Looking for a terminal illness for an NPC

[Silveressa]

I'm going to be doing  a high tech sci-fi game in a couple weeks and I need a good terminal illness to have the ships NPC mechanic to be secretly suffering from, (leading to some later sub plots and solid reason for betrayal of the group when she's promised a cure later on) unfortunately I'm drawling a blank on something suitable.

Specifically I need an illness with the following requisites:

-Incurable and ultimately terminal (something high future tech can't cure with cyber implants, gene therapy, and  future medical science stuff and will ultimately result int eh death of the host in a matter of months to a few short years.)

-Few outward symptoms during the majority of the disease (Ideally so the person can, with the right medical injections appear healthy and maintain a degree of functionality until the final stage of the illness.)
 
Relatively rare- Something obscure enough the rest of the crew likely won't have heard of the illness before, lending an air of suspense and mystery behind it.

Low risk of transmission- Ideally it should be hard for the carrier to transmit the illness to the rest of the crew in the current stage of the illness except under specific rare conditions (blood contact/exposure to spinal fluid, etc..)  Later on it can always become more contagious, but for now I'd prefer it if the rest of the crew don't run the risk of contamination during their opening adventures.

So far I have the following concepts but nothing solid enough to use yet:

Neural failure: Some sort of slow neural damage/degradation due to long term exposure to hyperspace energy fields and what not in the reactor chamber. On the plus side it ties in nicely with the mechanic background, but doesn't seem like it would be continual and terminal if one stopped working around machinery and would likely be a commonly known hazard associated with starship mechanics.

Retro Virus: A nice nasty alien virus that corrupts DNA resulting in eventual mutation and death, or collapse of the RNA substructure over time. The downside is it could be theoretically cured relatively simply via gene therapy/augmentation. (Which is a standard medical technology in the game world and it's common to see groups enhancing operatives/military etc.. with gene splicing)

Alien parasite: Some other worldly nasty infecting a vital part of the mechanics body that will eventually kill the host upon maturation. (Perhaps thread worms interwoven around the spinal cord or some sort of larvae nestled in the center of the brain.) The downside is it could be easily cured with surgery and cybernetic replacement of any damaged organs so it would have to be especially nasty parasite to work as the illness. (such as a parasite that releases a deadly neurotoxin upon death/attempted removal or emits a psychic death scream that drives the host insane)

Prions: Essentially an infectious agent composed of protein in a misfolded form. (http://en.wikipedia.org/wiki/Prion ) These have real promise since an alien prion could prove all but impossible to destroy in an infected host, yet hard for the host to transmit to others. The downside is they don't seem especially easy to detect via medical scan/exam  someone is infected with them in the first place.

Any ideas to further develop the terminal infection/infestation would be most appreciated. 

[axlerowes]

How far down the SCI ladder do you wanna go on this one?   Would you rather the symptoms be an intuitive result of the insult or  something a little harder to swallow?

[Silveressa]

Would you rather the symptoms be an intuitive result of the insult or  something a little harder to swallow?

Not sure what you mean by the "result of the insult" exactly but I need something that's more or less plausible and makes sense as being able to infect and kill a human host despite advanced medical treatment.

(One of my players has a fair degree of scientific/medical training and will be playing the ships med tech, so the more "hard science feel" this thing has the better it'll fit into the campaign and appeal to the group.)

[axlerowes]

1 of 4

Methoglobin disorder.
 Oxygen metabolism is really dangerous. It produces a lot of free radicals, reactive oxygen species and can be hard on the local pH.  All these by products of Oxygen metabolism makes carrying out basic biological functions hard.  Humans are engineered to function to in narrow window of O2 availability.  One of the ironies of space travel is that the artificial atmospheres are often overly oxygen rich: regulating the CO2 and the O2 is a tricky equation that can go wrong both ways.  One way to deal with this is to treat your deep space workers, particularly those that work near Oxygen producing reactors like cold fusion, with engineered stem cells treatment.  These engineered stem cells travel to the bone marrow and differentiate in when oxygen levels in the blood become too high. Once they differentiate into hematopoietic cells they start producing an engineered form of methemoglobin (TGM).  TGM binds oxygen and won’t release it.  The stem cells respond to high levels of oxygen in the blood and start producing TGM.   Your boy was once the kind of guy that need this treatment   He did his tour in these oxygen rich environments that, thanks to his bio-engineered hematopoietic compartment.  He received an ablative chemotherapy which completely removed his Bone marrow (BM) stem cells and he receives a transplant of new cells.  He goes on about his life happily.  But little did he know the ablation was incomplete.  He has retained not only undifferentiated the methemoglobin cells but his own BM cells in smaller quantities.
 
Okay recent past, he gets a knockdown bacterial infection that cause catastrophic pneumonia and system wide sepsis.  No problem for “modern” medicine, they cure his symptoms, toss him on some superantibiotics and he seems fine.  However the pneumonia put your boy into a hypoxic and then they treated him by putting is oxygen tent and give him injections of oxygen rich blood.  This oxygen rich state caused his engineered stem cells to reactivate and start producing TGM.  Additionally the massive immune response and cytokine storm caused by bacterial infected caused an equally massive T cell independent activation of all his antigen presenting cells and B cells. Both his donor B-cells from his BM reconstitution and his surviving BM cells.  This massive immune response caused self antigen to get presented to the adaptive immune system as well as foreign antigen.  The surviving host immune system, small though it may be, started responding to donor red blood cells.  So your sick boy has a host vs graft disease in which he is killing his own bloods and he producing methemoglobin which is binding up all the free oxygen. He is suffocating.  How he is treating this himself is by giving his self oxygen supplements and increasing the oxygen content in his living quarters.  This oxygen rich environment is only making things worse.

Side effects, methemoglobin turns your skin blue and makes your blood brown.  Your boy will be subject to fainting spells and light headness.    Also based on the activation state of his immune cells that he is fighting an infection. Once they find out he has an auto immune infection they may start to treat that, but then they still have to deal with the methemoglobin.  Many of your doctors tactics may actually make things worse.

[axlerowes]

2of4



Quantum chimeras.
This one involves more hyperspace technology fiction.  So lets assume each time jump through hyperspace you are moving through Quantum realities. This explains why hyperspace jumps takes no time at all, the jumps not the sublight travel between jumps,  and you are actually two places at once for a moment when jumping.  Because for that moment of non time you are inhabiting two realities.  However the person that come back from the reality, brings a little bit of their alternate reality self with them, usually it is just a few molecules that might be different.  But your boy is special, not only has he been through a lot of hyperspace jumps but so have his other Quantum reality selves.  Indeed for some reason the math of the universe has created your boy in most realities and in most realities he works with hyperspace drives.  Thus numerous versions of him are jumping through him and leaving bits of themselves in him and the versions of himself he jumps through are also have a lot of alternate reality stuff in their systems. 

The conceit that these alternate realities have noticeable differences, and the reality of your boy in other dimensions may be different. He may be a robot, or dead or what ever.  But each jump brings just a little bit of foreign material with them.  Now this mans is beginning to suffer dysfunction because he is being made up of increasingly incompatible parts.  It will manifests itself as spontaneous tumors, legions and sometimes ever more dramatic things such strong static discharges and hallucinations.

[axlerowes]

3 of 4


Here you could just slow the pace of the infection down and change it so he only wants to get to a venus like planet. He will retain his mental function but lose his basic survival instinct.

http://strolen.com/viewing/Sivvers

[axlerowes]

I will hold off on four for now...but it is tumor causing retro-virus

[Silveressa]

give me four any way, I'm loving this! 

[Pariah]

Privyetasis (Xenoseptus privyetii
Originating in the Septimus system, this obscure multicellular parasite causes Molybdenum (Mo) deficiency in its host, leading to the development of neurological symptoms, accelerated heart rate and breathing, coma and eventually death.  Treatment of this parasitic infection is difficult due to the fact that using anti-parasitics to kill off the privyetii will cause a massive release of Mo, leading to ataxia in the limbs, and multiple organ failure, generally centering around the liver and kindeys.  Treatment is further complicated by the fact that taking Mo supplements causes the privyetii parasite to bloom in the host's blood stream, requiring higher and higher doses to remain effective while making death far more likely once the parasite is killed.

[valadaar]

Mindworm

A virus that has infected the nervous system directly - similar to an actual computer virus. It exists purely in the ebb and flow of thought.  It manifests itself as another personality that only, so far, speaks to the victim. It has shown itself capable of controlling the body and could cause the victim to kill themselves or others once certain criteria programmed into it are met.

It may be possible through careful monitoring to see the impacts of the virus through MRI, but you would need a pre-virus baseline to be able to figure out which activities are those of the host and those of the virus.

The victim's own intellect would power the virus, so it would be nearly possible for the victim to help themselves directly, as it would be able to read the victim's thoughts and simply countermand the activities.   A contest of wills would occur any time the two were at adds with each other.

Just a thought on something different.

[Murometz]

These are all great! Someone start a scroll!! 

[dark_dragon]

Fernstein's Malady
Fernstein's Malady (Also known as Autoimmune Neurofibrillary Prionic Tauopathy; ANPT)  named after renowned physician Professor Bernard Fernstein occurs when antibodies directed against the person's neuron's myelin sheaths cause the formation of defective situational pseudo-tau prions (SPTPs). Contrary to demyelinating diseases, ANPT does not cause the degradation of the myelin sheath. Rather, the sheath is modified in situ into an insulating Myelin/SPTP hybrid. The disease belongs to a class of conditions known as phagocytic disorders, whereby phagocytes (White blood cells that protect the body by ingesting foreign particles) act abnormally.

ANPT is actually a misnomer due to original speculation about the mechanism of action. The current preferred name is Fernstein's Malady.

Occurrence is believed to be due to the traumatic transfer of mutated dendritic phagocytes to close proximity to an axon. (often due to penetrative wounding of a pre-inflamed area of the body) The mutated cells secrete malformed cytokines that deform the Myelin proteins in a way that is poorly understood, leading to the formation of a hybrid Myelin/SPTP sheath selectively on somatic motor neurons (those that control skeletal muscles).

SPTPs will cause the breakdown of microtubules in the surrounding cells, while leaving the axon unharmed, microtubule protein will then proceed to bind to the Myelin/SPTP hybrid and form hard fibres around the affected axon. For unknown reasons, these fibres will be sites of intense calcification, causing severe, debilitating pain and mechanical damage to the surrounding tissues. In patients who die of ANPT, decomposition will reveal thin white filament throughout the body, some big enough to be seen with the naked eye. During the later stages of the disease, the fibres are so thick and numerous that motor function will be mechanically impaired.

Since the calcification and SPTP damage cannot be reversed, once acquired, this disease is irreversible. Amputation of an affected site could prove useful, but since the symptoms take years to develop, by the time a diagnosis is made it is too late, as SPTP formation has occurred throughout the body.

There are two modestly successful management options that will often be effective in increasing a patient's life expectancy after diagnosis:

• Immediate viral vector gene therapy can destroy the vast majority of defective dendritic phagocytes, which will stop the spread of the calcification sites, if not the process itself. Before the wide availability of reliable viral vector gene therapy  immunosupression was used to slow the spread of the disease.
• Taking artificially crafted SPTP co-proteins, that bind to the SPTPs and stop the formation of new calcification sites can reduce the speed of degeneration. While gradual improvements in treatment effectiveness have been made, no current treatment can completely hold off the progression of the calcification and fibre formation.
  

Symptoms: Gradually worsening muscular pains over several years, often defying diagnosis
Incidence: 1 in 5 000 000
Mortality: 1 year after diagnosis: 25%, 4 years after diagnosis: 86%, 7 years after diagnosis: 98%, 10 years after diagnosis: 100%

[Mourngrymn]

but I need something that's more or less plausible and makes sense as being able to infect and kill a human host despite advanced medical treatment

They are incurably attached to a mother in law like mine. Kills the weak minded faster than a bullet, but sucks the life out of the strong willed and takes years to disintegrate the soul.