“…In contrast to filovirus VHF (23), in LF patients, the profound shock, vascular damage, and hemorrhage in late-stage victims of Old World arenaviruses are not associated with a "cytokine storm." In fact, we (15,35,38) and others (5-7, 27, 39, 40) showed that LASV replication in vitro and in vivo is associated with the suppression of proinflammatory responses, impaired activation of innate immune cells, and delayed cytotoxic T cell responses, contributing to unchecked viremia and fatal outcomes.…”