Disease Templates

Not all strains of the same disease are identical. Diseases mutate and change over time, so the PCs may encounter local strains of devil chills, filth fever, and other diseases that are different from those with which they’re familiar. These different strains might be particularly fast-acting, easier to spread, resistant to treatment, or otherwise improved over the default version of the disease. The following section presents several templates that can be applied to any disease to represent more dangerous strains. Several templates can be applied to the same disease to create a truly horrifying plague. The special properties of a disease with a template are difficult to predict without special training. Unless a character spends at least an hour examining the disease and its victims and then succeeds at a Wisdom (Medicine) check (DC = the disease’s attack bonus + 20), they identify the disease as its more common variant, without realising the differences.

Incurable

An incurable disease is all but impossible to cure completely.

Attack The disease’s attack bonus is reduced by 5.

Recovery The disease cannot be recovered from with any number of missed attacks. Whenever the afflicted creature is missed by a the disease’s attack by 5 or more, it is automatically missed by the disease’s next attack as well. Even spells that can normally cure diseases only cause the disease to become dormant for 2d4 days, after which the disease continues to attack the affected creature.

Only powerful magic like a miracle or a wish is sufficient to completely cure a creature of an incurable disease.

Lingering

A lingering disease is one that tends to remain with its victims for a long time and is difficult to cure completely.

Attack The disease’s attack bonus increases by 2.

Effect Any ability score damage or drain dealt by the disease is reduced by 1 (to a minimum of 1).

Recovery The number of consecutive missed attacks required for the victim to recover from the disease increases to double the normal amount.

Special Any effect that would cause a creature suffering from the disease to be cured of it (including lesser restoration) instead counts as a single missed attack for the purposes of curing the disease through missed attacks. No more than 1 missed attack can be accrued in this way within a single period of the disease’s frequency (1 day, for most diseases), even if multiple effects would cure the creature of its disease.

Finally, even if a creature is completely cured of the disease, small amounts of it remain within its system, and there is a 30% chance per day that the creature becomes reinfected, and must by missed by a new attack or contract the disease again. This chance decreases by 5% per day, until it reaches 0%.

Magic-Resistant

A magic-resistant disease is protected against magic.

Sometimes this is because the disease has a magical origin or has been infused with magic, and sometimes it’s because the organisms that cause the disease simply react differently to magic than most infectious organisms do.

Attack The disease can affect creatures that are normally immune to disease, whether that immunity comes from a racial trait, class feature, spell, magic item, or other source. However, diseases have disadvantage to hit such creatures.

Cure The disease is particularly difficult to remove using magic. Lesser restoration can’t cure the disease, and even more powerful spells such as heal require a successful spellcasting attack roll with a -10 penalty (DC = 10 + the disease’s attack bonus) to remove the disease.

Special The disease responds violently to any attempts to heal it using magic. Whenever the diseased creature is subject to a spell or ability that cures diseases, it is attacked by the disease. This does not reset the disease’s frequency, and being missed by this attack does not count toward the number of consecutive misses required to be cured of the disease.

Plague

A plague is a disease that spreads very effectively, and can easily pass through an entire community in a short period of time. If left unchecked, plagues can ravage entire cities or regions, and in the case of particularly deadly or virulent plagues, can potentially even bring an end to mighty civilisations.

Type If the disease’s type is ingested, it instead changes to inhaled. If its type is injury, it instead changes to contact. If its type is contact or inhaled, it remains the same.

Attack The disease’s initial attack bonus increases by 5. The attack bonus remains the same for all subsequent disease attacks.

Special Simple contact with or, in the case of inhaled diseases, spending time near a creature infected with a plague can expose others to the disease. If the plague is an inhaled disease, then a creature afflicted with the disease creates an aura of disease around it. Any coughing, sneezing, and in some cases, even breathing releases clouds of disease-causing organisms into the air. Any creature that comes within 30 feet of the diseased creature is exposed to the plague and attacked by it. A potential victim is attacked each time it moves within 30 feet of a diseased creature, to a maximum of one attack every 10 minutes. Any creatures that remains within 30 feet of the diseased creature is attacked again every 10 minutes. If the plague is a contact disease, each time a creature touches the diseased creature, or touches an object that was touched by the diseased creature in the last 24 hours, the potential victim is exposed to the plague and is attacked.

Ravaging

A ravaging disease is one whose effects are particularly difficult to heal, and that can permanently scar victims.

Effect If the disease deals ability damage, each time the disease’s attack hits an affected creature by 5 or more, 1 point of that ability score damage becomes permanent ability score drain instead. If the disease rolls a natural 20 on an attack, all of the ability score damage becomes permanent ability score drain.

Recovery The number of consecutive missed attacks required to recover from the disease increases by 1.

Special Ability score damage and drain dealt by the disease cannot be healed as long as the affected creature is still infected by the disease. This applies both to natural healing and magical healing (such as lesser restoration).

Vicious

A vicous disease’s attacks on the body are ruthlessly efficiency.

Attack With each hit, the bonus of any future attacks by the disease increases by 1. These increases stack to a maximum of 5.

Effect Any Constitution damage or Constitution drain dealt by the disease increases by 2. Otherwise, in addition to its normal effect, the disease also deals 1d4 points of Constitution damage.

Virulent

A virulent disease is particularly fast-acting, and runs its course in hours, rather than days. While this could mean the disease runs its course more quickly, leaving the victim disease-free, virulent diseases are particularly taxing on their victims and often end in death.

Onset If the disease’s onset is normally measured in weeks, it is instead measured in days. If it is normally measured in days, it is measured in hours. If it is normally measured in hours, it is measured in minutes.

Frequency If the disease’s frequency is normally measured in weeks, it is instead measured in days. If it is normally measured in days, it is instead measured in hours. If it is normally measured in hours, it is instead measured in minutes.

Effect If the disease doesn’t already deal Constitution damage on a hit, it deals 1 point of Constitution damage in addition to its normal effect on each hit. If it normally deals Constitution damage, increase the Constitution damage by 1.

Special If the diseased creature is hit by two consecutive attacks, it is sickened until the next time it is missed by a disease attack. If the diseased creature is hit by four consecutive attacks, it is nauseated until the next time it is missed by a disease attack. These penalties are in addition to any other effects of the disease, and cannot be removed as long as the creature remains diseased. Even if the creature is normally immune to the sickened or nauseated condition, that condition still applies; only immunity to diseases protects against gaining the condition from a virulent disease.