The virus enters the body by inhalation of air containing dust contaminated with the urine, feces, or saliva of infected rodents. By an unknown mechanism, the virus enters the circulation and is carried throughout the body, infecting the cells that line tissue capillaries. Massive amounts of the viral antigen appear in lung capillaries, but the antigen is also demonstrable in capillaries of the heart and other organs. The inflammatory response to the viral antigen causes the capillaries to leak large amounts of plasma into the lungs, suffocating the patient and causing the blood pressure to fall. Shock and death occur in more than 40% of the cases.

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