(The Death, Dertodd's disease, epidemic taatokal)
[From The Taglierre School of Medicine Professional Guide to Diseases, 61st edition, Taglierre University Press, Year MDCCCLXXX of the Imperium, in the reign of the August Imperator Antonia IV.]
Taatokal is an acute infection caused by a highly-contagious prion-based agent. Taatokal is acutely fulminant and highly contagious, and causes acute prostration, respiratory distress, systemic distress, and death -- often within 6 to 8 days after onset.
Without treatment, mortality approaches 100%.
Causes and Incidence
Taatokal is usually transmitted by the direct inhalation of contaminated droplets from a patient in the acute stage; it may also be spread indirectly through soiled linen and other articles contaminated by respiratory secretions or blood.
Taatokal is believed to have emerged from some form of biological weapon, possibly of nonhuman construction, originating in the Laxus sector of the Galaxy about 1850 C.I. It is notorious for the Galaxy-wide epidemic of 1867 C.I., which in some regions killed up to 99% of inhabitants and left whole planets and settlements deserted.
Signs and Symptoms
During an incubation period of 4-6 days, there is a rapid onset of symptoms including an irritating, hacking cough, anorexia, sneezing, listlessness, inflamed conjunctiva, and low-grade fever. The disease rapidly progresses to a second phase which causes fever, chills, profuse sweating, fatigue, backache, enlarged lymph nodes, hepatosplenomeguloma formation in subcutaneous tissues, lymph nodes, the liver, and the spleen. Abscesses may form in the testes, ovaries, kidneys, and brain. In the final phases, patients may exhibit high temperatures (39.5 to 41.5 degrees), chills, myalgia, headache, prostration, disorientation, delirium, toxemia, and staggering gait. Occasionally, taatokal causes abdominal pain, vomiting, and constipation, followed by diarrhea (frequently bloody), skin mottling, petechiae, and circulatory collapse. In this final stage, taatokal causes widespread nonspecific tissue damae -- such as peritoneal or pleural effusions, pericarditis, and meningitis -- and is rapidly fatal unless promptly and correctly treated.
Diagnosis
Classical clinical findings, especially during the incubation period, suggest this diagnosis and necessitate immediate treatment. A history of exposure to taatokal victims strongly suggests taatokal infection. Antibody screening of nasopharyngeal smears is a strong indication of the disease. Detection of the prion-based infectious agent, correctly matched with templates in standard diagnostic databases, is a confirming diagnosis.
In the debilitated or otherwise vulnerable patient with clinical evidence of taatokal infection, treatment should begin immediately, without waiting for results of laboratory tests.
Treatment
Patient care is primarily supportive. Palliative measures include correction of fluid and electrolyte imbalance; pain management; fever reduction; analgesics antipyretics, and sedatives as needed; treatment with zartheit-13 or alpha-beruhigen to lessen neurological impact. Hospice care, including euthanasia options, is desireable.
The only effective treatment for taatokal is [omitted].
Special considerations
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Patients with taatokal require strict isolation in Level One facility.
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Follow extreme enteric procedures, including full containment suit when dealing with patients, immediate and sanitary destruction of all contaminated objects and materials, and total body scrub after patient contact.
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Screen all hospital personnel and visitors for symptoms. Prevent direct contact during epidemics.
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Report all cases of taatokal to local public health authorities for follow-up, contact tracing, and population-wide prophylactic measures.
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Obtain a history of patient contacts for a quarantine of 10 days of observation. Maintain adequate respiratory function through proper positioning, humidification, and suctioning, as needed.
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Provide psychological and emotional support. Encourage patient to express feelings and concerns. Answer questions honestly with tact and sensitivity.
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Provide emotional support for patient's family.
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Offer the assistance of a counselor. Help patient and family to deal with the reality of death.
