The Ruby Fever

Fortunately, Ruby Fever appeared only once in the history of Mirintha and was eventually eradicated through the combined efforts of all affected peoples. Over the short period of time it roamed the Elysarian continent, it took thousands of lives. Although the following accounts do not constitute a medical work, the events surrounding Ruby Fever should be documented for posterity.

Transmission & Vectors

Ruby Fever was transmitted through blood as well as other bodily fluids. This made the fever highly infectious and led to a rapid spread across Elysaria. Borendal, however, remained unaffected by Ruby Fever. The fever spread at a blistering pace, especially in densely populated areas.
The disease was highly contagious even at the onset of the first symptoms. The fact that the initial signs could easily be mistaken for a simple cold facilitated the early spread of the fever.

Causes

The cause of Ruby Fever lay in a tragic accident. In the 2nd Age, the Kerdil experimented with magical artifacts.
At this point, we would like to briefly remind the reader of the core of these experiments. The Kerdil took everyday items, which outwardly did not differ from their non-magical counterparts, and imbued them with magical properties using runes.
Among these artifacts was the "Heart of Eternity," an inconspicuous pendant that was supposed to lead to extended life through blood magic. The detailed explanation of the heart-shaped amulet's functioning, which was crafted from a flawless ruby, would go beyond the scope of this text but can be found in the corresponding work if interested.

The Heart of Eternity

Such a beautiful trinket ... maybe replicate it?

In the year 723 of the 2nd Age, the amulet was lost. It reappeared only in the year 218 of the 3rd Age but was not recognized as such. Through an accident, the magically charged ruby shattered, releasing its powers. Because the ruby was destroyed rather than properly used, its abilities reversed, leading to Ruby Fever.

Symptoms

Early Symptoms:

The infected experienced high fever, chills, and severe fatigue. Their eyes became bloodshot, and their skin developed a rash with a ruby-red appearance. This initial phase lasted about ten days.

Advanced Stage:

As the disease progressed, the infected began to bleed from their eyes, nose, and mouth. They suffered from severe internal bleeding, leading to organ failure. These advanced symptoms lasted approximately five days and ended as abruptly as they had started.

Behavioral Changes:

In the last three to five days of the terminal stages, the infected became delirious and aggressive, attacking others and thus spreading the disease even more rapidly. They were therefore often been contained during the advanced stage.

Attention! Graphic display of blood!

Drawing of a patient with Ruby Fever in the second stage

Poor souls, that doesn't
look good ...

Treatment

Ruby Fever could not be treated until the very end. Healers were only able to alleviate the symptoms in the second stage of the disease using herbal mixtures. The fever could be reduced and bleeding lessened, though not completely stopped. In the third stage, affected individuals were restrained to their beds, if possible, to prevent the spread of the disease and attacks on healthy individuals.
Ultimately, the pandemic was brought under control through the combined efforts of the affected peoples, and the fever ended as suddenly as it began. During the search for a cure, an ancient document from the First Age, The Song of Life was found in the Great Library of Sifa. The detailed circumstances regarding the discovery of the document and the accompanying processes would diverge from the topic here. Therefore, it is only mentioned that the "Song of Life" ultimately led to the end of the pandemic.

I really need to check out that library. Soon!

Prognosis

Ruby Fever had a mortality rate of 100%, with most victims dying within three weeks of the onset of symptoms. A cure could not be found, despite the efforts of mages and healers from all affected peoples. The only survivors of the Ruby Fever were those not infected at all.

Affected Groups

Ruby Fever did not discriminate in its victims. All social classes, genders, and age groups were exposed to the pandemic. However, due to various external circumstances, some cultures or species were more or less affected.
Due to their relatively isolated way of life, the Seramkerdil were hardly affected by the fever, as they had little contact with the outside world and still maintain this isolation. Their relatives, the Bukitkerdil, were also minimally affected due to their small settlement sizes and reclusive lifestyle at the time.
The entire eastern continent of Mirintha remained nearly untouched, as there were hardly any shipping routes between the two continents at that time. Consequently, the Kadal, primarily residing in Borendal, suffered almost no losses. Due to its effects on the blood of the infected, the Augalai were immune to the fever. It appears that the composition of the Augalai's life fluid is different enough from that of other humanoid species to render them unaffected.
The most affected were undoubtedly the Valo and Vajoperi, as they already had an extensive trade network and numerous large settlements, which facilitated the spread of the fever.
Since the Vodnik retreated to their underwater cities shortly after the disease became known, historians assume that the losses among this people were also relatively low. However, as there has been no contact with them to this day, these assumptions are unreliable, and it is possible that the entire population fell victim to the fever despite these drastic measures.

Hosts & Carriers

The fever was transmitted between different species but had no effects on the animal world. The less humanoid a species was, the less susceptible it seemed to be to the fever.

Prevention

The only way to avoid Ruby Fever was isolation. Since the fever was fortunately not airborne, this measure proved to be extremely effective. As a solution many of the infected were put into

Epidemiology

Ruby Fever was primarily spread via trade routes. Infected individuals in the early stage quickly carried the fever from one city to the next, where it spread rapidly due to the often cramped living conditions.
Given its magical origin, it is now hoped that we will not experience such a catastrophe again.

History

As previously mentioned, Ruby Fever occurred only once in the history of Mirintha. This happened in the year 218 of the 3rd Age. As a consequence of Ruby Fever, the populations of the Valoperi, Vajoperi, and Tilki drastically declined, but they managed to recover in the following centuries.
The most significant consequence of the pandemic was undoubtedly the disappearance of the Vodnik, if one can call it a disappearance. Fearing that their already sparse population might be wiped out by the fever, the Vodnik took a radical step. They utilized their ability to breathe underwater and abandoned all settlements on land. The entire population retreated to their underwater cities. Since then, the Vodnik have not been seen on the mainland of Mirintha. Their cities on the continental mainland have since been occupied by the Vajoperi, and as the reader surely knows, the two islands are now firmly in the hands of pirates.

To where did they disappear?
Will they ever come back?
Some way to contact them?

Cultural Reception

To counter the spread of Ruby Fever, strict quarantine measures were implemented, as previously mentioned. Infected individuals were taken outside the cities and lived in improvised tent cities. The affected were both pitied and feared, resulting in only a few volunteers willing to care for the sufferers. The fear of personal infection was too great.

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TLDR for my players

The Ruby Fever was a magically induced pandemic that swept across Mirintha in the year 218 of the Third Age and killed large parts of the population on Elysaria.
The disease was eventually defeated by means of the Song of Life.
As a result of the pandemic, the Vodnik retreated from the Earth's surface and have not been seen since.