Sandbox:Asem

# Overview
Updog syndrome is a disease that affected Human beings in the 21st century. It was caused by the SuperBug , whose origins are still disputed, with several indications that it may have been developed by an alien species. The syndrome had a varied presentation, the common features included inattentiveness, decreased mental capacity, drooling, laziness with sudden bursts of activity, uncontrollable diarrhea, constant tweeting and an increased appetite for gluten-free products. Despite several treatment options being developed, the disease was only eradicated in the year 2069 after Emperor Joffrey gathered all affected patients in cages and then put them on rockets headed directly to the sun with the assistance of trillionaire, and first human fusion individual, Jelon Mezos, in what was known as project "Best Summer Tan".

# Historical Perspective
- File:Audience-band-concert-1105666.jpgThe burning of FyreMan, announcing the start of the fest (2041)Updog syndrome was first described in 2041 by American innovator and InstagTwitter personality @Kute_Lash_Curls854873 who documented several cases during her coverage of the 14th Burning Fyre Man Fest which took place in northeastern Venezuela. Several outbreaks were reported in the following weeks across the globe.
- In 2044, the North Korean CDC announced that it had isolated the causative pathogen, an unusual spherical bacterium with a completely opaque surface and it was named SuperBug.

# Pathophysiology

## Pathogenesis
- The pathogenesis of Updog syndrome is as follows:
- The pathogen, SuperBug, enters the host by using a laser beam to open the skin after anesthetizing the area with a Tranq-Dart.
- Afterwards, the SuperBug starts its migration to the brain by one of two ways:
- Swimming in the blood stream and going through the blood brain barrier using the laser beam but on a different setting.
- Teleportation, with the destination usually being one of the lateral ventricles, with more predilection for the left over the right.
- The SuperBug then tries to establish a connection to a neuronal body or axon to start its influence, the psychic abilities of the SuperBug seem to only work on nearby neurons and a preference for the corpus callosum has been noticed, possibly because of access to both brain hemispheres.

# Epidemiology and Demograghics
Updog syndrome was a very contagious condition. Though the exact mechanism of inter-personal transmission was not fully-understood, it was believed that a healthy individual spending as little as 5 seconds in the same room with an affected individual was enough for the SuperBug to infect the new individual, giving rise to the 5-second rule. The disease seemed to affect all groups of the human population with no regard to age, race, sexual orientation, gender identity, city of birth or eye brow thickness.

# Differentiating Updog Syndrome from Similar Conditions
Several publications introduced in the 2040s disputed Updog syndrome as an exaggeration of social media addiction. Those studies were disproven after the introduction of the Laser-Pointer-in-Eye diagnostic test.

# Risk Factors
The only confirmed risk factor for Updog syndrome was an interaction with an infected person for longer than 5 seconds. However, the American CDC announced a cautionary announcement in 2045 for people who might be at an increased risk of faster infection. The risk factors are listed in the table below:

# Screening
Until 2058, the most widely used screening test for Updog syndrome was known as the glowing 1000 degree knife challenge test. The test was developed after several influencers noted that Updogified individuals exhibited a fear of being burned. The test was conducted in a variable-size room and done by heating a vibranium knife, or any wide-blade kitchen knife really, to about 350 degrees Celsius (the 1000 degree name was for promotional purposes), at which point the knife would be glowing red. The knife is then introduced to the suspected infected person via a small robot. The patient would have to lick the knife 3 times, if no burn is sustained, that was considered to be a negative result. If the patient sustained a burn, it was considered a positive test and both patient and robot were crushed by the walls of the room and then their remains were incinerated. If the patient refused to lick the knife, the test was considered a positive and the patient and robot were treated accordingly (this was cited as one of causes for the robot revolt of 2066 by several historians).
In 2058, the Laser-Pointer-in-Eye diagnostic test  was introduced by the International Federation of Jade Crystal Owners. This was a much cheaper and faster test, as the laser pointer can be used several times, unlike the knives that had to be discarded. The patient's head was fixed to a hard surface and their eyelids sewn open, a laser pointer is then directed at the pupils. Screaming, yelling, cursing and/or involuntary urination were considered positive results, and until the introduction of Red Kryptonite Crystal (RKC) treatment in 2063, infected patients were sent to a farm up state.

# Natural History, Complications and Prognosis
Updog syndrome has a very varied presentation and progression. Symptoms can present within minutes of exposure, though there were some cases reported on a Huffington Buzz Lord of the Rings Quiz in which symptoms appeared as late as 4-54 weeks after the initial exposure. Drowsiness, laughter and a twinkle in the eye are among the earliest symptoms, from that, progression of symptoms can happen over 3 days up to 2 months (3 weeks if patient was in solitary confinement), though a progression into a full blown tweeting storm can happen in as soon as 30 minutes post-exposure.
Until the introduction of the first treatment modality in 2063, prognosis was very poor with most patients reported deceased at the 3-year follow up. With the RKC treatment, mortality rates only changed slightly, as a single RKC could only be afforded by the richest 4712 people, disgraced president Frank Underwood (the world's 4713th richest person) was the last person to undergo the glowing 1000 degree knife challenge test (he managed to lick the knife only twice before attempting to choke it to death). When the MRTHA test-treatment was discovered in 2067, it managed to stop, and sometimes reverse, the progression of symptoms. Those patients were then placed under solitary maximum security quarantines, and were later chosen as involuntary volunteers to the Best Summer Tan project.

# Diagnosis
The diagnosis of Updog syndrome was very challenging due to the varied symptoms and the often long incubation period. The glowing 1000 degree knife challenge and the Laser-Pointer-in-Eye diagnostic tests were very helpful in the diagnostic courts.
The MRTHA (Martha-Related sTopping Hallucinations Auditorily) test-treatment, as the name suggests, was considered both diagnostic and therapeutic. It consisted of shaking the patient violently while yelling "SAVE MARTHA!" repeatedly, and it often resulted in stopping and/or reversing the progression of symptoms.
All physical exam, lab tests and imaging studies were inconclusive in findings to diagnose Updog syndrome.

# Treatment
The first treatment modality for Updog syndrome was introduced in 2063 (RKC). Due to inaccessibility and high prices, more research was done which resulted in the introduction of the MRTHA test-treatment in 2067, which was significantly cost effective. Treated patients were placed under solitary maximum security quarantines to insure their safety and to avoid reinfection and they were later introduced as part of the Best Summer Tan project in 2069.
After the project was completed, the remaining human population of less than 5000 people were all living in the luxurious underground bunker facilities under mount Rushmore which had a sophisticated ventilation system that drew air from special openings at the tip of president Lincoln's nose. Though they all died after Thor accidentally dropped his hammer right over the ventilation hatch and was too drunk to remember where it was.