Death occurs between days 7-16 from shock. Ebola interacts with liver cells, endothelial cells, and macrophages. The capillaries begin to leak fluids and plasma. Disseminated intravascular coagulation may also occur which depletes the blood of platelets and interferes with normal clotting. The person bleeds out of every orifice, including sites of needle sticks.
Shock is due to low fluid volume in blood vessels.
Tissue oxygenation is decreased, causing multiorgan failure. In addition to severe thrombocytopenia, there is an initial lymphopenia followed by a dramatic neutrophilia with mostly immature cells. Virus is present at high titers in most body secretions, including blood, urine, feces, semen, and vomit. Also present on the skin from sweat. After recovery, the virus can still be transmitted sexually for up to 7 weeks.