Ghoulism

A new breed of Vampirism.

...It’s so fun to watch them try to run from you.
The flailing and screaming when she tripped on fallen bricks from ancient, crumbling buildings. Pleading for her fragile life as I neared her, stepping on her already broken ankle. Shrieking. Blood curdling screams echoed through the streets as I bit down on her calf, consuming the supple meat of the young girl, probably barely fourteen. She reminded me of what I could have been, but I was too hungry to care.
She died soon after I began, whether from shock or blood loss I can't say, but only a bloodied skeleton and some of the more distasteful organs remained. The wandering starved can have those. I wouldn’t need to eat again for weeks, but it’s just so entertaining to watch them squirm as you eat them right in front of their eyes.

— Excerpt from Maria Kier's "The Monster Within"

Transmission & Vectors

Unlike standard Vampirism, the transmission of the disease is limited to two sources.

• Being bitten by an existing Ghoul and escaping without being consumed.
• Being chosen by Zinyana, not currently possible as she is dormant and cannot choose new Ghouls.

Symptoms

Contraction

Much like Vampirism, Ghoulism causes intense fevers upon first coming into contact with a particular strain of Vampirism. In addition to fevers, one will experience gory night terrors that cannot be awoken from, as the body shuts down to fight the disease. The fatality rate for the fever is roughly sixty percent. Most from the fever itself, a few from heart attacks caused by the nightmares.
If one survives, there is no chance of returning to their old life. Upon becoming a ghoul there is a feeding frenzy, often making victims of the infected's friends and family, especially given the circumstances of the world at the disease's height. However, there is no stage of remorse for most people. Many make the transition into active ghouls nearly the same day as they turn, but a few experience the normal grief stage and attempt to suppress their urge to feed.

Feeding

The required food is the flesh of mortals, not simply blood. The more one feeds, the more accustomed to feeding the ghoul becomes, eventually relishing every chance to slaughter a mortal being in ever more imaginative ways. One of the more famous ghouls, Samath-Raghul, earned the nickname "The Flayer of Zinyana", upon skinning and eating not only entire survivor camps, but all other members of his own coven.
If one does not feed, there is no dormant state as with standard vampirism strains. One will begin to lose their minds, eventually becoming a starved ghoul, an irreversible state of mindless feeding and wandering. This is the closest a ghoul can come to death without truly dying, but they can never return to a normal state. The longer a ghoul goes without feeding, the more ill and tired they look. If well fed, they look young and healthy, but they never lose their glowing eyes.

Abilities

So long as a ghoul is fed, they enjoy the standard abilities commonly found in fed vampires. Enhanced senses, strength, and agility. In addition, each ghoul is gifted with unique abilities, much like those found in Born Immortal individuals.
An example of a ghoul ability is Maria Kier's "Glamour", an ability that allows her to alter how she is perceived. This was used to great effect to pose as a young survivor and infiltrate survivor encampments, such as the one that eventually became the nation of Denidaria. She also used the ability to cause her victims more fear during the hunt.
Another is Samath-Raghul's nearly unlimited shapeshifting abilities, used for both hunting and utility. Instances of the ability being used are...

• Holding wounds closed using small tendrils.
• Transforming into a writhing mass of flesh and organs in order to scare off purists.
• Transforming into a large creature for quick travel over long distances.

Treatment

Ghoulism cannot be cured, and the only way to not lose yourself to hunger is to eat the flesh of other sentient mortals. After nations had begun to be founded and reformed, it was discovered that blood from normal vampires could be ingested over the course of several cycles in conjunction with bloodletting and infusions to gradually flush the ghoul strain out of the blood, replacing it with more tame forms of vampirism.
As this is not a cure, the vampire still requires blood to survive. Theoretically, the vampire could be weaned off of blood over time, but this has not been tested.

Epidemiology

From AC766, when the disease was created, and AC865, when Zinyana was put back to rest, ghouls outnumbered mortals in every race that fell ill. They began as small numbers of individuals that carried the disease, but were not infected. During riots instigated by Zinyana herself, ghoul populations exploded as people were unexpectedly bitten. The disease spread through major cities as more ghouls were created.
They moved in massive crowds, slaughtering and consuming people, leaving organs and bloodied skeletons in the streets. By the end of the listed period, over 45% of the affected populations were dead, 13% were mortal, 18% of the population was ghouls, and 24% were starved, as competition for fresh corpses was growing stiff.

History

The first outbreaks were in the year AC776, a decade following a literal war between organized crime groups in the streets of several nations, but the epicenter was in the Dendarin Empire, Exia, and Bausable. Zinyana, the mad immortal, had awoken from her induced sleep and began spreading a disease. A modified strain of vampirism that could not be ignored, and required more than just blood to sustain the infected.
The first major attacks were in AC777, centered in the city of Dendora, the capital of the Dendarin Empire on the coast of the Inner Sea. During this attack, the man who would come to be called "Samath-Raghul" would be found in a prison, and was willingly made into a ghoul.
The attacks escalated in severity until the attacks were more common than periods of calm. Most nations of the world fell by the year AC850. Hundreds of ghoul covens would wage war against one another for nearly 40 years before the world showed signs of recovering. In AC887, the city of Sanctuary was founded.
Shortly after, the Purists were founded, and they began hunting down the leaders of these ghoul covens. This destabilized the leadership and chain of command, often causing the covens to fight amongst themselves until few members remained.
Ghoul populations decreased as more purist bases were established in more cities. Eventually these safe cities would become the capitals of many new nations in the world. Many wandering bands of Starved still walk the woods, and there are still active ghouls. Some are serial killers, some raid graveyards, and some act as hired killers to feed, but most have seen treatment to trade Ghoulism for a more standard form of Vampirism.

Type

Magical

Parent

Vampirism

Cycle

Chronic, Acquired

Rarity

Uncommon