I'm still putting together campaign material for my alt-history technothriller Shadowrun campaign (Altered States). The following is a second draft writeup of VITAS, annotated in Shadowrun style (though not by the usual gang of criminal lowlifes). Apologies for length.

EDIT: This should have been much shorter. To compensate, I've put additional information—the classic Shadowrun-style comments—in spoiler tags. This should reduce the info overload.

Those who want to read the original article can, those looking for the details in the comments can do that, as well. Apologies for those who smacked too hard into the wall of text.

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Virally Induced Toxic Allergy Syndrome (VITAS)
Source: The American Encyclopedia, 2021 Online Edition. Dr. William Kohl, MD; Pathologist, USAMRIID.

Virally Induced Toxic Allergy Syndrome (VITAS) was a deadly viral epidemic that spread world-wide in 2010. The disease was the most severe pandemic in human history, killing approximately 20% of the world’s population through direct effects (1.38 billion), and another 25% through secondary effects (such as famine, civil unrest, and consequent diseases). VITAS caused permanent allergies even in survivors, which prompted the development of advanced hypo-allergenic materials. Political after-effects of the disease included a global economic depression and the Balkanization of many large countries (including The People’s Republic of China and The United States of America).

Outbreak

VITAS began in July of 2010 in a remote region of India, near China and Burma, and spread rapidly into all three countries. The first deaths from the disease occurred 1-2 weeks later, thereafter escalating rapidly in number. The mounting death toll in the region prompted healthcare workers to notify the World Health Organization (WHO) of the possible existence of a new and more deadly strain of the seasonal flu. (At this time, neither Burma nor China had reported any deaths from VITAS, though later investigation revealed significant casualties in both countries, concurrent to the deaths in India.)

A month after the first casualties, Dr. Prasad Kapoor of India’s National Institute of Pathology in New Delhi first identified VITAS as a novel plague, unrelated to the flu virus. A report detailing his findings, and blood samples from infected patients, were provided to WHO and the Centers for Disease Control, and work on isolation and gene sequencing began immediately.

Dr. Kapoor’s report prompted the first widespread media coverage of the virus, under the names “The New Delhi Plague” or “The New Delhi Flu”. The Indian government began efforts to contain the virus, but by the time of Kapoor’s report it had already spread to Australia, Egypt, the United Kingdom, and Panama.

The disease spread quickly, and in almost all cases went untreated. Potential treatments for the disease existed, such as steroids, but there is no recorded instance of them being used.Medical Effects

VITAS was fairly unique among infectious diseases, as it had no observable primary symptoms. Its only effect was to induce new allergies in infected patients. All other symptoms came from anaphylaxis, their own immune system’s reaction to the newly-developed allergy. Observed anaphylaxis symptoms matched those of natural allergies, and included mild reactions (syncope or loss of consciousness, rashes, shortness of breath) as well as lethal manifestations (myocardial infarction or asphyxiation).
Most people never develop allergies severe enough to be life-threatening. Prior to VITAS, only .5% to 2% of the population experienced anaphylaxis during their lifetime.

In contrast, all those infected with the disease became sensitive to a few allergens, and many became allergic to a multitude of allergens. (Common allergens being, e.g., wheat or milk, metal or vinyl, and pet dander or dust mite excretions.) The danger to specific individuals varied according to which allergens they became sensitive to and how severe their anaphylaxis symptoms were.Transmission and Progression

VITAS was an air-born contagion, transferred by bodily fluids (sneezing, speaking, coughing) and dust. Outside the body, it could survive for up to a day, in dust or on surfaces.

The disease was highly contagious. In the United States alone, it is estimated that 80-90% of the population were exposed, and 75% of the total population developed the disease.

Once contracted, the disease has a latent period of 12-24 hours, then an asymptomatic period of 3-6 days, during which the patient is infected but not symptomatic.

The first symptoms were extremely mild, consisting of a light rash, shortness of breath, or lightheadedness. Severe symptoms, present in 25%-30% of all patients, usually began 12-24 hours later. In most cases, VITAS infections lasted 5-6 weeks from the onset of first frank symptoms. During this time, those with mild or moderate symptoms were only sporadically symptomatic.Global Effects

VITAS transformed global society. It caused economic and civil disruption on a scale never before seen. It ignited civil and regional wars and lead to the creation of several new countries as larger nations Balkanized. Trans-national bodies, such as the United Nations, ceased to exist as did nearly all multi-national alliances, like the Northern Atlantic Treaty Organization.

Economic devastation lead to the Second Long Depression, and a huge increase in global poverty levels. Life expectancy, standard of living, and literacy all tumbled, in many cases to pre-Twentieth Century levels.

Cultural changes were widespread, in some instances causing a resurgence of traditional culture, in others radical changes away from pre-VITAS cultural norms. Religious observation generally increased, which had a significant impact on the later Awakening of magic.

Debate on the full impact of VITAS continues in academic circles. Most agree that a full accounting of its effects won’t be possible for decades, perhaps centuries.
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Edited for space, to make reading easier. Sorry.

(moved to another thread)

This looks like the idea has been solidified to a retro-virus, something that rewrites the bodies genetic code, to create allergic reactions (something that is not, in present time, fully understood).

If the person were primed by VITAS to be more sensitive, they could develop reactions much faster than the typical person. They are also almost impossible to counter, since the genetic rewrite is permanent, and would have to again be rewritten after the virus was destroyed.

This is basically mirrors the reasons that HMHVV is so unstoppable. It could work well, and might even explain the reflexive terror that the 6th world reacted to HMHVV: they'd seen the pattern before.

I like it.

Thank you. I've been trying hard to make it not suck.

(Time to spout the fruits of my allergy research.) It could be a retrovirus, one that modifies the specific stem cells in bone marrow that produce white blood cells (WBC), so they become more prone to creating allergies.

Alternately, VITAS could infect the specific WBC that produce reactions to allergens. So long as the person has the virus, the WBC will over-react and the person accumulates new and more deadly allergies. Once VITAS has faded, and the WBC are replaced (WBC die off after a few days to a few weeks), the person doesn't develop new allergies but the ones they've been gifted by the virus remain.

The first is, as you noted, permanent. They'll be accumulating new allergies all their lives. The second isn't permanent, but the allergies are. Right now, I'm leaning towards the second.

I mentioned in the article that hypo-allergenic research is very advanced in this timeline, because something like 55% of the survivors have mild to moderate allergies. This causes a lot of problems.

Enter adventure idea: Players are sent into Aztlan to retrieve an agent who's gone off-grid. He tells them of an Aztlan base that has been researching weaponized VITAS, to use against the US. They go there to try and destroy the research and, if they're clever, can find research designed to cure allergies.

Allergies got no cure, in the real world. But finding one, and bringing the paydata back with them to the US, could save 55% of the populace from some bad stuff, and could even inoculate people against the effects of VITAS (not the virus itself, but the allergies it creates). You know, just in case Aztlan has some weaponized VITAS shells sitting around in another facility.

(Weaponized VITAS shells. Doesn't that phrase just drip ominous implications?)

That's one way a small mission can have a big effect.

(And, this adventure idea proves the utility of massively over-thinking apparently small things. Had I not been so driven to research and writeup VITAS, I'd have never come up with the idea.)

Plus, you know, vampires and ghouls.

In Altered States, Seattle is the destination for the millions of people displaced from NAN. They're packed into refugee camps. (That's where the Barrens come from.)

The first appearance of HMHVV is an outbreak of ghoulism in the camp. People panic, ghouls proliferate, and the government cordons off the area and the survivors, eventually walling it off. It's called The Pen, and inside packs of ghouls hunt humans (who the government won't let leave).

Kind of like Bug City, but with ghouls.

Vampires and the like (dzoo-no-qua?) come later, as HMHVV mutates.

Thanks for the comments. Any others you might have are welcome.

if you are looking at this being a pandemic, then the 2nd option needs a good reason as to the ineffectiveness of things like anti-virals.

Two best options off the top of my head are a highly resistant strain (which for viruses is surprisingly not as likely) or a mutable strain, like HIV, that changes throughout the course of the infection, making it difficult to target.

Keep in mind also that it is possible to have "allergic" reactions without necessitating the change in white blood cells as well. Multiple vectors for the allergies would also make for a very insidious virus and complicate the methods of testing for it severely. Otherwise, I'd think a test of white blood cells would confirm the infection.

The ghouls will be well fed, as that's not the only disease that will develop in a crowded refuge camp in a period of large-scale disorder....

Hadn't thought about it. Though one part of the writeup could explain it: "During the epidemic, those of us 'on the ground' just didn’t know what the disease did, how it killed, or how to treat it."

If you don't know it's a virus, how can you know to treat it with anti-virals?

More, most people seemed well, up until a day before they just fragging died. For those who developed (or would develop) severe reactions, there wasn't time for a course of antivirals.

And if you did, they'd be developing new allergies while they were in the hospital, allergies to stuff in the hospital. Continual treatment for severe anaphylaxis is just as bad as the virus itself.

"Epi pen." That is, an epinephrine injector. Epinephrine is adrenaline, that chemical that jolts your system when you're startled or terrified. A single dose in a day is survivable. But more than that wears out your heart, lungs, and a whole lot more. Shooting 20 epi pens into a person every couple of days until the anti-virals have time to work just isn't a viable option. You'll kill the poor bastard trying to save him.

Such a test was developed... eventually. The problem with a blood test is knowing what you're looking for. And VITAS moved too quickly for anyone to find out until long after it was all over.

"Identification of the symptoms and progression took a year. Conclusive identification of the pathogen (the first step towards developing a diagnostic test) took another year and gene sequencing another six months. Even the name 'VITAS' wasn’t coined until two years after the the initial outbreak (by a pair of researchers from USAMRIID)."

The VITAS plague, at least the major global outbreaks, lasted about 6 or 7 months. There just wasn't time.