Advanced stages of infection with the opheliadis ague are known as opheliads, and they are the most dangerous to those who have not yet contracted said ague. The madness that follows the advanced infection manifests as a craving for water and a singsong quality and tone of voice, with the victims often drowning (with a feeling of ecstasy). Attempts at rescue only serve to spread the ague, as all body fluids and secretions are highly infectious. This infectiousness starts much earlier, before the onset of symptoms, meaning that opheliads often infect loved ones and lovers before the true extent of their ague is known.

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