Post by Catsmate on Nov 25, 2019 11:01:23 GMT
Another odd disease with which to vex players.
Between late 1916 and 1925 more than five million people around the world started displaying odd symptoms of a new disease, one that disappeared a few years later and, except for rare cases in later decades, hasn't been seen again. It had, and has, no cure and no known cause or vector.
In six years about two million died, a death toll overshadowed by the 'Spanish 'flu' and the horrors of the Great War.
Known to scientists as Encephalitis lethargica the disease effects the brain, leaving people speechless and immobile, in "a statue-like condition" but aware of their surroundings; as passive as zombies, hence the name "sleepy sickness"1. While many of the infected recovered, most didn't recover fully with lingering neurological effects that left them passive and lethargic. The condition is also linked to a form of Parkinson's disease in later life.
The first cases were detected almost simultaneously in France and Austria, with Dotors Constantin von Economo and René Cruchet publishing details of the disease within days of each other, early in 1916. Later research suggests the first cases emerged in Romania2, then part of the Austro-Hungarian Empire, in early 1915 with the disease spreading through the troop movements of the Great War. The first cases were found in Vienna in late 1916, reaching epidemic status in 1917, with cases in France emerging about the same time. It was epidemic in France and England in 1918 and had overrun most of Europe in 1919 and spread to North America, Central America and India.
The peaks of encephalitis lethargica occurred in 1920 and 1924 and subsequently dropped off sharply.
Symptoms and effects.
The onset of encephalitis lethargica usually presents as a gradual onset "flu-like symptoms"; weakness, general malaise, aches, low-grade fever, pharyngitis (sore throat), shivering, headache, vertigo, and vomiting.
The neurological symptoms usually followed, often very quickly (a few hours was quite common); excessive sleepiness, inability to focus the eyes, fever, movement disorders et cetera. Symptoms were variable, and often changed even hour-to-hour.
While patients often experienced an overwhelming desire to sleep, and would sleep for abnormally long periods, they were easily awakened and often aware of everything that had happened while 'sleeping' referered to as pseudo-somnolence.
Those displaying these symptoms has a mortality rate of >50% but survivors were less prone to long term effects.
A smaller number of those infected displayed a 'hyperkinetic' form of the disease where the initial phase was manic rather than passive; involuntary muscle twitches, and vocalisations. After hours or (usually) days this would progress to generalised restlessness, weakness, and fatigue that would persist for days or weeks.
Other effects of this form included stabbing/burning pains, usually in the face and limbs, visual and tactile hallucinations, and reversal of the usual day-night sleep cycle3.
The third, and least common form of the disease is referred to as the akinetic form. In this form patients experienced rigidity and lack of movement, though with with no noticeable weakness, and were very slow to alter their posture.
Patients often exhibited 'flexibilitas cerea' (waxy flexibility; the body remains in a given posture until external force is applied, similar to a wax dummy) and remained rigid and immobile for long periods of time. Facial muscles were particularly effected with emotions hardly noticeable, though those infected remained mentally normal.
Recovery was sometimes very rapid, but also lasted several months in other cases.
Usually it was a few years after recovering4 (those who didn't die anyway) that patients developed the chronic phase; Parkinson's like effects such as tremor, slow movement, impaired speech and muscle stiffness were added to sleep disturbances, eye muscle problems5, involuntary muscle movements, speech and respiratory abnormalities and psychiatric disorders such as mood swings, euphoria, increased libido, hallucinations, and excessive puns, joviality, and silliness.
All in all a strange and mixed set of symptoms and effects.
Causes, vector and treatment.
The cause of EL is still unknown. It's widely linked to the outbreak of the H1N1 'flu epidemic, both statistically and through tissue testing to find the virus however this link is also widely discounted. Certainly the first cases of EL don't map well to the probably origins of the 'flu.
Some scientists believe that encephalitis lethargica wasn't a single disease, but several that spread due to the mass population movements. Another theory suggests that encephalitis lethargica is cased by a herpes type virus8 that opportunistically infected though whose immune system was wakened by influenza or were otherwise rendered vulnerable.
There was no cure, only supporting treatment for symptoms, possible with 1920's medicine.Even today where the rare cases occur only limited support is available; steroids and anti-Parkinsonian drugs such as Levodopa6 have some effects.
The infection route of EL is unknown; while the disease was considered contagious there were numerous cased where direct transmission from person to person is unlikely.
All ages, sexes and races were infected though those between 10 and 45 were most susceptible and over half of cases occurring in people between the ages of 10 and 30.
Game use.
I see three main uses for this bit of historical trivia.
1. What was it - Research
Probably not really for the classic type of Who game, more for the academics and researchers. Though perhaps someone like Nyssa might be interested7. The cause of EL are unknown in the present so head back and figure out where it came from, what it is and how it spreads. Simple really.
Except for avoiding infection with it, and the HIN1 strain of influenza. Oh there 'a a world war going on...
2. We've been infected!
Rarely are Whovian travellers bothered much by disease, Nyssa's brief infection with Lazar's disease being an exception. However on a visit to the Great War or the Roaring Twenties they could pick up something "flu like" that rapidly gets worse.
Unless you're planning to kill the character you'll need a suitable plan to save them.
3. Alien influence
Was encephalitis lethargica a 'normal' Terrestrial disease? Or the result of meddling, perhaps an attempt at biological warfare by humans gone wrong or one by aliens/time travellers/dimensional travellers that failed.
I've suggested that the (possible) origin in Romania meshes nicely with the traditional home of vampire legends; was some Mad Scientist meddling with vampirism, perhaps modifying vampire blood and administering it to test subjects to create a better soldier?
Then again it could be down to negligent space, time or dimensional travellers infecting humanity after accidentally arriving in eastern Europe.
Or might the mingling of humans from many eras during the War Games have allowed one or more viruses to mutate among the soldiers taken by the War Lords returned by the Time Lords. Possibly necessitating a little meddling to fix their negligence...
Comments? Ideas? Suggestions?
1. To differentiate it from African Sleeping Sickness, a different and better understood disease.
2. The perfect place for blending in Sinister Experiments involving vampirism of course.
3. Another possible connection to vampirism.
4. Though it could be days and rarely decades.
5. Most notably "oculogyric crisis" where the eyes rolled upwards and remained in that state for minutes or hours.
6. As shown in the film Awakenings however, the effects of Levodopa are short lived and rapidly ineffective.
7. In the EDCverse interested in adding it to her arsenal...
8. This was discussed in the final report of the Matheson Commission in 1942 (a private body set up to study and cure the disease in 1927) which suggested that herpes vaccines were showing promise.
Between late 1916 and 1925 more than five million people around the world started displaying odd symptoms of a new disease, one that disappeared a few years later and, except for rare cases in later decades, hasn't been seen again. It had, and has, no cure and no known cause or vector.
In six years about two million died, a death toll overshadowed by the 'Spanish 'flu' and the horrors of the Great War.
Known to scientists as Encephalitis lethargica the disease effects the brain, leaving people speechless and immobile, in "a statue-like condition" but aware of their surroundings; as passive as zombies, hence the name "sleepy sickness"1. While many of the infected recovered, most didn't recover fully with lingering neurological effects that left them passive and lethargic. The condition is also linked to a form of Parkinson's disease in later life.
The first cases were detected almost simultaneously in France and Austria, with Dotors Constantin von Economo and René Cruchet publishing details of the disease within days of each other, early in 1916. Later research suggests the first cases emerged in Romania2, then part of the Austro-Hungarian Empire, in early 1915 with the disease spreading through the troop movements of the Great War. The first cases were found in Vienna in late 1916, reaching epidemic status in 1917, with cases in France emerging about the same time. It was epidemic in France and England in 1918 and had overrun most of Europe in 1919 and spread to North America, Central America and India.
The peaks of encephalitis lethargica occurred in 1920 and 1924 and subsequently dropped off sharply.
Symptoms and effects.
The onset of encephalitis lethargica usually presents as a gradual onset "flu-like symptoms"; weakness, general malaise, aches, low-grade fever, pharyngitis (sore throat), shivering, headache, vertigo, and vomiting.
The neurological symptoms usually followed, often very quickly (a few hours was quite common); excessive sleepiness, inability to focus the eyes, fever, movement disorders et cetera. Symptoms were variable, and often changed even hour-to-hour.
While patients often experienced an overwhelming desire to sleep, and would sleep for abnormally long periods, they were easily awakened and often aware of everything that had happened while 'sleeping' referered to as pseudo-somnolence.
Those displaying these symptoms has a mortality rate of >50% but survivors were less prone to long term effects.
A smaller number of those infected displayed a 'hyperkinetic' form of the disease where the initial phase was manic rather than passive; involuntary muscle twitches, and vocalisations. After hours or (usually) days this would progress to generalised restlessness, weakness, and fatigue that would persist for days or weeks.
Other effects of this form included stabbing/burning pains, usually in the face and limbs, visual and tactile hallucinations, and reversal of the usual day-night sleep cycle3.
The third, and least common form of the disease is referred to as the akinetic form. In this form patients experienced rigidity and lack of movement, though with with no noticeable weakness, and were very slow to alter their posture.
Patients often exhibited 'flexibilitas cerea' (waxy flexibility; the body remains in a given posture until external force is applied, similar to a wax dummy) and remained rigid and immobile for long periods of time. Facial muscles were particularly effected with emotions hardly noticeable, though those infected remained mentally normal.
Recovery was sometimes very rapid, but also lasted several months in other cases.
Usually it was a few years after recovering4 (those who didn't die anyway) that patients developed the chronic phase; Parkinson's like effects such as tremor, slow movement, impaired speech and muscle stiffness were added to sleep disturbances, eye muscle problems5, involuntary muscle movements, speech and respiratory abnormalities and psychiatric disorders such as mood swings, euphoria, increased libido, hallucinations, and excessive puns, joviality, and silliness.
All in all a strange and mixed set of symptoms and effects.
Causes, vector and treatment.
The cause of EL is still unknown. It's widely linked to the outbreak of the H1N1 'flu epidemic, both statistically and through tissue testing to find the virus however this link is also widely discounted. Certainly the first cases of EL don't map well to the probably origins of the 'flu.
Some scientists believe that encephalitis lethargica wasn't a single disease, but several that spread due to the mass population movements. Another theory suggests that encephalitis lethargica is cased by a herpes type virus8 that opportunistically infected though whose immune system was wakened by influenza or were otherwise rendered vulnerable.
There was no cure, only supporting treatment for symptoms, possible with 1920's medicine.Even today where the rare cases occur only limited support is available; steroids and anti-Parkinsonian drugs such as Levodopa6 have some effects.
The infection route of EL is unknown; while the disease was considered contagious there were numerous cased where direct transmission from person to person is unlikely.
All ages, sexes and races were infected though those between 10 and 45 were most susceptible and over half of cases occurring in people between the ages of 10 and 30.
Game use.
I see three main uses for this bit of historical trivia.
1. What was it - Research
Probably not really for the classic type of Who game, more for the academics and researchers. Though perhaps someone like Nyssa might be interested7. The cause of EL are unknown in the present so head back and figure out where it came from, what it is and how it spreads. Simple really.
Except for avoiding infection with it, and the HIN1 strain of influenza. Oh there 'a a world war going on...
2. We've been infected!
Rarely are Whovian travellers bothered much by disease, Nyssa's brief infection with Lazar's disease being an exception. However on a visit to the Great War or the Roaring Twenties they could pick up something "flu like" that rapidly gets worse.
Unless you're planning to kill the character you'll need a suitable plan to save them.
3. Alien influence
Was encephalitis lethargica a 'normal' Terrestrial disease? Or the result of meddling, perhaps an attempt at biological warfare by humans gone wrong or one by aliens/time travellers/dimensional travellers that failed.
I've suggested that the (possible) origin in Romania meshes nicely with the traditional home of vampire legends; was some Mad Scientist meddling with vampirism, perhaps modifying vampire blood and administering it to test subjects to create a better soldier?
Then again it could be down to negligent space, time or dimensional travellers infecting humanity after accidentally arriving in eastern Europe.
Or might the mingling of humans from many eras during the War Games have allowed one or more viruses to mutate among the soldiers taken by the War Lords returned by the Time Lords. Possibly necessitating a little meddling to fix their negligence...
Comments? Ideas? Suggestions?
1. To differentiate it from African Sleeping Sickness, a different and better understood disease.
2. The perfect place for blending in Sinister Experiments involving vampirism of course.
3. Another possible connection to vampirism.
4. Though it could be days and rarely decades.
5. Most notably "oculogyric crisis" where the eyes rolled upwards and remained in that state for minutes or hours.
6. As shown in the film Awakenings however, the effects of Levodopa are short lived and rapidly ineffective.
7. In the EDCverse interested in adding it to her arsenal...
8. This was discussed in the final report of the Matheson Commission in 1942 (a private body set up to study and cure the disease in 1927) which suggested that herpes vaccines were showing promise.
