hyperruemia

Ruemia is the condition of having detectable levels of Rumavec in the blood. It is associated with being infectious with regard to the Z-virus, although in rare cases such people can be asymptomatic.
Hyperruemia is a serious medical condition where the level of rumavec in the blood is above 8,500 IU/mL if someone has never been infected before, or 25,000 if they have already gone past the turning point at least once. This can cause rumaleptic seizures. The definition is considered more "fuzzy" in those who have undergone the turning point at least once: Close to 100% of those who have not turned before will get a seizure at 12,000 IU/mL. But the correlation is much weaker after the turning point; there is no measurement at which we can see ~100% of chronic infected have another seizure.
Hyperruemia is usually transient, lasting only a week in those who have already had a turning point at least once. If it lasts more than 4 weeks, and it is not currently winter, it is unlikely to go down much without medical intervention and is therefore declared chronic hyperruemia.
All members of Licentia are taught about rumaleptic seizures, so knowledge about them is high compared to the past.

Causes

Anything that can cause an increase in the level of Z-virus in the blood can cause hyperruemia. The most well-known cause of hyperruemia is getting a zeitgabber's saliva in one's bloodstream. While most drastic in non-infected, as the resulting hyperuemia is what causes the turning point marking the non-infected's departure from their past life, a zeitgabber biting another zeitgabber can also cause hyperruemia if the biter has a sufficiently potent level in their saliva.
Not all cases are caused by bites, kisses, or other forms of saliva-contact with zeitgabberim. The level of Z-virus in a zeitgabber's blood can change from time to time. Like with other chronic blood-based diseases, viral load can spike during the winter or times of stress.

Risk Factors

Immunosuppressed infected are at a higher risk of developing hyperruemia and have a harder time getting their numbers down. A case study of a cachaemite-zeitgabber with AIDS who did not stick to his HIV-related treatment found that he had a viral load of 57,000 IU/mL with regard to the Z-virus and 1,015,000 RNA copies/mL with regard to HIV. In spite of this, he did not develop a seizure, although researchers wonder if this is because of his weakened immune system rather than in spite of it. Indeed, rumaleptic seizures are thought to be at least partially caused by immune response.
Different zeitgabberim have different levels of the Z-virus in their saliva. Some are barely infectious, while others have highly concentrated levels that make a mere cough a danger to non-infected. The higher a zeitgabber's viral load in their saliva, the more likely a bite (or kiss) from them is to cause hyperruemia. Salivary viral load tends to correlate with blood-based viral load, but this is not a hard and fast rule.

Treatment

Those whose hyperruemia is so bad that they end up with very frequent seizures undergo mass transfusion. Should mass transfusion fail, they undergo what has been dubbed pillguzzling.
For those with hype-hype or borderline chronic hyperrumemia who are not constantly seizuring but still are at risk of it happening about weekly, treatment is less drastic. Antivirals that work on reverse transcriptase such as entecavir and tenofovir disoproxil have no effect on hyperruemia, as the Z-virus, being a DNA virus, does not use that enzyme. (Hepatitis B, a dsDNA virus, does to some degree use reverse transcriptase and respond to these treatments so this was trialed anyway before being dismissed.) However, pegylated interferon alfa-2b has shown great promise in lowering viral load. With that being said it cannot "cure" the Z-virus any more than antiretrovirals "cure" HIV. The virus will persist, it'll just be at lower levels and those levels will be less likely to rise.

Sequela

Hyperruemia is rare during pregnancy, but when it does happen, it can quickly cause eclampsia. Eclamptic seizures are distinct from rumaleptic seizures, but there is definitely a strong correlation between them. Baseline chronic hyperruemia, however, rarely causes pregnancy complications beyond higher risk of miscarriage.

Hosts & Carriers

One slightly atypical example of baseline chronic hyperruemia is the found of Licentia herself. Zero's viral load has been tested and found to be at a baseline of about 35,000 IU/mL with additional 15,000 IU/mL spikes, but doubts about the test have been raised. She has been noted to get rumaleptic seizures when bitten by someone with a very high viral load, which should only increase her viral load by about 10,000 IU/mL, less than her seizure-less spikes, and the viral load of her saliva falls within the typical range for zeitgabberim without hyperruemia. Further research is needed.

Prevention

Non-infected who wish to take Rumase and do so under medical supervision are unlikely to ever develop this, provided they are not immunocompromised. This is in fact why Rumase was approved in the first place -- without hyperruemia, seizures do not occur upon infection.

Type

Viral

Parent

Rumase-Associated Illness

Children

• chronic hyperruemia
• rumaleptic seizure

Rarity

Common