Foromortem: The Burrowing Death

Foromortem, also known as the burrowing death, is caused by nectrotic ticks that live in the Hool Marshes. While tick bites can be painful, in many cases they go unnoticed until after the tick has burrowed itself under its host's skin. Necrotic ticks eat away at the host's muscle, secreting a toxic ooze which destroys muscle and fat tissue, leaving a subcutaneous trail of black/brown liquid waste under the skin.

Transmission & Vectors

Foromortem is caused by the necrotic tick's consumption of muscle, and fat tissue and the resulting insect waste trapped in the host's system. While individuals with Foromortem are separated from the rest of the community, the disease cannot be spread by shaking hands, hugging, sitting near or next to an infected individual. The disease does not spread through body fluids, though contact with tick waste will cause severe skin irritations.

Symptoms

The area around the initial tick bite will be red and slightly inflamed for several hours. After the tick burrows itself under the host's skin, the area becomes hard and is surrounded by redness. During the first couple days mild swelling or blister formations occurs as the tick searches a place to latch. Transient swellings mark the migratory course through the tissues and are followed by minor swelling and/or blister formations. These marks are most often found on the inside of elbows/knees, on the soles of feet, and around genital areas. The affected areas will be mildly to severely itchy. 3-5 days after the initial bite the tick latches and begins to eat the host's muscle and fat tissue, causing more severe symptoms (see sidebar).

Treatment

This treatment for the burrowing death is the worst thing you can do to an infected person - except for everything else that's been tried.

— Blade

Historically, treatment for Foromortem included amputating infected areas, locating the burrowed tick and burning it while it was inside the infected individual to prevent disease spread. Because these treatments result in a release of diseased fluids, finding an cleric willing to provide this treatment was rare and casualty rates were high. Many infected individuals chose to seek out a viiret rather than endure the medical procedures.
Clerics at the Malarigh Center for Reflection and Refuge have recently developed a prolonged treatment but the members of the swamp community are especially fearful of this disease as the cure requires multiple rounds of treatment and trained supervision every three weeks. As many members of the swamp community actively avoid populated areas, usually for legal reasons, being infected by this disease is particularly problematic.

Prognosis

If left untreated, Foromortem is often fatal. Despite the severity of the disease, the Aaquidae Vitae ritual has increased the likelyhood of complete recovery from this disease.

Cultural Reception

The disease was originally considered a divinely-sent punishment that inflicted the criminals hiding in the Hool Marshes. The recent tensions between Keoland and the Sea Princes have forced the Keoland Royal Army to create a supply line in the marsh region. After several soldiers became infected, finding a cure for the disease has been a high priority.

Player Hooks

An individual from Thornhill has shown early signs of Foromortem. Superstitious members of the community are unwilling and unable to provide assistance. The individual's daughter begs you to either take their parent to the Malarigh Center for Reflection and Refuge, where they could be arrested, or to a cluster of Viirets known for consuming diseased flesh.

Affected Species

• Human

Stage 1 Symptoms

• minor swellling
• blister formations
• area mild to severely itchy
• Inflicted individuals complain of periods of intense pain that appears worse than would be expected from the appearance of the initial irritated area

Stage 2 Symptoms

• The blisters in the initial area turn a brownish-black color, fill with a dark, foul-smelling fluid
• Discoloration, peeling, and flakiness around
• web-like lines of brown/black fluid under the skin, spreading across the body
• Redness and warmth around the webs
• flu-like symptoms including nausea, fever, dizziness, weakness

Diseased Game Mechanics

Any event that causes the infected creature great stress—including entering combat, taking damage, experiencing fear, or having a nightmare—forces the creature to make a DC 13 Constitution saving throw