Caught up as I was with clinical rotations I have not revisited this series in several months. Having some time now I decided to return to some potential real-world equivalents of diseases found on planetos.
The disease I wish to consider today is butterfly fever. This malady is native to the island of Naath perhaps most famous as the homeland of Danaerys Targaryeon’s right-hand woman Missandei. As the name suggests the condition is transmitted by a species of diurnal butterflies native to Naath “particularly a large black-and-white variety with wings as big as a man’s hand, according to Archmaester Ebrose”. The disease is also marked by the eponymous symptomology with fever being the earliest overt manifestation of the condition. This is followed by painful spasms that cause the afflicted to undertake dance-like movements. The final stages of the condition involve blood leaking from the victims’ pores and skin and viscera falling off their bones.
Two aspects of butterfly fever closely link it to the real world. The first of these as I have perhaps previously commented on is the potential role of disease as a shield against foreign conquest. In the case of Naath the Ghiscari, Valyrians, a company of Volantene slavers as well as corsairs all attempted to exploit the island and were decimated by the condition. This adheres somewhat to the roles African sleeping sickness and malaria played installing European colonization of Africa and creating its reputation as the “White Man’s Graveyard” a posting so dreaded that even double pay was insufficient motivation. The second and the one that I primarily focused on in finding a direct real-world disease correlate was the fact that the butterflies and therefore the disease is strictly diurnal. This aspect of butterfly fever immediately made me think of lymphatic filariasis. This condition is carried by three different species of filarial parasites. As reported by the WHO Bancroftian filariasis occurs in two forms: in the most common form, the microfilariae circulate in the blood at night, whereas in the second form they occur continuously in the blood but increase in number during the day. This corresponds with the feeding times of the vectors that transmit them and amazingly are so acutely tuned that if an infected individual travels the filarial organisms will emerge in accordance with the temporality of the location of origin. While the day/night cycle is my primary basis for drawing the connection the fact that both are largely island based diseases carried by insects further underscores the connection.
