Ebola interacts specifically with liver cells and cells of the reticuloendothelial system. The lining of blood capillaries are attacked (either directly by the virus or by the cytokine cascade secondary to infection of macrophages). The capillaries start to leak fluids and plasma proteins. Some patients experience intravascular coagulation, and subsequent loss of normal clotting capability. This eventually leads to shock because of low water volume in the body. This also causes a general interruption of tissue oxygenation causing critical organ failure. Clinical shock, once present, is usually impossible to reverse.

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