#cbrne

Note: I initially missed the “biological warfare” portion of this ask. 

Hmmmm. So hemoptysis -- bloody sputum -- is a symptom of a few things. 

One of those is arteriovenous malformation (AVM) of vasculature in the pulmonary system. If that’s the cause, and the AVM is a symptom ob a bigger vascular problem, they could cause a fairly sudden death. I wouldn’t throw the book across the room if that’s explained in the story. 

The major causes of hemoptysis I’m aware of are pulmonary edema -- blood flow backing up into the pulmonary vasculature until it floods the lungs -- and tuberculosis, which is legendary for it. 

Perhaps your character had a heart attack, and they can’t clear their pulmonary vasculature, and they die fairly quickly of it. However, this would come with other unwanted side effects. A pulmonary artery aneurysm is possible but honestly fairly unlikely, because the pulmonary arteries are low-pressure systems. 

One other cause: it’s really rare, but an aneurysm of the aorta can cause a fistula with the tracheobrochial tree (the physical space in which air passes), causing blood to enter the airway, and this could be rapidly fatal. 

My issue in general with the bloody cough trope is that it’s... kind of misguided. Sure, it’s visually dramatic and so forth, but, if I’m honest, basing a disease around one symptom is backwards. Bloody cough is what you want. What you seem to need is a rapidly fatal disease to give your character. 

NOW THAT I’VE REREAD THE QUESTION LIKE A NOT-MORON, let me take this down the biowarfare tack. (I’m leaving what I’d already written because other people might have questions about bloody coughs.) 

Biowarfare is interesting, and I honestly don’t know too much about it. Fortunately, in modern times it hasn’t been used much; chemwar is much more common and much easier to control and target. 

Biowar weapons typically include difficult-to-kill viruses (such as ebola) or bacteria (like anthrax). 

However, if you’re willing to make up a disease, you could realistically have a genetically engineered virus that attacks the lining of the lungs and airways, and they basically have bloody asthma to death. You’d get a fever, wheezing, swelling in the airways, cough, then bloody cough, then death. Your evil bioweapon-maker characters could probably, in fact, modify a version of [RSV -- Respiratory Syncytial Virus] -- to suit their evil plans. (They’d have to modify it so that it’s extremely aggressive and also doesn’t “look” like RSV to the immune system; adults are typically immune to RSV as we know it, but kids under 2 can have really bad cases of it. In fact, maybe this disease is special-built to target children...) eRSV (for Engineered) as a name, perhaps? 

Sorry I don’t have anything realistic off-hand to give you as a bioweapon, but in all honesty, I feel a lot safer knowing that, too :) 

Hope this helped! 

xoxo, Aunt Scripty

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