.

Potential Conflicts of Interest: Disclosures can be viewed at www.acponline.org/authors/icmje/ConflictOfInterestForms.do?msNum=M14-0096.

Requests for Single Reprints: Trish M. Perl, MD, MSc, Department of Epidemiology and Infection Prevention, Johns Hopkins Medicine, 600 North Wolfe Street, Osler 327A, Baltimore, MD 21287-5425; e-mail, tperl@jhmi.edu.

Current Author Addresses: Dr. Perl: Department of Epidemiology and Infection Prevention, Johns Hopkins Medicine, 600 North Wolfe Street, Osler 327A, Baltimore, MD 21287-5425.

Dr. McGeer: Mount Sinai Hospital, Microbiology/Room 210, 600 University Avenue, Toronto, Ontario M5G 1X5, Canada.

Dr. Price: Denver Health and Hospital, MC-4000, Denver, CO 80238.

Ann Intern Med. 2014;160(6):432-433. doi:10.7326/M14-0096
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In this issue, Arabi and colleagues report a case series of severely ill patients infected with the Middle East respiratory syndrome coronavirus. The editorialists comment on the report and emphasize the need for transparency and collaboration in the scientific community to identify optimum management and prevent a pandemic.

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Two Heads Are Better Than One
Posted on June 11, 2014
James F. Burris, MD
Department of Veterans Affairs, Washington DC
Conflict of Interest: None Declared
A recent editorial (1) that referenced the ancient Greek myth of Medusa in its title but not in its text discussed some similarities and differences in the SARS and MERS-CoV coronaviruses. Medusa, one of the Gorgons, had writhing snakes instead of hair and a face so terrifying that it turned to stone anyone who looked into it. She was slain by Perseus, who avoided looking into her face by watching only her reflection in his mirrored shield.

A perhaps even more apt classical allusion for the challenges posed by these two coronaviruses (and perhaps others yet to come) is the Lernaean Hydra. This somewhat reptilian beast had multiple heads, and each time one was cut off two more grew in its place, making the monster progressively more dangerous the more it was attacked. One of the Labors of Hercules was to slay this beast, which he finally accomplished by cauterizing each neck with a torch after cutting off its head. We may need the clinical equivalent of a lightsaber to meet the challenges posed by the many-headed coronaviruses.

Classical allusions become more and more hazardous both to the one who alludes and to the audience as fewer and fewer of us have had enough of a classical education to carry the old myths around in our working memory, but they can still serve to make a point and enliven a text.

James F. Burris, MD
Washington, DC

1. Perl TM, McGeer A, Price CS. Medusa’s Ugly Head Again: From SARS to MERS-CoV. Ann Intern Med 2014; 160: 432-433.
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