While we were unable to monitor cardiogenic shock, increased cytokine levels in heart and lungs from infected hamsters (Figure 7, Figure S1) and humans [11], [41] including elevated levels of TNF α and IL-6, which both suppress myocardial function [44], [45], and IL-12, which has been associated with myocarditis in mice [46] support cardiac depression in HPS. This evidence concerns the gene TNF and depressive symptom measurement.