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I'm looking to create a lethal disease for a sci-fi book. The plot surrounds a group of rich people taking teenagers off earth to start a new life away from this illness. The pandemic has been going on for a few years already and there's no cure yet.

Some ideas I came up with:

  • A coronavirus mutation, more deadly than existing ones. I wasn't sure how it could be made to lie dormant and what would cause it to reactivate afterwards.
  • Rabies. There's a pretty long incubation period, which I liked. Could I make it contagious somehow? Also, I'd need it to be non-curable.
  • Klebsiella pneumoniae infection made contagious so that it infects people's lungs and that resists treatment and constantly gets worse? I wasn't sure how this would work.
  • Kuru disease. I wasn't sure how to transmit this without cannibalism. Also, the incubation period is 10-50 years, which I'd need to shorten.

Requirements:

  • Anyone can be infected by it. The disease can stay dormant inside of them for a few years so no one knows if they already caught the disease. However, at least half the population hasn't been infected yet. Tests exist but are very expensive.
  • Children aren't endangered by it but are often carriers. They are infected more easily and also infect others more easily. Teenagers can be infected by it but don't develop symptoms until they're in their mid-twenties
  • All adults (from roughly their mid-twenties) are in danger of developing the symptoms of this disease and dying from it (approx. 90% death rate).
  • There is no cure and those who do recover are in danger of being infected again in the near future.
  • I don't care how it was originally started. I'd like it to be all over the world, now, with no cure in sight, only ways to delay the deaths of those who have it.
  • It needs a name.
  • Ideally, I'd like to base it off an already existing disease or virus and with create the disease I'm looking for with realistically mutating it.
  • The most practical way of transmission seemed to be through the air (through droplets) by coughing, sneezing and (to a lesser degree) talking and through contact with contaminated objects and surfaces, then touching eyes, nose, or mouth before washing hands, I'm completely open to other suggestions on this point.

    The main complications in creating this pandemic are:
  • The somewhat slow infection rate (I'd like people to still be able to safely assume they don't have it)
  • Reactivating the disease. How does it reactivate?
  • Only adults are in danger. Children's immune systems are weakest, so they are most likely to be endangered by such a disease.

    Any suggestions on how to alter the sicknesses, or for any other diseases/viruses etc. that could create such a pandemic?
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    $\begingroup$ Rabies is extremely contagious already. The vast majority of coronaviruses produce common colds; as of June 2020, even the current deadly! scary! COVID-19 coronavirus has not managed to kill more than 0.007% (that's zero point zero zero seven percent) of the world population. $\endgroup$ – AlexP Jun 26 at 12:09
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    $\begingroup$ @AlexP Just to point out that the relatively low kill count for Covid-19 can largely to attributed to aggressive safety measures and lockdown (and amazing work by health workers !). Places where they're had poor public safety measures are significantly worse and not getting better, whereas strong measures have dropped dead rates to zero or close to where kept in force long enough. Covid-19 is thought to have an "uncontrolled" death rate of more like 2% to 4% (when health systems would be overwhelmed). Please do not under-estimate the lethality of Covid-19. $\endgroup$ – StephenG Jun 26 at 13:59
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    $\begingroup$ @user613 yes, yes it is. The reason it's not usually treated as contagious from person to person is because we usually tie those infected beyond help to a bed, but bites and, in rarer cases, scratches and other wounds exposed to the infected's saliva can transmit the disease (the very fact that rabies is hard to extinguish is already an indicator of how it's good at infecting). The key here is that biting other creatures isn't nearly as effective as a means of transmission as being capable of infecting people via the respiratory system. $\endgroup$ – ProjectApex Jun 26 at 14:54
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    $\begingroup$ @ProjectApex I did sort of know that, it just didn't seem contagious enough. I guess I could base this disease off rabies though, and decide that it's contagious through other means too. (respiratory droplets, contact with eyes, nose and mouth if rabies are on them, also once the saliva is dry). I'd have to work on it being incurable and possible to get infected with again. $\endgroup$ – user613 Jun 26 at 15:56
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    $\begingroup$ @user613 that's basically the course of many zombie-esque outbreaks, a disease that was originally like rabies but became capable of transmitting through air and water, quickly spreading beyond control. To have it able to remain incurable and capable of remaining dormant, I recommend a virus much like HIV, as that virus is basically both of those (high mutation rate is what makes it so hard to cure and it can remain within one's body with no symptoms whatsoever for even years). $\endgroup$ – ProjectApex Jun 26 at 16:00
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You have already invented your disease.

If you try to make it a real thing it will just crimp your style. What you have is fine and leaving big unknowns will move your story along. Name it after a place where it showed up and you have got your disease. I would suggest a viral disease or some spin on prion because bacterial are less sneaky. People could have different ideas about that too; it is still up in the air.

The only trick is the adults only piece. Leave that up in the air. Maybe the lethal stage is triggered by a second infection, or some other immunologic event, or getting really drunk, or having sex, or getting a shot, or seeing a meteor. People have different ideas about it which will make for good narrative because your characters will have something to talk about.

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    $\begingroup$ Those seem to be storytelling issues - you painted yourself into a corner. You are writing about a fictional plague in the middle of a real plague. Give it an obviously non-COVID name like "The Purple Plague" or "Super Malaria" or "Facebook Syndrome." Chekhov's gun applies -- if you make readers learn the characteristics of the fictional plague, then there better be a payoff for those readers. Alternately, you can choose a different reason to leave Earth, and save the plague for another story. $\endgroup$ – user535733 Jun 26 at 15:05
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    $\begingroup$ @user613 could a solution be that while you, as an author, know lot of details, your protagonists themselves doesn't really know? take the current example of coronavirus, and ask a random folk about specific details about it. He will probably either don't know, or just repeat what he heard from the medias, and two random people may say contradictory thing about it. Make sure that some facts said by your protagonists turn ou to be false, or any other contradiction, so your reader know that what your protagonists know may not be true. Basically, make the disease vague in-universe $\endgroup$ – Kepotx Jun 26 at 15:15
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    $\begingroup$ @Kepotx are you suggesting I make up my own disease, and just make the details unclear to the characters? I like the idea of clearly showing that the protagonist knows false information about it. Wouldn't they start to learn more as it progresses, though? Once they've come in contact with a dozen people who had the disease and died from it, how unclear could the details realistically remain? $\endgroup$ – user613 Jun 26 at 15:46
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    $\begingroup$ @user613 - people die of lots of things and everyone remains baffled. Even the same disease can go radically different ways in 2 different individuals. Having different people have theories about the disease would be great. Your readers will first encounter the protagonists version. He will laugh at the "see a meteor" version when he hears it but the "get really drunk triggers it" gives him pause... $\endgroup$ – Willk Jun 26 at 20:03
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    $\begingroup$ Also you could make the symptoms random, and weird. And even more random and weird are rumors about symptoms. There are rumors about people covered with pimples that go to the bone. Rumors about people who have orgasms till they die - could that happen? Rumors about people who are spreading the disease on purpose.... crazy talk, right? The disease is scary, and it is real but it does not ever seem to be the same thing twice. $\endgroup$ – Willk Jun 26 at 22:30
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One potential idea that you could base your disease off is chronic wasting disease, which can be seen in deer. While no human cases have been reported, it has been shown to infect primates, so it is possible that it could infect humans.

Like Kuru disease and mad cow's disease, it is caused by prions, but as noted by the CDC it can be spread through bodily fluids like blood and saliva, as well as contact with contaminated soil. Symptoms occur between 18-24 months after infection, and include continued loss of weight and behavioural changes such as decreased interaction with other animals, and is always fatal.

This covers most of your requirements except for it primarily affecting adults. Like Willk pointed out, you could leave as a mystery- there are still a lot of unanswered questions regarding prions so it's likely that in your world there will be a lot that the medical community doesn't know about the disease.

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  • $\begingroup$ thanks! Your suggestion, besides for the potential in CDC, opens a whole new world of diseases, ones that animals have and there are no cases of humans having but theoretically they could catch it. I will have to look into it more. $\endgroup$ – user613 Jun 27 at 18:34
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It could be a variant or mutation of a human papillomavirus (HPV). There are lots of them so a new variant might not be picked up that quickly as it spreads through the population, especially if it seems harmless.

HPVs are spread through simple contact and come in a couple of main varieties - one which infects the skin and one which infects mucosal tissue.

I would suggest a skin-infecting one that instead of creating a wart, slowly sets up a skin cancer invisibly under the skin which by the time it's detected is already in stage 3. Children's skin is different (thinner or more sensitive or whatever) so when they catch it it's just a really itchy patch that they scratch leaving a tiny wound that the immune system deals with; teenagers' skin is too full of hormones for the virus to be able to survive for long.

As to the detection of the virus and making people aware of it and it being taken as a serious threat, well, HPV as it currently exists may constitute up to 25% of female cancers in the developing world.

I found a document on human papillomavirus and cervical cancer but it has quite a bit of detail on HPVs generally https://www.ncbi.nlm.nih.gov/pmc/articles/PMC145302/

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