Biological Warfare in 5th Edition Gamma World - Sean Kindred

These are rules that cover potential bioweapons that adventuring Heroes might face in Gamma World. Modifications to the disease rules given in the Gamma World rules, pgs. 55-56, were necessary to accommodate the dangerous nature of these diseases. While it is unlikely that the Heroes will face an enemy with a weaponized Smallpox aerosol bomb, they might encounter these diseases in the aftermath of the use an ancient bioweapon, or even the remnants of biowar from the Shadow Age. Some of these diseases are or were naturally occurring, and given that widespread biological warfare was a likely facet of the Apocalypse, many will be found in the wild. Like radioactive deathlands, areas contaminated with Anthrax spores are one possible hazard. Finding ancient artifacts that may be contaminated from exposure during biowar is another possible scenario. "Modern" bioweapon agents are shown below, and a description of each is given, as well as the game stats for the disease. Some new medical artifacts are outlined, to assist the Heroes in coping with the horrors of biological warfare.

Viral Agents
Disease Name	Virulence	Strength	Incubation	Contagious?
Encephalitis	Amazing	Any†	Ordinary	No
Influenza	Amazing	Marginal	Good	Yes
Smallpox	Amazing	Any†	Marginal	Yes
Yellow Fever	Amazing	Any†	Ordinary	No

* = this agent has a 100% mortality rate, see below for details
† = the strength of this agent can be anything from Marginal to Amazing, GM's decision
‡ = Anthrax treatment is a special case, see below for details

New Disease Rules

Agents are shown with four relevant stats. Strength indicates the danger represented by the disease in question. Values from Marginal to Amazing correspond to the table on pg. 56 of the "Gamma World" rules, and modify the CON check accordingly. A new value, Hopeless, was added to represent a 100% mortality rate. For Agents with a Strength value of Hopeless (such as Inhalation Anthrax and Pneumonic Plague), there is no chance of a natural recovery. Make CON checks at +3 (as per Amazing), and ignore any recovery results. Only medical aid can possibly help someone infected with such a lethal agent. The Incubation value operates as per the standard disease rules, and represents the length of time after infection until symptoms arise. A third stat has been added, to represent the possibility of infection resulting from exposure to the agent - Virulence. This is the result level needed on a CON check after exposure to avoid infection. If that check is successful (i.e. a result is rolled that is equal to or higher than that shown in the Virulence column for the indicated agent), then infection is avoided and the Hero can go about his or her business as normal. Otherwise, the Hero is now infected with the agent in question. CON checks are now made as per the normal rules for disease on pg. 56 of the "Gamma World" rules, using the Strength value indicated for the agent, to determine the progress of the disease. Finally, the last value, Contagious?, indicates whether or not the disease is communicable from one infected host to another. If the value is 'No', then infection can only result from exposure to the initial vector and not from an infected host, no matter how ill.

A Note about Anthrax

Anthrax treatment is a special case. Antibiotic therapy is only effective if begun before symptoms begin. This means that Ancient Age antibiotics are useless once the incubation period is over. Once symptoms set in, only Shadow Age antibiotics, or super antibiotics, have any chance of helping the victim. Even then, those advanced medicines only function as standard antibiotics, granting a -3 bonus to CON checks.

New Artifact Items

Pharmaceutical, antibiotics - super (S): These pharmaceuticals are used to cure bacterial infections. They are administered by injection only, coming in sealed, pre-measured injectors. Unless the victim suffers from Anthrax, or an antibiotic-resistant strain of a known bacteria (GM's discretion - normal antibiotics are useless in that case), then the super antibiotics operate as normal antibiotics, granting a -3 bonus to CON checks. The treatment lasts for only 3 days, with one injection required per day. Like normal antibiotics, super antibiotics are useless against viral infections.

Pharmaceutical, antiviral (S): These pharmaceuticals are used to treat viral infections. Administered orally or by injection, antiviral drugs grant a -3 bonus to CON checks, greatly improving the patient's chances of fighting off the disease. Standard treatment lasts for 10 days, with the entire treatment time necessary, even if the patient recovers early, to insure complete eradication of the virus. The drug must be taken once per day.

Pharmaceutical, vaccine (A): This is a whole class of injections, each tailored to promote resistance to a specific disease. The injection grants immunity to a specific agent, viral or bacterial. Duration is typically several years, with boosters (i.e. more injections) usually required periodically. See the disease descriptions for specific vaccine information. Of the listed agents, vaccinations are available for all of them with the exception of dysentery.

Disease Descriptions

Inhalation Anthrax: Anthrax is caused by the bacterium Bacillus anthracis. While anthrax commonly affects hoofed animals such as sheep and goats, humans may acquire this disease as well. Historically, the main risk factor for acquiring inhalation anthrax is breathing in "aerosolized" anthrax spores from industrial processes such as tanning hides and processing wool. Inhalation anthrax can also be used as a biological weapon. The making of a fatal anthrax biological weapon, where spores must be aerosolized in order to cause the inhaled form of the disease, requires advanced biotechnology. Inhalation anthrax develops when anthrax spores enter the lungs. There are usually two stages of inhalation anthrax -- the first stage can last from hours to a few days and is similar to a flu-like illness with fever, malaise, headache, cough, shortness of breath, and chest pain. The second stage often develops suddenly and is notable for shortness of breath, fever, and shock. This is highly fatal. Vaccination has been developed and is given in a 6-dose series.

Brucellosis: This disease is caused by contact with farm animals carrying the Brucella bacteria. Brucella bacteria infect cattle, goats, dogs, and pigs. Transmission of the disease to humans occurs by contact with infected meat, placenta of infected animals, or ingestion of unpasteurized milk or cheese. People working in occupations requiring frequent contact with animals or meat, such as slaughterhouse workers, farmers, and veterinarians, are at high risk. Acute brucellosis may begin with mild flu-like symptoms or with fever, chills, sweating, muscle aches, joint aches, and malaise. Characteristically, fever spikes every afternoon to levels around 104 degrees Fahrenheit. Advanced symptoms include: fever, chills, excessive sweating, weakness, weight loss, fatigue, headache, abdominal pain, enlarged liver, back pain, loss of appetite, joint pain, muscle pain, and swollen glands.

Cholera: An infection of the small intestine caused by the bacterium Vibrio cholera. Cholera is an acute illness characterized by watery diarrhea. The toxin released by the bacteria causes increased secretion of water and chloride ions in the intestine, which can produce massive diarrhea. Death can result from the severe dehydration brought on by the diarrhea. Cholera occurs in epidemics when conditions of poor sanitation, crowding, war, and famine are present. The infection is acquired by ingesting contaminated food or water. A type of vibrio also has been associated with shellfish, especially raw oysters. Risk factors include residence or travel in endemic areas and exposure to contaminated or untreated drinking water. A vaccine is available that gives short-lived, limited protection against the cholera bacteria. Booster doses are given every 6 months for people who remain in an area where cholera is a risk. When outbreaks of cholera occur, efforts should be directed toward establishing clean water, food, and sanitation because vaccination is not very effective in managing outbreaks. Symptoms can vary from mild to severe, and include: sudden onset of watery diarrhea with a "rice-water" appearance and a "fishy" odor, up to 1 liter per hour; rapid dehydration, rapid pulse, dry skin, dry mouth and mucous membranes, excessive thirst, "glassy" or sunken eyes, inability to generate tears, lethargy, low urine output, abdominal cramps, nausea and vomiting.

Dysentery (Amoebic dysentery; Intestinal amoebiasis): Amoebiasis is an infection caused by the parasite Entamoeba histolytica when it infects the intestine. The parasite can live in the large intestine without causing disease; or it can invade the colon wall causing colitis, acute dysentery, or chronic diarrhea. The infection may also spread through the blood to the liver and rarely, to the lungs, brain, or other organs. Transmission occurs through ingestion of cysts in fecally-contaminated food or water, use of human excrement as fertilizer, and person-to-person contact. Cockroaches and house flies can also spread the cysts. Typical symptoms of intestinal amebiasis consist of frequent diarrheal bowel movements with cramps or colicky abdominal pain. Pain on defecation is common, as is fever, vomiting, fatigue, weight loss, and intestinal gas. The diarrhea may contain blood or mucus, and may occur from to 10-20 times per day.

Pneumonic Plague: An infection caused by the organism Yersinia pestis which occurs in wild rodents and is transmitted to humans. Plague is transmitted among rodents and to humans by flea bite or ingestion of the feces of fleas (causing Bubonic plague). It can also be transmitted human to human when a plague victim develops pneumonia and spreads infected droplets by coughing. In weaponized form, Pneumonic plague can be distributed via aerosol. Symptoms include severe cough; frothy, bloody sputum, and difficulty breathing. Almost all victims of pneumonic plague die if not treated.

Typhoid Fever: Typhoid fever is a bacterial infection characterized by diarrhea, systemic disease, and a rash -- most commonly caused by the bacteria Salmonella typhi. Salmonella typhi are spread by contaminated food, drink, or water. Following ingestion, the bacteria spread from the intestine to the intestinal lymph nodes, liver, and spleen via the blood where they multiply. Early symptoms are generalized and include fever, malaise and abdominal pain. As the disease progresses, the fever becomes higher (greater than 103 Fahrenheit), and diarrhea becomes prominent. Weakness, profound fatigue, delirium, obtundation, and an acutely ill appearance develop. A rash, characteristic only of typhoid and called "rose spots," appears in some cases of typhoid. Rose spots are small (1/4 inch) red spots that appear most often on the abdomen and chest. Other symptoms include: severe headache, fever, malaise, abdominal tenderness, constipation followed by diarrhea, bloody stools, nosebleeds, chills, confusion, agitation, mood swings, and hallucinations. Typically, children have milder disease and fewer complications than adults. A few people can become carriers of Salmonella typhi and continue to shed the bacteria in their feces for years, spreading the disease, as in the case of "Typhoid Mary".

Encephalitis: Encephalitis is an inflammation of the brain. Encephalitis is most often caused by a viral infection. The specific viruses involved may vary. Exposure to viruses can occur through insect bites, food or drink, or skin contact. In rural areas, arboviruses that are carried by mosquitoes or ticks, or that are accidentally ingested, are the most common cause. In urban areas, enteroviruses are most common, including Coxsackie virus, poliovirus, and echovirus. Other causes include herpes simplex infection, varicella, measles, mumps, rubella, adenovirus, rabies, West Nile virus (another potential bioweapon), and only rarely, vaccinations. Once the virus has entered the blood stream, it can localize in the brain causing inflammation of the brain cells and surrounding membranes. White blood cells invade the brain tissue as they try to fight off the infection. The brain tissue swells and can cause destruction of nerve cells, bleeding within the brain, and brain damage. Symptoms include: sudden fever, headache, vomiting, photophobia, stiff neck and back, confusion, drowsiness, clumsiness, irritability, loss of consciousness, stupor, coma, seizures, muscle weakness or paralysis, sudden severe dementia, amnesia, and impaired judgment. Permanent neurologic (such as memory, speech, vision, hearing, muscle control, and sensation) impairments can occur in people who survive severe cases of encephalitis.

Influenza: A viral infection of the respiratory tract that causes fever, headache, muscle aches, and weakness. There are three types of influenza virus. All are spread from person to person by inhaling infected droplets from the air. Type A is usually responsible for the large outbreaks and is a constantly changing virus. New strains of Type A virus develop regularly and result in a new epidemic every few years. Types B and C are fairly stable viruses. Type B causes smaller outbreaks, and Type C usually causes mild illness similar to the common cold. Symptoms include: fever, cough, nasal discharge, headache, muscle aches and stiffness, shortness of breath, chills, sweating, fatigue, malaise, stuffy nose, sore throat, clammy skin, nosebleed, nausea and vomiting, diarrhea, joint stiffness, elbow pain, loss of appetite, and an impaired sense of taste. In rare cases, influenza may cause a severe pneumonia that may be fatal even in healthy adults. Vaccines are available in nasal or injectable form, have a 60-70% success rate, and must be administered yearly.

Smallpox: Smallpox is a viral disease characterized by a skin rash and a high death rate. Risk factors for smallpox include being a laboratory worker who handles the virus, or being in the environment where the virus was released as a biological weapon. Smallpox can be released by aerosol, and it would spread easily because the virus remains very stable in aerosol form. Smallpox is highly contagious from one person to another. It is most contagious during the first week, and is spread from saliva droplets. It may continue to be contagious until the scabs from the rash fall off. It may also be spread from bed sheets and clothing. The smallpox infection (if released in aerosol form, under favorable conditions, without sunlight) could remain viable for as long as 24 hours. In unfavorable conditions, the virus may only remain viable for 6 hours. There is clear evidence that shows that the virus can remain viable on bed linens and clothes for significant periods of time. The symptoms of smallpox infection are: high fever, fatigue, severe headache, backache, malaise; Rash raised and pink on the skin, starting centrally and spreading outwards (First the mucosa of the mouth and pharynx, then face, forearms, trunk, and legs. Rash turns to pus-filled lesions that become crusty on the eighth or ninth day.); delirium, vomiting, diarrhea, and excessive bleeding. If the smallpox vaccination is given within 1-4 days of exposure to the disease, it may prevent illness, or at least lessen the degree of illness associated with the disease.

Yellow Fever: Yellow fever is a viral infection transmitted by mosquitoes characterized by fever, jaundice, kidney failure and hemorrhage. Yellow fever can be divided into three stages:

• Early stage: headache, muscle aches, fever, loss of appetite, vomiting and jaundice are common.
• Period of remission: fever and other symptoms resolve -- most individuals will recover at this stage, yet up to 15% may move onto the third, most dangerous stage.
• Period of intoxication: characterized by multi-organ dysfunction -- liver and kidney failure, bleeding disorders/hemorrhage, brain dysfunction including delirium, seizures, coma, shock and in up to 20-30% individuals, death.

Other symptoms include: red eyes, face, and tongue; jaundice, bleeding, decreased urination, arrhythmias and heart dysfunction, and bloody vomiting. Yellow fever is a severe infection which may result in death in up to 40% of affected individuals