Lazarus Brain Infection

The **Lazarus** **brain infection (LBI)**, also called **red plague**, is the infectious disease responsible for the mass deaths and subsequent reanimation of zombies in *Strain Zero* and the *Remake* Universe. It was discovered sometime in early 2003 in Central America, from which it rapidly spread around the world via the international food trade; by October it had become a worldwide pandemic, causing the end of modern civilization and the near extinction of the human race. Its origins, whether they are natural, artificial or extraterrestrial, are unknown. Its spread and the subsequent downfall of civilization were worsened by the effects of the Collapse several years earlier.

The infection spread via airborne transmission, infecting the majority of the human population; once infected, the vast majority of humans undergoing biological ageing - typically beyond their mid-20s, when cell replenishment gradually becomes overtaken by cellular death - succumbed to total organ failure, while some others rose from the dead as decaying, flesh-hungry monsters resembling zombies from folklore. Due to the high infection and mortality rate, the planet was overrun by the reanimated hosts of the infection after the global outbreak.

## Pathology

When an infected host dies from any method, except extreme head trauma, the host will reanimate as the infection reactivates the brain and preserves most of its bodily functions to slow the decaying process; a deceased host can reanimate anywhere from three minutes to a day after death. As the brain begins to reactivate, violent and ravenous images invade the infected's thought process. Deceased hosts that died with violent thoughts and adrenaline have remarkedly shorter reanimation times than deceased hosts who died in a weaker state.

The reanimated regain movement and senses, but are deprived of higher thinking. The reanimated will act on a mindless animal instinct and aggression to feed, devouring any living or recently deceased beings that are still fresh. They have no sense of self or control, and will kill anything that they discover alive. Their senses remain somewhat intact, but decay overtime. The reanimated can detect behaviors and characteristics that separate the living from the dead such as fast movement, light, loud sounds, smell, and physical sensations.

## Variants

There are several variants of the infection, ranging from the original that was responsible for the mass deaths in October 2003 to the "dormant" variant within the brains of those who were infected before undergoing senescence (i.e. mostly those younger than their early to mid 20s).

### First Generation ("Shamblers")

In the case of the original strain, the vast majority who were infected died of total organ failure without reanimating; the handful that did, however, returned as undead creatures heavily resembling zombies. This "first generation" of undead, nicknamed "shamblers", are very similar to classic zombies from folklore and pop culture: slow, flesh-hungry and unintelligent. Soon after death, the zombie begins to decay like a regular corpse as the pathogen metabolises the necrotic soft tissues; zombies with ample access to food appear to decay much slower than starved zombies, suggesting that the undead possess an instinctual urge to replenish their own decaying flesh by devouring that of the living.

Shamblers react to virtually any external stimuli, especially sound and smells. When several shamblers respond to the same stimulus they group together into clusters; as clusters grow larger their sound attracts other clusters, eventually forming a herd that moves as one. Even if an individual shambler does not react to a stimulus they will usually follow another that has, causing large groups to form that mindlessly follow the decaying instincts of a single individual. They also rarely attack one another.

These grouping behaviours can be used by survivors as a form of defence: since shamblers react to one another, rendering an individual incapable of attacking - i.e. cutting off its jaws - will usually prevent other shamblers from also attacking. Since their sense of smell is tuned to seek out living flesh it is possible for survivors to camouflage themselves by hiding their scent, therefore making them "invisible"; this is accomplished in two known ways: covering oneself in zombie blood and guts or lining one's clothes with charcoal.

While the decay process is slow and feeding can slow it further, by the events of "*Divide*" - eight years after the outbreak - most shamblers are heavily emaciated, with some ceasing to function altogether.

### Second Generation ("Revenants")

   Zombies that arise from the "dormant" variant are very different from the first generation. The second generation, nicknamed "revenants" by survivors, reanimate inside an hour (sometimes within minutes) and retain much of the strength, agility and speed of their living selves, allowing them to chase and overpower their prey. They also demonstrate problem-solving intelligence, such as opening doors, performing ambushes, climbing barriers and avoiding traps, making them extraordinarily dangerous. Every human that survived the initial outbreak is infected with the "dormant" strain, and any form of death other than trauma to the brain will cause them to reanimate.

Some revenants are faster and more aggressive than others, while others appear more intelligent; nonetheless, they all react violently to external stimuli such as sound, scents and light. They are far less likely to sit and wait for passing prey and usually blindly attack anything in front of them, even other zombies if they get in the way. Like shamblers, revenants demonstrate herding behaviour but will typically break rank and move ahead. While their sense of smell is significantly greater than first-gen zombies, revenants can still be bypassed by wearing zombie guts as camouflage. Revenants are also not immune to the decay caused by the infection; given enough time, revenants lose the higher thinking and motor skills of their living selves, causing them to more resemble the first generation. Even so, some revenants retain the ability to climb walls and use tools such as bricks and stones long after advanced decay has set in.

### Darkdwellers

    When someone infected with the dormant strain of LBI succumbs to natural causes, such as cancer, they reanimate in seconds and transform into aggressively territorial creatures dubbed "darkdwellers" or "shriekers".

Like revenants, darkdwellers remain fast and agile well after infection and possess an animal-like intelligence, but one far greater than the decaying revenants; for example, they have been known to back off when their prey fights back or leaves their territory, form mating pairs and faintly recognise their loved ones. Another key difference is that darkdwellers can be killed via trauma to the entire body, such as blood loss or drowning, unlike regular zombies which can only be killed by a blow to the brain. They are also known to walk and run on all fours, and, in the ruins of Fargo at least, are skilled climbers. While their bodies do not decay, all darkdwellers possess distinctive white skin and tend to avoid sunlight.

#### Proto-Dwellers

Those bitten and infected by darkdwellers transform into "proto-dwellers", highly aggressive creatures that actively avoid sunlight while not retaining any form of higher intelligence; in effect, they are a cross-between a revenant and a darkdweller.

### Einherjar

The fourth variant of the infection gives rise to creatures called "einherjar", a unique type of infected that retain their human intelligence while possessing the aggression and durability of zombies; they can be considered, in essence, a human-zombie hybrid. Thus far, they have only been encountered in northern California and appear in *So Help Me God*, while they are absent in *Strain Zero*.

## Nicknames & Terms

While the term "zombie" does exist within *Strain Zero* universe, it is seldom used. This is explained that the young survivors of the apocalypse are uncomfortable with using the term. Instead, they use different terms to refer to the zombies.

## Transmission

The infection is a latent pathogen that spreads via airborne, and possibly direct contact, transmission with a 99.9% infection rate. It spreads throughout the blood of the host and concentrates in the central nervous system. The infection becomes active when the host ceases all living functions, or when an active agent of the virus is introduced into the bloodstream.

Once a deceased host is reanimated, its tissues and bodily fluids - namely blood, saliva, skin, and viscera - contain an active agent of the pathogen. Infection of the active agent is transmissible through biting, scratching, or contaminating an open wound of a healthy individual. If any of these fluids enter the bloodstream of a healthy individual, the active agent will invade the brain like meningitis and cause a cytokine storm. The adrenal glands hemorrhage, resulting in the brain and major organs shutting down, followed by death. Once the active agent spreads, it has a near 100% mortality rate.

The time from infection to death varies depending on the severity, placement, and number of bites - as well as the reanimated age of the undead and possible other conditions, such as blood loss. Ultimately, infection kills a healthy individual within 48 hours after exposure. Ingesting the active agent or exposure to the eyes can cause a serious, but many times treatable, infection that is very similar to sepsis.

## Signs and Symptoms

In the second generation, there are no known symptoms when the infection is dormant. The following are symptoms of when an active agent of the virus enters a healthy individual:

* Dizziness
* Weakness and fatigue
* Fever
* Delirium/hallucinations
* Chills
* Nausea/vomiting
* Pale skin
* Diluted pupils
* Soreness
* Fluid discharge
* Spontaneous aggression or anger
* Fainting
* Hair loss and missing scalp pieces
* Dehydration
* Coughing up blood
* Pale yellow sclera
* Internal hemorrhaging
* Organ failure

Those infected with the first generation of the pathogen primarily suffered organ failure and internal hemorrhaging within days of contracting the infection.

## Diagnosis

Due to the infection rate, it is common knowledge that virtually the entire human population is infected with LBI. Typically, diagnosis for the active pathogen is observation of symptoms and signs of infection; usual signs of infection are bite marks, fingernail scratches, or the contamination through an open wound.

### Overlord Protein Test

The only clinical method of diagnosis is the Overlord Protein Test (OPT) created by Delta Force doctor Tanya Steele soon after D.F.'s arrival at Adams Air Force Base. Invented after the discovery of "slow turners", it is an immunoassay that tests for the concentration of overlord protein - the LBI protein responsibile for invading, controlling and necrotising the human body after death, hence "overlord" - in an active infected and tracks the progress of infection; depending on progress, or one's "OPT", an infected person is placed into one of the following categories.

* Stage 1: latent
	+ 1a: trace amounts of overlord protein; all surviving humans are stage 1a and it is thus considered "normal"
	+ 1b: trace; found in those that have approached "near death" from injuries or sickness
	+ 1c: background; found in those that have died and been resuscitated; infection does not progress past this point without additional pathogenic load (i.e. from bites or total brain death)
	+ 1d: background; recent infection from bites or exposure to infected fluids
* Stage 2: infection
	+ 2a: background; overlord protein cascade begins to overwhelm the immune system
	+ 2b: first symptoms appear; dizziness, weakness and dehydration
	+ 2c: fever, nausea, chills and mottling of the skin
* Stage 3: advanced infection
	+ 3a: delirium, hallucinations and coughing up blood
	+ 3b: eyes begin to cloud, motor skills weaken
	+ 3c: heightened aggression, ticks and muscle spasms
	+ 3d: overlord protein cascade triggers LBI protein expression in all soft tissues, organ failure begins
	+ 3e: organ failure results in death
* Stage 4: Zombification

## History

The infection's true origins, whether it is natural, artificial or even extraterrestrial, are entirely unknown, even to the U.S. military. The first known record of it was in Central America in 2003, although it is possible that it has been present far longer and may have inspired the *"zombi"* in Haitian folklore.

The global spread of the pathogen occured due to contamination of crops and livestock, neither of which were affected by the pathogen. Due to the global socioeconomic issues of the time, cheap food products were sold internationally to areas with high population densities, spreading the pathogen across the world within weeks. Sporadic outbreaks occured in the months before the disease reached critical mass in late 2003; the economic and social situation at the time heavily impeded governmental efforts to contain the spread of the infection, especially within the United States.

Critical mass was achieved when the pathogen evolved the ability to spread in bodily fluids, such as blood and spit, within animals that would go on to contaminate soil, food and water. Further spread was caused by the pathogen's latency in those not undergoing senescence - hence, every human younger than their early to mid 20s - which allowed it to spread to parents or older siblings. By October 2003, all humans were infected, either with the active strain or the dormant strain; this culminated in Outbreak Day, when many governments were finally overwhelmed by the infection.

Post-outbreak, LBI appears to be endemic; consumption of infected meat or water is safe, however, due to all survivors being infected with the dormant strain of the pathogen, which is only "activated" upon brain death.

## References

1. ↑ Henry discovers this technique by accident while trapped in the mall in "*A Long Road Ahead*"
2. ↑ 2.0 2.1 Ben and the other camouflaged prisoners at the Black Building avoid several revenants while walking through a herd
3. ↑ The technique used by the Frontiersmen
4. ↑ Yasmine reanimates within a minute in "*Concrete*"
5. ↑ The Delta Force soldier reanimates in less than 20 seconds in "*Dissent*"
6. ↑ Henry, Sarah and Ben are ambushed by revenants on a supply run, causing Henry to be pinned under a fallen helicopter blade, in the prologue of "*A Long Road Ahead*"
7. ↑ Sergei and Nancy claim that decayed revenants still had the intelligence to recognise which parts of their fence were weakest and climb over
8. ↑ A single revenant learns to avoid Eden's traps in "*Gasman*"
9. ↑ The only two named darkdwellers yet encountered - the Mother and Carl McKenzie - both died of cancer before reanimating
10. ↑ The transformed Carl confronts Henry in the forest and leaves him be after recognising his scent in "*Conquer*"
11. ↑ Drew kills his first darkdweller by shooting it with two arrows
12. ↑ When they both fall into the Red River, Kieron manages to trap a darkdweller underwater, drowning it
13. ↑ In *Season 4: Remake Part II*, several people in Greencole are struck by a sepsis-like illness after their drinking water is contaminated with eviscerated zombies
14. ↑ Holly discovers that she is stage 1c in "*Rules*" due to having briefly died during Hope's birth
15. ↑ A military document in Port Collier reads: "Pathogenic identity: '''UNKNOWN'''. Symptoms: organ failure, death.<br>'''NEW STRAIN DETECTED:''' symptomless, activated upon '''BRAIN DEATH'''. Terrestrial nature: '''UNKNOWN'''"