Red Rot
Spindle Content Warning A trigger warning before reading further. This article contains graphic descriptions of bodily functions and gore related to disease transmission. It also includes many artistic representations of a disease process on the body which may be triggering and upsetting to some. If you feel uncomfortable or feel this information may upset you, it is best if you do not read further.
Transmission & Vectors
Red Rot is transmitted via tainted water sources. Lakes and coastal regions with high areas of flooding and potential for standing water are the most vulnerable. Because of the constant flooding around the edges of the MegaCities, the water systems are under constant barrage of unsafe water overrunning the flood gaps and other safety measures.
Causes
Algae blooms originally thought to be the continued effects of a Cyanobacterium, the blooms lack the telltale scummy/shiny appearance that accompanies a a bloom. Instead the water appears unchanged, clear or cloudy depending on the general composition of the other flora present.
Moreover, while early detection and symptoms are the similar to a cyanobacteria outbreak, later signs of disease progression are very different and more deadly.
Symptoms
Early Symptoms Description
Early signs of Red Rot appear as a general malaise and paling of the skin, especially around the mucus membranes. Skin appears ashen, the iris pales and looks as if the patient's eyes are covered by a film.
Small markings appearing under the eye, and by the temple. These markings start out as freckle-like in appearance.
Physical symptoms are gastrointestinal upset, nausea, hyperemesis, diarrhea. The patient becomes dehydrated and fixated upon thirst. Patients shy away from treated water, instead returning again and again to the original water source. It is imperative when discovering a new vector to find those in these early stages in order to locate and eliminate the source of contamination.
These symptoms last between twelve and twenty-four hours, beginning four to six hours after ingestion of the contaminated water.
Stage 2 Symptoms
In stage two gastro symptoms abate, many patients feel a sense of calm after the manic need for water in the previous stage. This stage is considered a lull in the disease process, any markings at this point scab over and patients will likely return to work feeling as if their illness has cleared. This is the first time Red Rot is considered contagious. The illness is now transmissible via contact only. Clusters tend to form in this stage and go undetected until the further development of symptoms.
Starting in hour nine of stage two, the irises take on a red/gold tint depending on the originating colour of the patients eyes. Those with blue eyes tend to shift red and are very visibly red within forty hours of the contamination or contact. Brown eyes will present as a gold shift until the red takes over in the iris as well, but the colour shifting to red takes several more hours to present.
Stage 3 Symptoms
End stage Symptoms see a returning of the red shift. Once the patients eyes shift red the next set of symptoms cascade with the freckle like markings spreading along the forehead and under the eyes. They start off brown/gold and turn red as they fill and burst.
Patients experience delirium and become nonsensical as the bacteria attacks along the nervous system. Those who survive do not report pain during this stage, as there is definitive signs of nervous system involvement. Investigations of this stage has lead to the hypothesis that when the bacteria enters the brain it circumnavigates the pain centres and disables them.
Treatment
Treatment outcomes depend where in the disease process the patient is discovered. A relatively simple broad spectrum antibiotic is effective in stage one. However, by the time the patient has recovered from stage one, the bacteria has mutated and other methods are required. A more targeted approach is required, skin collection and other samples are required to pinpoint the sensitivity as variants of red rot are sensitive to different antibiotics depending on vector location.
Stage three is harder still and the survival rate drops precipitously once there is nervous system involvement. Not only are patients delirious during this stage they often become combative as the bacteria attacks within the amygdala and the frontal lobe. Some breathing is suppressed as a side effect of CNS involvement but the bacteria has not been found in the lungs during ant postmortem examination of patients.
Prevention
Clean water sources are essential, and maintaining flood locks and adequate cleaning of water purification equipment is necessary climate change makes clean water difficult to obtain. Off planet water sources must be kept separate and never interact with local water sources so as not to cross contaminate any samples.
Epidemiology
There are three times when outbreaks are possible during disease progression.
- Water sources contaminated with the algae.
- During the lull phase of stage two when patients exhibit a lessening of symptoms and return to daily life.
- During endstage just prior to death while the blisters on the skin break and spread infection through contact.
History
First recorded outbreak of Red Rot off Earth occurred in 425AF. The source of the infection was tracked back to an entire shipment of Water Reclamation tanks from Earth, the built in water purification system was offline for a full maintenance and refit and communities were provided reclamation tanks for the necessary eight week refit.
By the time the source of infection was discovered, 25% of the population had developed second stage symptoms and the ensuing lull caused mass outbreak and panic. Seventy-five percent of the population developed stage one symptoms by week three with fifty-four percent in stage three. Survival rate of red rot prior to outbreak was 82%, and following the outbreak dropped to 14% with mass casualties being reported in every community.
The population of Crescent city at the beginning of 425AF was 568,896, and by the end of August 425 had dropped to 248,768. Whole communities were wiped out, destroyed. Cremation was standard practice but the crematoriums could not keep up with demand and mass disposal and space disposal became necessary to mitigate the spread of opportunistic infections such as cholera and dysentery.
Terran Governments refused to take responsibility for their improper cleaning of the water tanks, and it was suggested by remaining government of Crescent City that it was an intentional act by SpOre in order to take over when every opportunity to purchase controlling interest in the outpost was met with refusal.
Cultural Reception
There is a cross-cultural fear of Red Rot as the disease mostly affects those already effected by the ongoing climate crisis. Those living in climate refugee locations where government inertia has lead to crumbling infrastructure, bribery, and poor health outcomes have higher instances of Red Rot among it's population. Even those who survive an infection once the blisters burst there is scarring which further ostracize victims during naturalization processes.
Very through in this disease description. The lull makes for excellent transmission. I also like how you included climate refugees, who are especially vulnerable.
Adazuri: A shonen-inspired magitech fantasy world home-brewed for 5e.