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'''Report Content: Results of the Medical Mission to Argurtha -- Romulan Plague Aid
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Ensign Chythar Skyfire
''2393, Vol. 320, No. 4 ''<br />
Medical Officer'''  
<font size=4>'''Investigation and treatment of an unknown virus presenting in a Romulan population'''</font>


''USS Excalibur NCC - 41903 - A''
<font size=3>Chythar Skyfire</font>


'''Author's note:'''


Anything denoted by * is going to be explained in the addendum, as well as any personal thoughts on the subject matter.
<h2>Introduction</h2>
Starfleet Medical was alerted to an epidemic outbreak of an unknown disease on a Romulan colony. It was reported to possess a high transmission and mortality rate, and Starfleet assistance was requested. A [[USS Excalibur-A|multi-mission explorer vessel]] was dispatched in order to investigate and render aid.




This report is compiled in regards to the errand of medical urgency we were sent upon Argurtha. Very little personal thought has been included for the cohesion of this report.
<h2>Investigation</h2>
Upon arrival, detailed histories were taken from the infected and existing medical records were interrogated for information. Tissue samples were recovered from the deceased in the morgue, using standard Starfleet procedures. Further samples were gathered from asymptomatic individuals exposed to the disease.




After hearing of a plague that was threatening to wipe out the population of the planet, the weight of the problem was pressed onto the CMO of the Excalibur, Lieutenant MacLaren. The Romulans appear to have been using a set of substandard RFID tags to track the infected. This wasn't effective, as another team found additional data and were analyzing it while the substandard tags issue was being dealt with. Starfleet Intelligence had come up with a theory as to where the plague started, and that is where the medical team began its search for answers. The CMO of the Romulan settlement the team was investigating was deceased before our arrival -- a victim of the plague who (according to the logs) died 24 hours before our arrival. Ensign Folds of the medical team posed the suggestion of examining the CMO's records. Updates were supposed to occur hourly, although it wasn't the way it went down.  
Existing attempts to discern the epidemiology of the disease had included the use of radio-frequency identification (RFID) tags to track the movements of the infected. Unfortunately, the tags themselves were of poor quality and the gathered data was of little use to the investigators.




<h2>Findings</h2>
Ensign Folds had taken Ensign Cuthbert down to the morgue to examine tissue samples. I was in charge of examining contagion matrices. The symptoms, as determined by Lt. Hiram Baker and Crewman Banks, included rapid tissue degeneration that mimicked E-coli and hemmoragic fever. There were additional questions that followed whether the degeneration of the internal organs was accompanied by either vomiting or  diarrhea. It was, in both cases. I felt that it was similar to the norovirus of Terra's 21st century, though this idea was quickly quelled. Letant's version of the incubation period said that it varied considerably, although he stated 2 weeks as his final answer. The data I found  suggested that it had a 99% communicable rate, and has an incubation period of 2 weeks, and no signs of variance. It was found later by Dr. Folds to be 100% communicable. The pattern of symptoms seemed to be 50-50, the viral colony inside the host had a set genetic makeup that when exposed to the host's DNA became fatal.  
The pathogen was identified as a virus with an incubation period of approximately 2 weeks. High levels of the virus were present in the respiratory system during active infection, resulting in a rate of airborne transmission estimated at 99%. Mortality rates were also observed to be approximately 99%.




The signs and symptoms included rapid tissue degeneration reminiscent of several strains of viral hemorrhagic fever, including bleeding diathesis, petechia, edema, hypotension, and muscle pain. Gastrointestinal signs were also present, with patients exhibiting vomiting and diarrhea in the late stages of the disease. Death or the beginnings of recovery typically occurred two to five days after symptoms began to present.


The plague seemed to be transmitted by a strange amphibioid that was unaffected by the disease, and the only amphibioid the team examined had died from injuries that weren't caused by the plague. The security detail and I headed over to Commander Orman's location to collect blood samples from folks who were resilient to the disease, as all reading material had exhausted its usefulness. Apparently Lt. Luna Walker had stumbled into the scene where I was working at the time, and had been confirmed to be a carrier but not infected. The lieutenant seemed lucid, from what I can recall. The interesting thing is that she appeared to be infected with two strains, but even more interesting is that she is a human/Romulan hybrid. Her human genetics must have developed antibodies once it hit her system. The blood samples I collected from the other group of hybrids also aided in the research, and during that time I heard rumors that it all started at a school with children.


With no match to any known existing viruses, the pathogen was named '''''Plasmodium-falciparum Romulopesti (PFR)'''''.




A young Romulan named D'Rantho came in contact with one of these amphibioids -- the one that Dr. Folds had examined. The Romulan had only been in contact with the amphibioid for a short time, but he looked like he was about to die. Lt. MacLaren saw to him while I and the nanite colony known as B were analyzing blood samples. The hybrids' resilience to the virus was impressive, although apparently an explosion interrupted my research.
An amphibian form of life native to the colony world was determined to be the natural reservoir for the virus. As is often typical with natural reservoirs, the lifeform was asymptomatic and carried the virus as a subclinical infection. The source of the outbreak was discovered to be a child who had come into brief contact with one of the amphibian lifeforms.




PFR was observed to be unable to cross species to Betazoids and Orions, and a Human-Romulan hybrid was found to be infected with two strains of the virus, whilst remaining asymptomatic.


The disease had no effect on humans*, or Betazoids*, or Orions*. This was determined during the aftermath amidst the chaos that erupted in Sickbay during the time bracket that followed the aftermath. Ensign Cuthbert* seemed to be showing signs of infection during the event. The hybrids' resilience seemed to be in-line with the human resilience I found in Luna Walker*, where all the hybrids appeared to have some human genetics thus able to produce the antibodies; which were due to a high concentration of vitamins C and D that I didn't find in any of the Romulan samples -- thus making the human genetics capable of producing the necessary antibodies.  I'd found a few similarities between the amphibioid and Lt. Walker, but not enough for me to make a positive declaration of anything. Both samples had similar pathology, but each was composed of a separate set of genetic markers. I wasn't able to make sense of it at first. Initial scans suggested that it began at the sight of contact, and that the virus affects different systems in different ways: while centered on the respiratory system for both intake and reproduction, it destroys other systems -- the lungs manage to sustain the least amount of damage.


<h2>Treatment</h2>
The infection of a [[Luna Walker|Human-Romulan]] hybrid allowed the Starfleet team to confirm that the Human immune system was able to produce the antibodies necessary to combat the virus.


These antibodies were synthesised aboard the [[USS Excalibur-A|response vessel]] using standard Starfleet equipment, and then delivered to the patients via an infusion that included vitamins C and D, which appeared to act as a catalyst for the antibodies via an as yet unknown mechanism.


The key to the antiserum takes the antibodies we collected from the various hybrid samples and combines with a healthy human's normal level of vitamins C and D. It is as thermostable as a cup of warm coffee, so it shouldn't be a problem to synthesize. If there are any additional complications with what Brek has labeled "The Skyfire Cure* ", it is possible to contact me*.


<h2>Discussion and Recommendations</h2>
Thanks to the cooperation of the Romulan colonists and the swift response of Starfleet, loss of life was minimised. As the natural reservoir was determined by the investigation, the colonists were able to successfully eliminate PFR from the amphibian population, drastically reducing the risk of another infection and outbreak.


At present there appears to be no lasting physical morbidities due to PFR infection, though many of the survivors have expressed some degree of post-traumatic stress. Psychological support is in place for these individuals, and for those who appear otherwise healthy, six-monthly follow-ups are recommended for a period of five years.


'''ADDENDUM: Personal Thoughts'''
Research into the interactions between human antibodies and vitamins C and D are required in order to further understand the exact mechanisms of the virus.


I was very nearly pulled off of this project due to bad hearing. My mentor, Lt. MacLaren lies injured and I became the point man on this antiserum. I hope I didn't disappoint you, Johanna. I hope you survive so we may speak again. I am not after awards, or the CMO position of the USS Excalibur.  If I wind up earning an award, I will accept it as an unexpected surprise. If I wind up promoted, I will accept that too and be even more surprised. I didn't mean to be a hero.


<h2>Addendum</h2>
Since the initial encounter on the Romulan colony, PFR has been observed in a population of [[Quarantine_(Garuda)|Cardassians]] and viral samples are known to have been [[Scourge_of_Romulus_(Victory)|stolen and/or traded illicitly]]. The author believes there is a strong possibility that new strains are being engineered to target different populations, and thus that research into PFR should be of the highest priority.


 
[[Category:Journal of Starfleet Medicine]]
'''ADDENDUM: Betazoids, Humans, Orions'''
[[Category:Drugs and medicine]]
 
[[Category:Chythar Skyfire|Skyfire Cure]]
Since all the scans run (Cuthbert, Shedet, MacLaren et al) showed no sign of a species jump, we concluded that the disease did not spread beyond what it had already. The disease seems to have been limited to the amphibioids and Romulans.
 
 
 
'''ADDENDUM: Lieutenant Luna Walker, Engineer'''
 
She was a unique one, and I believe that it was her blood that played the most signifigant role. Her unique gentic structure was such that she was capable of being infected with two strains of the virus, and she has miraculously been able to provide the antibodies I needed to exploit in order to develop the serum.
 
 
 
'''ADDENDUM: Ensign Alden Cuthbert, Security Officer'''
 
Cuthbert was wounded in the line of duty when he was providing an escort to Dr. Folds to the morgue on Argurtha to examine the amphibian. The blade he was stabbed with was not recovered, though the fact that it was a contact poison that had symptons which mimicked the plague symptoms at first is why it was believed early on that it had made the jump from Romulans to humans. If there is an award for sustaining injury in the line of duty, I vote he be nominated for it.
 
 
 
 
'''ADDENDUM: THE SKYFIRE CURE'''
 
As it was previously stated, the antibodies from Lt. Walker and several other hybrids were combined to make this serum, and infused additionally with a human's typical level of Vitamin D and Vitamin C, both of which are beneficial to the human immune system. Levels of both vitamins have been adjusted by -10% to account for Romulan physiology.
 
 
 
'''ADDENDUM: Contacting Doctor Skyfire'''
 
It is assumed that Lt. Commander Brek of the Diplomatic Corps has been or will be including all necessary information to contact me in the event additional problems arise as a result of this antiserum.

Latest revision as of 06:59, 4 June 2017

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2393, Vol. 320, No. 4
Investigation and treatment of an unknown virus presenting in a Romulan population

Chythar Skyfire


Introduction

Starfleet Medical was alerted to an epidemic outbreak of an unknown disease on a Romulan colony. It was reported to possess a high transmission and mortality rate, and Starfleet assistance was requested. A multi-mission explorer vessel was dispatched in order to investigate and render aid.


Investigation

Upon arrival, detailed histories were taken from the infected and existing medical records were interrogated for information. Tissue samples were recovered from the deceased in the morgue, using standard Starfleet procedures. Further samples were gathered from asymptomatic individuals exposed to the disease.


Existing attempts to discern the epidemiology of the disease had included the use of radio-frequency identification (RFID) tags to track the movements of the infected. Unfortunately, the tags themselves were of poor quality and the gathered data was of little use to the investigators.


Findings

The pathogen was identified as a virus with an incubation period of approximately 2 weeks. High levels of the virus were present in the respiratory system during active infection, resulting in a rate of airborne transmission estimated at 99%. Mortality rates were also observed to be approximately 99%.


The signs and symptoms included rapid tissue degeneration reminiscent of several strains of viral hemorrhagic fever, including bleeding diathesis, petechia, edema, hypotension, and muscle pain. Gastrointestinal signs were also present, with patients exhibiting vomiting and diarrhea in the late stages of the disease. Death or the beginnings of recovery typically occurred two to five days after symptoms began to present.


With no match to any known existing viruses, the pathogen was named Plasmodium-falciparum Romulopesti (PFR).


An amphibian form of life native to the colony world was determined to be the natural reservoir for the virus. As is often typical with natural reservoirs, the lifeform was asymptomatic and carried the virus as a subclinical infection. The source of the outbreak was discovered to be a child who had come into brief contact with one of the amphibian lifeforms.


PFR was observed to be unable to cross species to Betazoids and Orions, and a Human-Romulan hybrid was found to be infected with two strains of the virus, whilst remaining asymptomatic.


Treatment

The infection of a Human-Romulan hybrid allowed the Starfleet team to confirm that the Human immune system was able to produce the antibodies necessary to combat the virus.

These antibodies were synthesised aboard the response vessel using standard Starfleet equipment, and then delivered to the patients via an infusion that included vitamins C and D, which appeared to act as a catalyst for the antibodies via an as yet unknown mechanism.


Discussion and Recommendations

Thanks to the cooperation of the Romulan colonists and the swift response of Starfleet, loss of life was minimised. As the natural reservoir was determined by the investigation, the colonists were able to successfully eliminate PFR from the amphibian population, drastically reducing the risk of another infection and outbreak.

At present there appears to be no lasting physical morbidities due to PFR infection, though many of the survivors have expressed some degree of post-traumatic stress. Psychological support is in place for these individuals, and for those who appear otherwise healthy, six-monthly follow-ups are recommended for a period of five years.

Research into the interactions between human antibodies and vitamins C and D are required in order to further understand the exact mechanisms of the virus.


Addendum

Since the initial encounter on the Romulan colony, PFR has been observed in a population of Cardassians and viral samples are known to have been stolen and/or traded illicitly. The author believes there is a strong possibility that new strains are being engineered to target different populations, and thus that research into PFR should be of the highest priority.