Necrotic Consumption

Hunger is a constant in the wasteland. Most survivors learn to live with it, to ration, to make do. But there is a difference between hunger and starvation, and Necrotic Consumption is what happens when that line gets crossed and the body decides to solve the problem itself.
  The disease is metabolic, not infectious. It cannot be caught from another person, cannot spread through touch or air. It begins inside, when prolonged malnutrition pushes the Infection into emergency preservation mode. Faced with dwindling resources, the Infection redirects what little remains toward the heart, brain, and Infection pool, the systems it considers essential. Everything else becomes fuel. The body begins breaking down its own nonessential tissue for energy, consuming fat and muscle from the extremities first. What starts as a misguided act of biological triage ends in a cycle of self-cannibalization that the Infection cannot stop and the host cannot survive.
  The most common trigger is famine. Trade route collapse, crop failure, siege conditions, ecological disruption: anything that cuts a settlement off from adequate food for long enough. Characters who rely on stimulants and chems to suppress appetite run the same risk through different means. In rare cases, Necrology experiments have triggered similar reactions when organs are overexposed to regenerative serums without proper sustenance to support the process. The Infection needs fuel to function, and when the fuel runs out, it starts burning the house.
  Civic Strains are particularly vulnerable. Less accustomed to the cycles of feast and famine that wasteland life demands, their Infection surrenders to self-cannibalization more quickly than those adapted to scarcity. When a Civic Strain contracts the disease, it hits harder and faster from the start.
  Early symptoms present as fatigue, tremors, and rapid weight loss that eating cannot correct. The body is already past the point where normal food intake can reverse the process. Skin thins and dries. Veins darken as the Infection thickens to preserve circulation. Then the pain begins: increasing discomfort in the limbs as fingers and toes discolor, go numb, and begin to necrotize. The dead tissue breaks down into a tar-like residue as the Infection recycles what it has killed, producing a faint odor similar to burnt meat.
  In advanced stages, muscle rigidity sets in. Organs begin to fail as the Infection reaches deeper tissue in its search for something left to consume. The eyes sink, and in some cases develop a faint bioluminescent glow as the Infection's concentration in the skull peaks. The final collapse comes from cardiac arrest or systemic organ failure. Survivors carry severe deformities, scar tissue, and a permanent reduction in vitality that never fully recovers.
  Treatment tracks the disease's logic: if the problem is starvation, the early answer is food. At Stage 1, four proper meals spread through a single event can restore the body's balance. Palliative care at early stages requires only two meals per event to hold the disease steady. As the condition progresses, medical intervention replaces nutrition: salinated fluids for hyponatremia, intravenous nutrients via healing brews, and eventually surgical introduction of Infection material to prevent the body from cannibalizing its own organs. By Stage 5, no treatment remains. Death resets the disease to Stage 1, giving the afflicted another chance if the underlying starvation has been addressed.
  Necrotic Consumption tells a story about desperation. About what happens when the supply lines fail and the crops wither and the question stops being "what do we eat" and becomes "who goes hungry." The disease does not care about the answer. It only knows that the body needs fuel, and when none comes from outside, it will find some within.