Dust of the Dead

Edited by Koray Birenheide and Qurilion

The remaining villagers of Reeside were witnessing a rare spectacle for these days — a big group of riders, approaching the village. Since the Long Death was first noticed here a week ago, the surrounding lands were as if the populace had gone all but extinct. The closest villages were either empty or filled with sick people as well. The only cleric in the area has run away. And now at least three dozen people, armed and wearing sigils of different gods were riding to the village. Most of standing people went out to greet them, but the first one was Seward, the miller's son. Being one of the last infected, he survived the treatment and later buried his father along with three of four his sisters.
— Thank the gods you are here! You can now enter the village, the disease is gone! Many of us are in bad shape, and they need your help. You can have some rest and a meal here. And I will give everything I have, just please help my sister!
The riders, however, did not seem to hurry. At least ten of them broke off in front of the village and rode past it. Others, led by someone in full armour, stopped next to Seward.
— Is this village named Reeside? — The person asking was the leader of the riders.
Other villagers saw Seward, looking slightly confused by the subtly strange voice coming from the helmet, nod.
— Then, please, do not think too poorly of us...
Pair of quiet clicks, and Seward falls with two bolts in his chest. At that moment the whole group charged into the village, swinging swords left and right and shooting from crossbows. Villagers start to scream and run away, but how could they outrun the horses. The last thing that Seward saw, lying on the ground, was how one of his neighbours flared in a blink of the eye along with the horse he tried to escape on. Soon after that, the riders started to gather together on the edge of the burning village. Too soon for someone who was in it for the loot.
— We are done here, Razzira. — The man speaking was old, very old, dozens of years older than all other riders.
The leader turned around, revealing to be a young woman, no more than twenty-five years old. She was holding a helmet, sprinkled with blood, in her hands.
— Good. There are three more villages nearby. The closest of them is named Klostin, barely two miles from here. It will be the next one. Ride out!

The Dust of the Dead, also called The Long Death, is a very rare and infectious disease. It is believed to be mostly caused by the dust in old tombs. Eventually, it turns many infected into bloodthirsty monsters suffering from never-ending suffocation. Few have survived it, usually dying in process of treatment unless aided by powerful healing magic.
There are four stages of this disease, from becoming infected to dying. The chances to be cured are only somewhat decent during the first stage unless healing magic is used. There are no documented cases of successfully healing a fourth stage patient, regardless of who tried to assist in it. The most effective treatment so far is the quarantine and extermination of all infected. That even resulted in several settlements completely wiped out when people failed to detect the disease early on. In the realms of civilized humans, an order of paladins known as the Custodians is the one handling the disease along with the clerics.

Causes

According to Custodian lore, the Dust of the Dead is transmitted via both air and blood. The airborne source of the disease can be both the tomb dust or someone at the first stage of infection. In addition, at the second stage, the blood becomes contagious too. If any of that infected blood gets on an open wound, especially the deep one, the person would likely develop a partial second stage, so-called semi-second stage. The patient would not be infectious for a while but would start developing the second stage symptoms.

Symptoms

The First Stage (Infection): At this stage, the person gets first infected by air. There are no symptoms at first, but the disease starts to spread in the one's lungs. By the end of the first stage, the patient develops a strong infectious cough. It lasts for about a week (10 days).
The Second Stage (Development): The disease starts spreading across the body through the blood, infecting one's internal organs. It starts encrusting the organs, blocking oxygen flow. The infected starts to feel weak and lose weight, their body temperature falls, skin turns pale. The cough becomes more frequent and prolonged, sometimes with the pain in the chest or the feeling of lacking air. This stage is very individual in terms of length, and it can take anything from hours to weeks, about three days on average. Healthier people generally have a more prolonged second stage.
The Semi-Second Stage (Reverse Infection): The infection gets into one's blood through a wound. It acts similar to the second stage, but the lungs are affected simultaneously with all other organs and not before. As a result, someone who gets affected in this way often starts coughing only by the end of the stage. It combines the length of the second stage with an accelerated first stage, usually from 3 to 7 days. Thus, the infected can enter the third stage before developing a cough.
The Third Stage (Suffocation): Bone marrow starts to fail, not able to cope with the renewal of blood cells. The diseased starts to suffocate, and all his organs fail to work properly. The body temperature falls even lower, and the skin's paleness becomes easily noticeable. At this stage, one's immune system and overall health become bad enough for a person to die from it. Usually lasts in terms of days, rarely more than a week.
The Fourth (Last) Stage (Death): At this stage, the person is no more than a living corpse. Their blood lacks the required cells, organs don't get enough oxygen, and they are always suffocating to the point of actual death. Lasts until the patient dies, which usually is a matter of hour unless received proper treatment.

Treatment

There are four ways of treating this disease.

1. The patient can be drowned in water, preferably salt one. The goal is to wash the disease from the lungs before it gets in the blood. The treatment has mixed success, and some patients die in the process. A person may have to be drowned several times to increase the chances of the cure, but that increases chances of his death accordingly. This is considered to be the safest and easiest of all mundane treatments.
2. The patient can be exposed to extreme heat. The disease does not like the heat, so it can die before the patient does. This treatment can work even after the first stage though it is easier and safer to do it early on. It still runs a high risk of death, and almost all patients suffer damage to their internal organs caused by the heat. It is most commonly used when it is too late for drowning or if you have an able cleric with you.
3. It is believed that the strongest clerics are able to directly heal the diseased, especially during the early stages. Yet, it is quite a rare thing to be heard about, so many people do not believe in such a possibility.
4. Blood of the healthy person, should it be injected into a patient's body, can serve as a replacement of his own blood. There are even documented cases of such patients living for several extra months. The suffocation and general illness remain for the whole period though they take an easier form than without the replacement of blood.

Prognosis

Unless cured in time, the diseased always die from suffocation or general illness. There are no documented cases of someone bearing the fourth stage. Yet, many people try to prolong their own lives — or, rather, their existence by using other people's blood. However, they need a lot of blood, and people are usually not so willing to give it away, especially to the infectious. As a result, many people turn into blood-lusting monsters, moving purely out of pain and fear of death.

Prevention

You can't be sure to be protected from this disease if you take a breath where it is present. Covering your mouth and nose with cloth only reduces the risk of being infected, not makes it disappear. The only exceptions are paladins, who are immune to most diseases due to the divine power flowing through their body all the time.

History

The Dust of the Dead is an ancient disease, though its name and treatment vary a lot in different cultures. Short-living races tend to suffer from it more often, being less aware of just how dreadful it really is. It was often a cause of extinction of entire cities, nations and even races throughout the world. The list of famous people who died from this disease has no end, even though they were always first in line for the best treatment. Even many clerics died from it, being unable to heal themselves or withstand the usual procedure. And, of course, no one would even count all those millions and millions of people who have died from this disease.

Cultural Reception

The drowning of Clarence by Geoffrey Wheeler

Most people, especially from cultures that often suffered from the disease, fear and hate it. This attitude concerns infected people as well. In many settlements, a person can be killed by a mob for merely being surmised as a carrier of the Long Death. In other settlements, people would be more kind and just make you undergo a treatment enough times to either kill or cure. In human countries, criminals would be given a chance to avoid punishment by serving in places affected by the Dust of the Dead. Nowadays, this tradition becomes more popular among other cultures as well. For example, grey orcs often make cowards fight the infected ones to death.
If someone is under the suspicion of being infected, they would be usually arranged a meeting with a cleric. It may, though, take quite some time to find a willing cleric with good healing magic, especially in a less settled area. As a result, many carriers develop a second or even a third stage before getting examined. By that moment, many villagers that did not run away may be already infected, and even some that managed to run too.

Type

Bacterial

Origin

Natural

Cycle

Short-term

Rarity

Extremely Rare