Deadly Disease
T he world, for all its occasional beauty, is a
filthy place. Monsters aren't the only threat to your
survival—plague and disease stalk the land, destroying
Contracting Disease
villages and decimating cities. Sometimes the greatest Adventuring is not a clean business. Filthy sewers, rabid
threat to the city isn't the wild dragon—it's the lone child animals, rusty swords—there are countless ways in which a
with a lingering cough. person might contract a debilitating disease.
This chapter provides rules on catching and treating There are three basic steps to follow when dealing with
contagious diseases, and a selection of pre-made diseases disease: contact, incubation, and first symptoms.
to use in your game.
1 Contact
What is a Disease? First, your character needs to come into contact with an
A disease is an ongoing sickness that can infect your active disease. There are four ways this might happen:
character and spread to those around you, from the
mundane (flu, chickenpox, cholera) to the magical (mind • Direct Contact: You touch an infected person or
worms, dragonlung, gelatinous boils). diseased fluid—such as blood, sweat, or pus.
Diseases become more severe over time, progressing • Indirect Contact: You touch something that has been
through 4 stages—so try to stay healthy. contaminated with a diseased substance or fluid—a
doorknob, a shared bed, a knife.
• Bites: Something bites you—a fly, a tick, a leech—and
Influenza Touch, Air · DC 10
injects the disease directly into your body.
Disease Common 2 days
• Consumption: You eat/drink something that's been
contaminated—foul water, moldy bread, rotten meat.
A harmless cough and a slight fever can quickly turn into
Diagnosing Disease
GM: The guard blocks you at the door to the lord's
Rarity DC Description
chambers, Clanda. "Sorry ma'am, Lord Marin has
ordered us not to let anyone in. Personal matters." Common 10 A frequent occurrence
GM: The guard pulls a hasty salute, his resolve Mythic 30 A unique or magical sickness
were sick! I'll open the windows quickly to air out the
9 30 Mass Heal
Becoming Contagious
Magical Immunity
Severity Contagious
Some class features may grant immunity to diseases—such
Stage 1 Less than 25% hit points remain as a paladin's Divine Health. In these cases, your immunity
is not absolute—the resistance depends on the level of the
Stage 2 Less than 50% hit points remain
effect (class level, item level, spell level, etc.).
Stage 3 Less than 75% hit points remain
If you die from a disease, your corpse becomes a breeding 01-05 Diseases up to DC 15
Creating a Disease
To surprise your players with a sickness unique to your The GM is creating a mythic, magical disease that
world, follow these steps to brew your own diseases. spreads through sound—resonant flux. This unusual
Diseases
Name Description Rarity DC Inc. Transmission
Bubonic Plague Horrible buboes spread across the body Rare 25 1 day Touch
Chickenpox Tiny, itchy spots spread across the body Common 20 2 days Touch, Air
Diphtheria A throat infection that can lead to permanent scarring Rare 15 3 days Touch, Air
Smallpox Large, pus-filled spots cover the body Rare 15 4 days Touch, Air
Stonescale The skin turns grey as the mind turns feral Mythic 30 4 weeks Touch
Syphilis A persistent fever that eventually attacks the mind Common 20 4 weeks Touch (sore)
Tapeworm A parasite that lives inside the body causing weight loss Common 15 1 week Touch (excrement)
Typhoid Fever A bad fever and diarrhea Common 15 1 week Touch (excrement)
Whooping Cough Coughing fits violent enough to break bone Common 15 1 week Air
Often mistaken for influenza at first, swollen buboes mark A nasty infection of the throat that can cause permanent
the body and a near-certain death sentence. scarring if it penetrates the skin.
1 Your body aches and you have a slight fever. You 1 You have a sore throat and headache. You have -2
2 Painful buboes appear around your arm, groin, 2 You have swollen glands in your neck and it's very
and neck. You have disadvantage on all rolls. painful to swallow. You have -2 STR and -2 DEX.
3 Your fever burns extremely hot and you can't stop 3 Large, painful ulcers appear on your skin. You
sweating. You fall into a coma. have -2 CON and disadvantage on social checks.
4 Your internal organs fail and you die. 4 Pus-filled blisters appear on your legs, hands, and
Cured Your body is scarred by the buboes. feet. You have disadvantage on all rolls.
Stage Effect
Dysentery Touch (excrement) · DC 20
STR and -2 DEX. Easy to catch and painful to endure, one sip of dirty water
2 You have noticeable pox marks across your body. can be enough to ruin your whole week.
4 Your fever is burning hot. You have disadvantage 1 You suffer painful stomach cramps. You have
Cured You have a few small scars from the pox. You are 2 You have a mighty need to use the restroom. You
3 You can't keep any food down. You gain thirst and
Cholera Touch (excrement) · DC 10 4 Your body is too weak to stand. Your speed is
Cured You can't eat rich food during the next week
One drink of bad water and you'll be curled up by the toilet without being sick.
Stage Effect
Influenza Touch, Air · DC 10
causes you to vomit. -2 DEX and -2 WIS. A harmless cough and a slight fever can quickly turn into
2 You have diarrhea. -2 STR, -2 CHA, and you gain something much more serious without bed rest.
4 Your body goes into shock from severe 1 You have a bad headache and a runny nose. You
Cured You can't eat rich food for the next week without 2 Your entire body aches and your throat is sore.
Tiny spots that quickly become large, painful blisters across Tiny parasites that hide away in rotten meat and excrement.
your entire body, leaving you with pox scars. Watch what you eat.
1 You have a slight fever and feel weak. You have -2 1 You always seem to be hungry. You gain hunger at
2 You have a persistent headache and flat, red spots 2 You have lost a significant amount of weight. You
on your face, hands, and forearms. You have -2 have -2 CON and -2 STR.
INT, -2 WIS, and -2 CON. 3 You suffer from terrible headaches and some
3 Your spots become large, painful, pus-filled memory loss. You have -2 INT and -2 WIS.
blisters. You have disadvantage on all rolls. 4 The parasites have reached your brain. You fall
4 Your fever is extremely hot. You fall into a coma. into a coma and die.
Cured You have severe scars from the pox. Cured You have painful stomach cramps for one week.
As your skin turns grey and cracked, your mind decays to Sometimes it's better to go thirsty than take a drink of filthy
that of a wild animal. Kill them before they kill you. water. Don't risk it—boil it.
1 The skin around your eyes turns noticeably grey. 1 You have a fever, a headache, and frequent
You have disadvantage on social checks. nosebleeds. You have -2 to all modifiers.
2 Your skin is grey and cracked. Movement is 2 Red spots appear on your skin and you are easily
painful. You have -2 to all ability modifiers. exhausted. You gain fatigue at twice the rate.
3 You become very forgetful and increasingly 3 You suffer diarrhea. You gain thirst at twice the
aggressive. You have advantage on all STR rolls, rate and have disadvantage to all social checks.
and disadvantage on all INT, WIS, and CHA rolls. 4 Your fever is burning hot and you are delirious.
4 You have lost your mind and become a wild beast. You can't move or act on your own power.
Cured Your skin is permanently marked with stonescale. Cured You feel fragile for the next week.
The flesh is weak. Let your guard down for one night and 1 You have a mild cough and disadvantage on
1 A highly-contagious sore opens near your lips or vomiting. You have disadvantage on all rolls.
groin. You have disadvantage on social checks. 4 Your cough is so violent you have broken some of
2 A rash appears on your hands and feet, and you your ribs. You have 0 hit dice and can't move
have a fever. You have -2 DEX and -2 CON. without immense pain.
3 More sores appear on your body, and you are Cured You have an annoying cough for the next week.