Rust Lung
Rust Lung is a deadly chronic respiratory disease that originated within The City of the Southern Wildlands as a result of exposure to an unintended chemical compound created by an industrial refinery process. It resulted in the Rust Lung Crisis of 3574 PL.
Contents
Symptoms
Symptoms start as shortness of breath, though this may often be bypassed altogether, progressing rapidly to great difficulty breathing, painful and violent coughing, terrible wracking chest pains, and ultimately suffocation.
Death occurs as a result of suffocation, internal bleeding, or in an unpleasant combination of the two as one effectively drowns in one's own blood as the result of lung tissue being shredded.
Causes
A chemical compound known as “rust dust” was created as an unintended byproduct of a new refinery process first introduced in 3569 PL, and adopted for use across several industries within The City until its identification as the source of the affliction in 3574 PL.
Rust dust, invisible to the naked eye in small concentrations, was ejected by refineries into the atmosphere of The City, a notably confined space with limited ventilation, especially in the lower levels. This resulted in both highly concentrated pockets and widespread exposure to the substance.
When inhaled, the chemical reacts with the surface of the lungs to form a new compound (“rust”), resulting in a coating of a rust-coloured abrasive particulate substance that restricts breathing in even minuscule amounts, and pervasively destroys lung tissue over time.
The reaction within the lungs is gradual and potent, resulting in the continuous creation of the particulate as it gradually spreads to coat every available surface.
Tiny amounts of rust dust can be reintroduced to the atmosphere by the exhalation and coughing of the infected, resulting in further risk of spread and the gradual increase of exposure to those already infected, and the people around them.
Prevention
It took several years to determine the source and causes of Rust Lung, and as such preventative measures were either non-existent, broad and inefficient, or slow to be implemented at the height of the affliction.
The responsible refinery process was removed from use once identified in 3574 PL, and new procedures and guidelines since implemented for future practices.
Ventilation and filtration methods have proved effective at greatly limiting the risk of exposure, and have since been implemented throughout The City, especially in industrial and medical facilities, to reduce the risk of any future incidents like Rust Lung.
Treatment
So far, no cure has been identified or developed for Rust Lung.
The most effective current method of treatment is deBrusk’s deRust, developed by Shamus deBrusk in 3586 PL, over 17 years after the first confirmed cases. deRust involves the inhalation of a specially developed vapourised compound that reacts with the rust particulate within the lungs and renders it temporarily inert. While inert the ongoing reaction is halted, preventing further spread of infection, and vastly reducing the amount of rust dust be exhaled by the patient.
Frequency of treatment varies depending on severity of infection, ranging in current patients from twice a month to once every three months.
When combined with the divine healing abilities of The Order of the Ancient Heart, some amount of lung function can be restored while the spread is halted, though it is still susceptible to be lost again should the reaction resume.
Prognosis
All cases of Rust Lung, without treatment, result in death.
The life expectancy of an individual with Rust Lung, without treatment, ranges from five days to six months, depending on level of exposure and rate of spread.
Even with treatment, acute cases, as a result of higher doses and/or longer periods without treatment, historically have a 100% mortality rate. There have been no new such classified cases documented since 3577 PL.
It is theorised that with current treatment methods acute cases could be managed to prevent fatality, though it is acknowledged that the quality of life would be a severe concern.
Minor cases, with an initially survivable spread of the rust coating, have been successfully treated to partially restore and maintain lung capacity and prevent internal bleeding. Such cases require ongoing treatment for the duration of the individual's life, and special care as tiny portions of rust dust can be expressed from those infected.
Rust Lung Crisis
The failure to recognise the severity of the disease sooner, to quickly identify the source of the issue, and the broad adoption of the refinery process over the five years after its introduction resulted in the Rust Lung Crisis of 3574 PL. The crisis saw the number of cases of Rust Lung skyrocket from dozens over the previous several years to thousands in the span of a few months.
With virtually no understanding of the cause, limited understanding of the symptoms and best treatment practices, and very limited capacity for treatment, the disease claimed the lives of the majority of those afflicted in short order, and the number of cases continued to rise steadily.
The bold and decisive action proposed by then Minister of Health, Care, and Children Kenron Perkham saw him installed as The Steward, deposing Primrose Eaton after less than two years in office as she shouldered much of the blame for mishandling the situation.
Perkham oversaw the rapid rollout of containment procedures, diverted large amounts of resources to both treatment and research of Rust Lung, and the controversial immediate cessation of all industry production the moment the sector was implicated as a probable source.
With the time bought by these measures, the source was successfully identified and efforts to remove or reengineer the established process began. Though for most of the afflicted it was too late for treatment, better practices were established in order to treat those with early or minor cases, and to recognise infection much earlier.
As the situation improved, and new cases dwindled, Perkham championed the design and installation of expanded ventilation across The City (not just in the Industrial District), the inclusion of more rigorous filtration and pollutant analysis processes to all industrial emissions, and plans to create an emergency bypass to The Wall to allow for city-wide ventilation.
The cost of these undertakings (both materially and in future productivity), as well as the difficulty exacerbated by the previously stalled industrial production, and the brazen suggestion of any project that might undermine the integrity of The Wall, all created a great deal more friction and opposition for Perkham (who was hardly known for his diplomacy), especially from the influential industrial ministries.
Though he fought for what he strongly believed were necessary changes, and successfully established at least the fundamental aspects of his plans, he ultimately grew weary of the endless battle, and resigned from the position of Steward. He returned to the Ministry of Health, Care, and Children, though expressed no interest in the position of Minister ever again. Instead he worked closely with his ministerial successor Rémi Pascal to establish a new department to inspect and enforce industrial safety from outside the industrial ministries, with moderate success.
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