What is greyscale and how does it spread?

[FittleLinger]

right right, that all makes sense thx :)

I guess it is just weird, that the only person we have seen, tyrion, who is exposed to basically the most contaminated area in the world, is fine when he comes out, or at least as far as they can tell at the time. I guess it just seems like, if the disease is so contagious and people are so worried about it spreading then why wouldnt GRRM show us someone who actually caught it....I just mean us seeing someone catch it right away would show that it is a force to be reckoned with and we should expect to see it coming later on.....I guess, IMO, it doesn't seem like greyscale will play a huge part in the next 2 books as far as widespread outbreak goes.

But Jon Con caught it right away if I'm not mistaken. We have two examples - one catches it, one doesn't (for now) which makes it a dangerous disease after all.

[Suzanna Stormborn]

I belive there are three forms of the disease greyscale, grey death, and the grey plage. The grey plage is fast and kills every one it infects. Pentos lost like a third of its population to the plage after some infected rats ran off a ship into the city. Grayscale is a less deadly form that appers in damp climents. The measters seem to have found a way to stop the spead of greyscale in/on a person so they dont die. Wish we would hear about someone other than Shireen so I could belive that. The last is the most cofuseing the grey death

I'll flip through Dance after I post this to check.

So the stonemen are victims of the grey death? or they are greyscale once it has taken over the whole body?

[Elan Morin Tedronai]

I believe it can be spread by touching. IIRC, they were scared that they can get not only from the water, but from the stonemen themselves. As in, they were not only scared that stonemen could outright kill them, but also that they can infect them.

And Connington always wears gloves, so he doesn't actually touch anything or anyone. Also, he doesn't seem scared that his precious Aegon can catch it from him, so at least he doesn't think it's airbourne. Which gives us two possible answers - it's either only from water sources, and the more likely IMO - water sources AND touching of the contaminated area of a person carrying it.

Makes sense, it seems it can also be transfered through contact. Though it might also be superstition/faulty knowledge. Like the plague masks to protect from 'bad air' in middle ages. I've met people who think you can get HIV by touching or kissing people, and we live in a society in which information is rapidly and widely spread.

[Suzanna Stormborn]

But Jon Con caught it right away if I'm not mistaken. We have two examples - one catches it, one doesn't (for now) which makes it a dangerous disease after all.

man this is confusing, so JonCon caught it right away, he caught Greyscale right?

Are all three forms of the disease contagious?

Ok so what Tyrion could have caught is the same form that JC currently has correct?

[Elan Morin Tedronai]

Greyscale seemed more like leprosy to me than anything else. I believe it could be passed by contact.

It does have a lot of parralels. Scarred skin, loss of sensation, stonemen are like a leporcolony. It does not spread through water though. GRRM mght have used it as a basis, and added some elements on his own (transmission through water, different forms/related diseases..)

[FittleLinger]

Makes sense, it seems it can also be transfered through contact. Though it might also be superstition/faulty knowledge. Like the plague masks to protect from 'bad air' in middle ages. I've met people who think you can get HIV by touching or kissing people, and we live in a society in which information is rapidly and widely spread.

That's always a posibility, sure, but my belief comes more from the stonemen themselves. As in, I think it's more likely that some stonemen caught it from other stonemen, and not every single one of them had a swim in the bad water.

[FittleLinger]

man this is confusing, so JonCon caught it right away, he caught Greyscale right?

Are all three forms of the disease contagious?

Ok so what Tyrion could have caught is the same form that JC currently has correct?

Yep, he apparently caught it while saving Tyrion.

[Suzanna Stormborn]

Yep, he apparently caught it while saving Tyrion.

wait wait no no, he already had it I thought...he has it from the beginning....wait i need to check this out.

Edit: Oh shit you're right......Ok i was under the impression he already had it....damn.....

That's weird that no one checks him for it when they are checking tyrion.

I guess when I was reading, I assumed he already had it cuz of the was he is so accepting of it, like when he sees it for the first time it barely surprises him.

[FittleLinger]

wait wait no no, he already had it I thought...he has it from the beginning....wait i need to check this out.

Edit: Oh shit you're right......Ok i was under the impression he already had it....damn.....

That's weird that no one checks him for it when they are checking tyrion.

I guess when I was reading, I assumed he already had it cuz of the was he is so accepting of it, like when he sees it for the first time it barely surprises him.

I was under the exact same impression as you, untill another poster pointed it out me.

[Mladen]

I think we should all remember that greyscale is in fact, product of GRRM, which can have parallels with many diseases, but ultimately is none. Also, as many of you pointed out, there is simply not enough information by now, but also there are some things we do know about it. All in all, it is intersection of many diseases (cholera, DIC etc)...

[Ygrain]

I think it is spread by bodily fluids, skin particles etc., which can easily spread thruogh water sources. Normally, spreading a disease to other hosts depends on the infectious dose, the quality of the person's immune system, their momentary condition and a portal of entry. Mere skin exposition is usually not enough, it takes contact through mucosae, aspiration, wounds...

The fact that the disease is worse for adults than children has RL equivalents, e.g. chickenpox, as children's immune system works somewhat differently. Surviving the disease then lends immunity, but if the maesters are wrong, the disease just remains dormant and may be provoked again by cold. This, again, would loosely resemble chickenpox as the virus remains within the body and when the immune system is weakened, it can cause herpes zoster (shingles).

[Dr. Pepper]

ok, so is there any rational reason why tyrion didn't get it? I guess it can spread by touching but not always? or maybe some people have an immunity to it? like some people have a strong immune-system or something?

A rational reason for why Tyrion was not afflicted is that he was cleaned immediately with vinegar. As far as I recall, there is no text that suggests Jon Con went through the same rigorous cleaning. Jon Con may have doused himself, but it wasn't the same as Septa Lemore stripping Tyrion and carefully cleaning his entire body. Of course, not all immune systems are the same nor are all reactions to exposure the same. It's like two people being in the same room with a flu-infected person and both healthy people having the same diet and access to hygiene material, then one getting sick and one not. Just how it goes sometimes.

As Mladen mentioned, there isn't really a full fictional medical text provided about the disease and some of the info we do have about it is conflicting so it's all sort of an educated hypothesis on how it spreads, how it can be treated, and issues of presentation. I think we'll have a clearer picture if there is an outbreak that starts around Jon Con.

[TheNinjaDC]

Seems to be a mixture of small pox/chicken pox, the plague, and leprosy.

Each strain being more akin to one of the above, but none the less part of one core strain mixed with GRRM genetics.

[MaesterSam]

I agree that this is a highly unusual disease. It spreads from the extremities inward, NOT from a specific point of entry, which suggests it is a systemic disease. But then they mention that sometimes, you can cut off the affected fingers/hand and that stops it, which would suggest that the pathogen is only found in the affected tissue. So IMO, GRRM just made up a cool disease but didn't really research the science behind how it could work... it's a bit unrealistic as-is.

But,not to be a party pooper, I'll try to answer some of the other questions in the OP. :)

I would guess it is not easily spread by contact, otherwise JonCon wouldn't risk being around Aegon and his entire army while infected. Maybe the pathogen can only survive outside the body if it's in a damp/wet environment?

As far as only a section of the river being infected- it could be that the pathogen enters water when affected people (i.e. stonemen) come in contact with the water, but it can only survive in the water for a limited period of time. So the stonemen are continuously re-infecting the river around the Sorrows, but by the time you get X number of miles downriver, the pathogens have died so that water (as well as upriver) is safe.

Regarding a greyscale outbreak in Westeros- JonCon is a smart guy, and probably knows to keep his hand out of the drinking water. However, we might see some biological warfare if he purposely infects the enemy's water.... (shireen is a wild card, since so far we have not seen a case of childhood greyscale re-emerge in adults. She easily could start an outbreak at the wall if her infection re-emerges and she uses the common bathing areas...)

Lastly, I read a theory on another forum on why Tyrion didn't get infected. This is crackpot, and not my idea, but some people believe that Tyrion is actually Aerys Targaryen's son (b/c he always had a thing for Tywin's wife), and as a Targaryen he can't get sick. This would also allow him to ride one of the dragons, which many people would like to see. I personally don't buy it (he is SO much like Tywin!), but thought I'd put it out there anyway since it does have some supporters.

[illrede]

If very hot water, vinegar, chemical lime, and I'm assuming they're referring to naturally carbonated water alleviate it, it pretty much has to be calcium carbonate (like barnacle shell) (because that's pretty much a checklist of what calcium carbonate is soluble with) of that is giving the "stone" effect. That it's replacing the body perfectly, climate and conditions dependent, and of variable communicability I think the most elegant mechanism is it's a leftover from bacteria.

EDIT: And Grey Scale/Grey Plague could be a fairly simple spontaneous mutation that shortcuts its life cycle, past the point of being sustainable in a population. Antibodies for one still do for the other.

EDIT2: Maybe it's an infestation of barnacle-mites.

[-Ghost-]

Lastly, I read a theory on another forum on why Tyrion didn't get infected. This is crackpot, and not my idea, but some people believe that Tyrion is actually Aerys Targaryen's son (b/c he always had a thing for Tywin's wife), and as a Targaryen he can't get sick. This would also allow him to ride one of the dragons, which many people would like to see. I personally don't buy it (he is SO much like Tywin!), but thought I'd put it out there anyway since it does have some supporters.

Targs can and have gotten sick.

[-Ghost-]

Are we sure that Jon Con didn't have it prior to this whole thing? It's just weird that he wouldnt do the vinegar thing immediately like he wasn't really concerned about it. And why wouldn't Lemore or anyone else insist on him doing it and being checked? Unless he was against it because he had it already and wanted to hide it. Was there any mention on how quick the symptoms start?

[FittleLinger]

Are we sure that Jon Con didn't have it prior to this whole thing? It's just weird that he wouldnt do the vinegar thing immediately like he wasn't really concerned about it. And why wouldn't Lemore or anyone else insist on him doing it and being checked? Unless he was against it because he had it already and wanted to hide it. Was there any mention on how quick the symptoms start?

Well I think he has grown to hate himself enough that he sees the race with death as a stimule.

[illrede]

Are we sure that Jon Con didn't have it prior to this whole thing? It's just weird that he wouldnt do the vinegar thing immediately like he wasn't really concerned about it. And why wouldn't Lemore or anyone else insist on him doing it and being checked? Unless he was against it because he had it already and wanted to hide it. Was there any mention on how quick the symptoms start?

They said variable, but the first symptoms were spots of numbness. Which could be missed by the afflicted to begin with, much less noticed by someone else.

Also... people can be really stupid when it comes to disease.

[north of the wall]

I too always thought grey scale was based on leprosy... however leprosy is actually caught through nasal droplets and not touch of contaminated person(s).

I am not sure how much research GRRM has done to create his own disease but i think its safe to say he is the only one who truelly knows about grey scale.

also i doubt vinegar etc really helps, we are talking about an era (and fantasy world) which seems to have a lack of scientific knowlege. I always assumed the "cures" were wrong and just old wives tales.