Rabies

[johnny_oe]

tl;dr
The time from symptoms to death in rabies is wrong, the outcome should always be death, occuring within 2-10 days after symptom onset.

long version:
As a medical professional I appreciate the attention that is given to disease in the latest expansion. For us today, it is difficult to imagine HOW MUCH MORE disease affected the lives of people in those times and how arbitrary illness chose its victims from all social backgrounds (although of course the ordinary poor peasants were still more affected than kings&queens).
I think in general the game depicts the burden of disease to a certain level of realism, which is sometimes an annoying lot for gameplay.

But for one disease the effects are extremely far from reality. I have had relatives with rabies live for years ingame. Rabies is - even today - a 100% deadly disease once symptoms appear, usually within 10 days. (There are exactly five documented cases of survival with high tech medical support worldwide, see "Milwaukee protocol")
There might have been confusion between incubation time (can be several years in rare cases, but the infection cannot be detected even with modern methods, disease can only be avoided with vaccination not available until modern times) and time from symptom onset to death (2-10 days, treatment in ancient times impossible).

Therefore, I would suggest to change the responsible values in the game.

//edit: for sources refer to http://en.wikipedia.org/wiki/Rabies and links on that page

 

[Drakken]

I agree. Humans with rabies -the physical one - usually die very quickly.

The only type of 'rabies' in which people would survive longer would be in fact lycanthropy, which can mimick the attitude of someone with rabies.

 

[klopkr]

I have yet to see rabies in game but if it's like you describe it then it makes no sense at all. The only way to cure rabies is magic or misdiagnosis.

 

[Sirrobert1]

You can cure syphilis by cutting off your hand. So I'd hardly say this is the most unreal.

 

[Drakken]

I have yet to see rabies in game but if it's like you describe it then it makes no sense at all. The only way to cure rabies is magic or misdiagnosis.

 

[SigurdStormhand]

You can cure syphilis by cutting off your hand. So I'd hardly say this is the most unreal.

tl;dr
The time from symptoms to death in rabies is wrong, the outcome should always be death, occuring within 2-10 days after symptom onset.

long version:
As a medical professional I appreciate the attention that is given to disease in the latest expansion. For us today, it is difficult to imagine HOW MUCH MORE disease affected the lives of people in those times and how arbitrary illness chose its victims from all social backgrounds (although of course the ordinary poor peasants were still more affected than kings&queens).
I think in general the game depicts the burden of disease to a certain level of realism, which is sometimes an annoying lot for gameplay.

But for one disease the effects are extremely far from reality. I have had relatives with rabies live for years ingame. Rabies is - even today - a 100% deadly disease once symptoms appear, usually within 10 days. (There are exactly five documented cases of survival with high tech medical support worldwide, see "Milwaukee protocol")
There might have been confusion between incubation time (can be several years in rare cases, but the infection cannot be detected even with modern methods, disease can only be avoided with vaccination not available until modern times) and time from symptom onset to death (2-10 days, treatment in ancient times impossible).

Therefore, I would suggest to change the responsible values in the game.

//edit: for sources refer to http://en.wikipedia.org/wiki/Rabies and links on that page

Right - agreed. Having said that, we have Syphilis in the game when it was a completely unknown disease in the period, there is no evidence of a single case. There's evidence of a similar Syphilitic disease in Ancient Rome but it appears to have died out along with Roman urban living.

You can cure syphilis by cutting off your hand. So I'd hardly say this is the most unreal.

Setting aside the above, Syphilis is a bacteria, and eminently treatable, so it's not impossible a medieval physician might cure it. they'd have to stumble on Penicillin though. Maybe when the Physician cut off your hand he wrapped the stump in mouldy bandages.

 

[Lazarae]

And I'm fairly certain misdiagnosis is a thing. My physician told me I had... I think it was camp fever? I ended up developing cancer a month later. There's no guarantee it's ACTUALLY rabies until you get the rabies trait.

 

[RelVleDy]

I'm not saying you're wrong, but I find it funny a medical professional is quoting Wikipedia. Now I can talk shit about my art professor when they ask for sources.

 

[edza101]

Still, rabies is one of the deadliest diseases on earth which will still has an almost 100% mortality rate IRL after displaying symptoms; death occurring 2-10 days after this point.

Nobody in the middle ages could survive this.

EDIT: Even with an "intention to treat" protocol (making a concerted effort to treat symptoms and reduce damage rather than just providing a comfortable transition into coma/death through palliative care) utilising modern medicine, rabies racks pretty low with an 8% survival rate.

 

[klopkr]

I'm not saying you're wrong, but I find it funny a medical professional is quoting Wikipedia. Now I can talk shit about my art professor when they ask for sources.

You should never use a tertiary source in a professional or educational environment but it's perfectly fine in non-formal environment.

It's the difference between your doctor diagnosing you with rabies after a quick look at wikipedia and your doctor friend telling you rabies have a really lethal death rate.

Also pro-tip. Wikipedia lists all its sources so just use wikipedia's sources and nobody can fault you for using wikipedia.

 

[thevmag]

As soon as you hit the unpause button, the game drifts into alternate history.

This just so happens to be an alternate history where castration cures cancer, being a eunuch isn't irreversible, and cutting off your nose to spite your rabies is a totally valid
medical option.

 

[edza101]

As soon as you hit the unpause button, the game drifts into alternate history.

 

[Rognvaldr19]

Well, I've got Aztecs crawling all over Scandinavia, the black death coming in from the Byzantine Empire, and those most zealous of Catholics, the Umayyads knocking on my door, I'm going to go ahead and give rabies a pass on this one.

 

[Zyrious]

I'm really getting tired of the "Alt history = unrealistic argument". No, no it doesn't. Alt history = alternate history, not impossible history (except for sunset invasion, but that's a fantasy DLC). Just because history changes after you hit unpause, doesn't mean the laws of physics or science also change. I didn't buy this game for fantasy, but for a immersive middle ages experience, and there is nothing wrong with people making posts like the OP. I'm quite unmotivated to buy Reapers Due if it's as unrealistic as some posters here are describing, though i'm hoping it's simply a case of misdiagnosis and the treatment actually solving whatever it is you do have (Or only curing you because you weren't actually sick in the first place).

 

[Urzhail64]

Werewolf and rabies...would a werewolf carrier not die despite having rabies cause of being a supernatural creature ?

/foams at the mouth and howls at the full moon

 

[johnny_oe]

And I'm fairly certain misdiagnosis is a thing. My physician told me I had... I think it was camp fever? I ended up developing cancer a month later. There's no guarantee it's ACTUALLY rabies until you get the rabies trait.

Misdiagnosis is of course (realistically) common in the game and still occurs in many cases in real life today - not only for rabies. Your doctor normally does not know for sure what you have when he prescribes you an antibiotic for cough (bad idea in most cases). And yeah, it does happen in real life that you are diagnosed with a simple flu but do indeed have cancer.

But in my original post I was referring to the rabies trait - my ingame son had this for about 3 years before dying. So what I am saying is, as soon as you definitely know someone has rabies, the character should die within a week or so.

I did not check thoroughly on other diseases, but please remember that there is a lot of diseases that can heal by themself or become chronic in ways that have not symptoms for a long time (as the syphillis mentioned above). So if the doctor gives you a strange treatment and you feel better afterwards, that does not necessarily mean the treatment actually had any effect. I have the impression the ingame situation is also quite realistically portraying the patients view on this ...

And now the following is probably OT in this forum but I want to comment on this:

I'm not saying you're wrong, but I find it funny a medical professional is quoting Wikipedia. Now I can talk shit about my art professor when they ask for sources.

There are 97 references on that page, many of them linking to scientific publications on the topic, but not necessarily comprehensible even to the average doctor. I actually consider the wikipedia article itself a valuable source, especially when giving references to people who are not medical professionals. You would of course want to crosscheck it before relying on it.
If I quoted you from my textbooks, it would a) be in German, b) in professional language c) much less detailed and d) in most cases less exact, outdated or even wrong compared to scientific state of art. I would rather want to be treated by a colleague refreshing his memory about a rare disease on wikipedia than from his textbooks.

Now I became curious and checked three textbooks I have at home:
A (print from 2008): rabies is not mentioned at all
B (2003): 27 lines, the complete part on therapy and prognosis reads as follows: "Therapy: symptomatic, intensive care; Prognosis: after symptom outbreak lethal in almost 100%"
C (2007): 19 lines, similar about treatment and prognosis, but at least makes the important statement: "Seek help"

Please don't think I am offended by your post!
I just think that the same scepticism people have towards wikipedia should also be applied to other sources, be it professors, the books they suggest or any other authorities ...

 

[Gamengervi]

To be fair, it and bubonic plague are the most deadly diseases in the game.