In late stages of infection MARV particles can be isolated from nearly every organ [12, 14, 130, 194, 208] . Despite high viral load and necrotic lesions, only minor inflammation is observed in infected tissues and organs, indicating a dysregulated immune response [8, 14, 41, 194] . Strong liver pathology is observed, including increased serum activity of liver enzymes. This might influence synthesis of clotting factors and contribute to the observed coagulation defects in MVD [12, 41, 130, 194] . These factors together with systemic virus replication and associated pathology probably trigger the multiorgan failure associated with fatal cases.