Scaleskin
Scaleskin is an ancient diease originating during the War of the Dragons that would cause the skin of humans and dwarves to break up and harden into scales before painfully flaking off layer by layer. Not only was the disease extremely debilitating; the skin scales would remain airborne and get breathed in by nearby caretakers and infect them as well. This chance of spreading provoked a long period of paranoia both by clerical staff to be around their patients, and by others to be around healers that might be themselves infected. During the long, brutal years of the War of the Dragons, this distrust severely hampered efforts to keep armies healthy.
Halfway through the war, rumors that the dragons had magically developed the disease and set it upon humanity purposefully were proven. Not only had it been developed to limit the manpower the gods could deploy in their fight against the dragons; it had been specifically designed to provoke that distrust and limit the staying power of armies, which helped prolong the War of the Dragons for as long as 27 years. All humanoid species were equally susceptible to it, except for goblins. However, goblins were not yet part of urban society, and did little to take advantage of their immunity to help the other species. It took centuries for cultural trust in clerics and doctors to return, and various other plagues and diseases swept over and ravaged the world in the meantime far more than they would have if healers were a more common and respected occupation.
After the disease was proven to have been designed by the dragons as a preliminary act of war, there was no longer any chance of peace with dragonkind. The humanoid races resolved to eradicate dragons off the face of the world entirely, and for the most part succeeded. By the end of the War of the Dragons, very few remained deep in hiding, and dragon slayers, now the highest of heroes, continued to hunt down and wipe out their numbers bit by bit.
Even a thousand years later, Scaleskin disease still plagues the world. The dwarven citadel of Almira collapsed in 41 AD from a major outbreak of the disease. Tens of thousands died of the disease directly, and another hundred thousand died from the resulting collapse of the citadel. Luckily, however, scaleskin is significantly more rare than it once was, and very few large outbreaks of the worst disease the world has ever seen have occured since the world died and regional travel plummeted.
Transmission & Vectors
Scaleskin is primarily transmitted through infected airborne skin tissue that flakes off the infected.
Symptoms
In the first few days of an infection, bits of skin, often in inconspicuous areas, begin to turn to scale and flake off. In small quantities, the disease is not very painful or noticable, but the scales that flake are still contagious. Most of the disease spreads during this period, before the victims have realized they have gotten the disease and are spreading it to others.
Over the course of the next few weeks, the scales begin to cover all across their skin, resulting in widespread pain across the entire body. Layers of scaleskin flake off, resulting in temporary pain relief before the next layer of skin starts breaking out in scales as well. After a week or two, the skin has mostly flaked off, and the process continues into muscle tissue. Victims can barely move once it has taken hold across the majority of their body due to the pain resulting from moving parts of the skin that have turned to scales. Even breathing becomes a laborious act.
Treatment
There are two main cures. The most readily repeatable one is cleaving off and burning infected skin along with a few deeper layers that may have already gotten infected. This is, of course, very painful, and is sometimes done by burning the scaleskin while still attached, to help prevent more from getting into the air. If caught early, patients can be entirely cured with only some deep scars to show for it. More infected patients may see amputations or lifelong disruption of body function occur, but can still be cured if thorough enough physical removals are performed. However, due to the degree of contagion, there are usually far too many patients for the number of healers available, and removals are often too shallow or incomplete, or there simply isn't enough time or energy to help everyone.
The second option is to use magic to cure the disease, letting divine healing energy sweep across the body to purge the disease. While effective, this does nothing to help the body build up a resistance to the disease, and patients cured this way are likely to just get infected again. Additionally, magical curing like this is incredibly draining on a healer's psyche, and there are only a few people they can help this way in a single day. Depending on the location, this magical healing was sometimes reserved for the most important individuals, decided by the whim of the cleric, or given out by random lottery. Clerics often had to make the difficult decision whether to heal themselves or someone else, or maybe get on a short schedule where they only healed themselves every few days, inadvertently helping to spread the disease further.
Prognosis
Without external assistance to remove infected tissue, scaleskin is a highly lethal disease, with chances to survive it only around 15%. With total removal of infected tissue, it is possible to completely cure a victim of the disease, though they remain susceptible to future reinfection. People can build up immunity over time to the disease if it stays in their system long enough, but by then permanent debilitating damage to the body has usually occured, unless the disease is carefully managed for weeks to avoid breaking out too strongly. While physical removal is almost as damaging to the body as the disease itself, survival rates jump as high as 95%. It is only when the outbreak has spread so much that the healthcare systems of a city are stretched to their limit that survival rates once again begin to plummet, usually to around 40% chances of survival as long as at least occasional purges of the disease are performed. Unfortunately, even that cannot be guaranteed during the height of an outbreak, and mercy killings become common, both to end the suffering of the infected and to limit the volume of infection the healers have to manage.
Prevention
The most effective way to prevent the disease from spreading is to quarantine the infected and healers indoors a few buildings away from the healthy. Their is no known permanent cure for the disease besides letting it run its course and let the body build up a resistance to it directly, though in small outbreaks scaleskin can be effectively fought with magical curing spells. Though uncommon in the modern day, in the years of the War of the Dragons, entire buildings full of the infected were sometimes suddenly set ablaze, sacrificing the few to save the many tens of thousands still alive and healthy. Healers were not trusted to be free of the disease, and were usually just as avoided as those that were sick, even years after the last scaleskin outbreak in a region.
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