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ReDS is thought to be caused by Mycobacteria borelliasis, a bacterial strain carrying genes similar to the bacteria causing tuberculosis and the bacteria causing Lyme disease. Current theory holds that this is a new species arising from an extreme case of Horizontal Gene Transfer. This combination, as well as antibiotic resistance common to many bacteria, make ReDS immune to existing treatments for both tuberculosis and Lyme; there is, as yet, no known cure.

Infection Statistics[]

At present, over 25 million people worldwide are known to be infected with ReDS; the World Health Organization estimates that another 5 million are likely to be in the early stages of the disease. Some 3 million people have died from ReDS and its related health effects.

Disease Progression[]

ReDS is spread both by insect bites and airborne droplets (from coughing, laughing, spitting, etc.). The incubation period is typically one week; although the victim is asymptomatic during this period, she or he is highly infectious. Early signs of infection include high fever and flu-like symptoms, typically including lumps under the arms. The bacteria then settles into the lungs, nervous system, and/or digestive system, where it becomes chronic, with coughing, bloody mucous, pain in the extremities, chronic diarrhea, weight loss, and wasting. For people with seriously compromised immune systems, it can be fatal within a few weeks of contraction; about 10 percent of the people who contract it can expect to be dead within 5 years; the long-term morbidity rate remains unknown.

Although ReDS is not technically considered to be immunosuppressive, victims of full-blown ReDS have a much higher likelihood of acquiring opportunistic diseases.

Initial Outbreak[]

The first known case of ReDS appeared in Cuba in 2016, spreading initially to Central America and Europe, then globally. Early rumors that ReDS was an engineered bioweapon appear to be mistaken; the rumors continue to persist, however, in both low-information and information-overloaded populations. Syndrome, or ReDS. As bad as ReDS is, however, the WorldRun simulations suggest that it's only the first of a wave of successive global health threats.

Points of Impact[]

Areas hardest-hit by ReDS are largely--but not exclusively--in the tropical and subtropical regions of the planet. Temperate and even Boreal zones are not immune, however, as the outbreak in Stockholm demonstrates. (Stockholm is somewhat of an outlier, however, in that the current rate of infection seems to correlate with the initially very high number of volunteers for ReDS Relief work.)

The Quarantine superthreat is likely to be felt most strongly in locations that have some mix of the following characteristics:

  • High population density
  • High population mobility
  • High levels of transnational migration
  • High proportion of elderly or very young population
  • Limited access to preventative healthcare
  • Limited healthcare knowledge
  • Limited access to information resources
  • Compromised political stability
  • Strong community rivalries


Currently, treatment methodologies are diverse and mostly ineffective. A number of groups are working on developing a cure for ReDS; however, clinical studies have not yet begun to yield results.

A distributed computing project has also started to analyse possible cure scenarios.


The Quarantine superthreat interacts with the four other superthreats in the following ways:

Superthreat: Ravenous: Starvation exacerbates existing health crises, increasing mortality rates; pandemic disease disrupts food distribution, workforce productivity, and overall healthcare capacity.

Superthreat: Outlaw Planet: Piracy and griefing reduces access to and reliability of medicines; the spread of monitoring and sensor technologies improve capacity to watch crisis zones; in turn, the spread of disease increases demand for public monitoring.

Superthreat: Power Struggle: Energy costs, limitations on infrastructure, and increased demand for scientific research & development all limit resources available to fight pandemic; disease disrupts workforce productivity, reducing available economic resources for alternative energy development.

Superthreat: Generation Exile: Disaporas can serve as disease vectors; migration makes control of pandemic harder; migratory groups serve as ready scapegoats for outbreaks; pandemic can serve as trigger for expulsion of or violence against minorities.