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We appreciate the additional information that Dr Harlan has provided and regret that this information was not available to other investigators within the health department at the time our manuscript was prepared. He has described well the difficulties that unintentional carbon monoxide poisoning may present diagnostically, and we concur completely. Nonetheless, once carbon monoxide poisoning is considered, the diagnosis may be made definitely with a rapid and widely available diagnostic test.The point we wished to make, however, was that the delay between the time the first victims were found, soon after 11 AM, and the time the last patient arrived at the hospital, at approximately 9:30 PM, need not have been so long. In fact, patients 3 and 4 were found because one of them had recovered sufficiently to telephone for help. It was not our intention to criticize Dr Harlan or his coworkers, but to point
Wharton M, Bistowish JM, Hutcheson RH, Schaffner W. Carbon Monoxide Poisoning in a Motel-Reply. JAMA. 1989;262(6):772. doi:10.1001/jama.1989.03430060065014
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