Diseases and Contagions

A content expansion for 5th edition

Sample file

by Toby Lowther

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Not for resale. Permission granted to print or photocopy this document for personal use only. DISEASE 1 Disease ne of the most destructive forces in the At the end of each long rest, a creature suffering from Realms, beyond the power of mighty dragons broken bones can make a DC 11 Constitution saving throw and terrible villains, is the simple, creeping for each broken bone effect. After three successful saves, one curse of plague and disease. Simple, but set of broken bones is restored to normal function, and the unstoppable, diseases can lay low entire effect ends. A greater restoration spell can also restore a nations and infect even the mightiest of broken bone. Owarriors, draining their strength. Bone rot can be cured using a concoction of a root of the This expansion contains materials focussed on the concept Snowfoil flower mixed with a half pint of troll blood. Given an of diseases and plagues. It includes details for several hour, a character who has proficiency with an herbalism kit additional diseases beyond those offered in the Dungeon can turn the ingredients into one dose of medicine. If Master's Guide, as well as an additional cleric domain, consumed before a long rest, the medicine suppresses the sorcerous origin, additional background options, and effects of the disease until the end of the next long rest. After additional monsters. three doses, the medicine cures the disease. The medicine has no effect on bones already broken, which Sample Diseases are not restored by the disease. The diseases here expand upon the diseases offered in the Dungeon Master's Guide. Feel free to alter the saving throw Featherlung Featherlung refers to one of two respiratory diseases, which DCs, incubation times, symptoms, and other characteristics together are treated as one of the Three Plagues, the most of these diseases to suit your campaign. well-known contagious diseases of Faerûn. The two types of featherlung differ in how they suffocate the victim ─ one fills Bone Rot the lungs with dying flesh, while the other dries up all This wasting illness causes the bones to become brittle and moisture within the flesh of the lungs. gradually rot away. It is especially prevelant in swamps and in Featherlung is spread by inhalation. Any beast or places containing the dead, such as graveyards and humanoid that starts its turn in a gas cloud carrying the battlefields. disease or within 10 feet of an infected creature must make a A beast or humanoid that touches an infected creature or DC 13 Constitution saving throw, becoming infected on a corpse must succeed on a DC 11 Constitution saving throw failed saving throw. A creature does not need to make this or become infected. 1d3 days after infection, a creature saving throw if it is holding its breath. begins to feel deep aches in their bones, as with toothache It takes 1d3 days for featherlung's symptoms to manifest in but throughout the body. an infected creature. Symptoms include shallowness of The infected creature has disadvantage on Strength and breath, harsh coughing, and lightheadedness. The infected Dexterity ability checks and saving throws. creature suffers one level of exhaustion that can't be removed In addition, whenever the infected creature takes until the disease is cured, can only hold its breath for 1d10 bludgeoning damage, that creature must succeed on a rounds at a time, and can only survive 1 round without Constitution saving throw (DC equal to 11 or half theSample damage file breathing, before it drops to 0 hit points and is dying. taken, whichever number is higher). On a failed save, the When an infected creature takes damage, the creature infected creature's bones shatter under the impact. The effect must make a DC 13 Constitution saving throw or fall caused depends upon the part of the body struck by the unconscious. At the end of each of their turns, the creature damage. If the part was not specified, the DM can determine can repeat this saving throw, ending this condition on a the body part most likely to be hit by the impact or roll a d8 success. and determine the part from the table below. At the end of each long rest, an infected creature must Broken Arm. The creature loses use of that arm. It cannot make a DC 13 Constitution saving throw. On a failed save, wield a weapon or shield in that arm, or use that arm for the the creature gains one level of exhaustion. On a successful somantic components of a spell. save, the character can lose one level of exhaustion gained Broken Leg(s). The creature's base walking speed is from this disease. If a successful saving throw reduces the reduced by 15 feet for each leg broken. The creature has infected creature's level of exhaustion below 1, the creature disadvantage on Strength (Athletics) ability checks. recovers from the disease. Broken Ribs. The creature struggles to breath. They A creature which recovers naturally from the disease in cannot hold their breath for more than 1d10 rounds. At the this way is immune to the disease, but will continue to have end of each long rest, the creature must succeed on a DC 11 difficulty breathing in dry weather. The disease can also be Constitution saving throw or gain one level of exhaustion. cured by magic such as the lesser restoration spell. Broken Skull. The creature drops to 0 hit points.

d8 Impact body part Fury A plague caused by demonic forces, originally a Voidharrow 1-2 Broken leg demon called Scour. This disease of the mind causes 3-5 Broken arm increasing aggression and eventual madness. 6-7 Broken ribs 8 Broken skull

DISEASE | GENERAL 2 When a humanoid creature is bitten by a creature that carries If an infected creature succeeds its saving throw, it is cured of the disease, the creature must succeed on a DC 11 Wisdom the disease, and if the creature has not failed a saving throw saving throw or become infected. against this disease after first being infected, that creature It takes 1d6 hours for the symptoms of the disease to gains immunity to the disease, and has a 25% chance of manifest. Symptoms include development of oozing sores developing a mark shaped like a blue flame. and of strange, crimson, crystaline growths on the skin. An infected creature becomes increasingly aggressive, Spellscars irritable, and angry. If the creature feels insulted or offended by another creature, it must succeed on a DC 10 Wisdom Creatures which spontaneously recover from Halruaan saving throw or immediately attack the creature. At the end of consumption usually gained a spellscar. This may or may not each of its turns, the infected creature can repeat the saving include a visible mark (usually a blue flame on the skin when throw, returning to its right mind on a successful save. one was present), but it did grant the bearer immense power, At the end of each long rest, the infected creature must including the ability to tap a rare source of magical power make a DC 11 Wisdom saving throw. On a failed save, the DC called the spellfire. for the save to avoid diseased aggression increases by 1d6. This spellfire granted the wielder the ability to absorb spells On a successful save, the DC for the save to avoid diseased cast at them, convert them into raw magical energy, and then aggression decreases by 1d6. If the saving throw DC drops to 0, the creature recovers from the disease. A creature that fails use this in a myriad of ways, including healing their self, three of these saving throws gains a randomly determined project destructive bursts of flame from the eyes, flight, and form of indefinite madness, as described in the Dungeon even rare powers, such as the Crown of Fire. Master's Guide. Details for how to incorporate spellscars and spellfire into If a creature dies while infected with this disease, a swarm your campaign will not be included in this expansion. of rats with bites infected with this disease emerge from the However, if you do choose to incorporate these elements, the victim's body. effect of Halruaan consumption should be altered appropriately, such that a creature which does spontaneously Halruaan Consumption A deadly wasting disease of magical origin, Halruaan recover, rather than merely gaining immunity and the consumption infected creatures who ventured into the possibility of a mark, gains a spellscar. wastelands of Halruaa before its return, although similar In addition, creatures already bearing spellscars are immune diseases can be contracted by creatures in other to Halruaan consumption. Plaguewrought lands. For each hour a creature travels in a plagueland infected with this disease, that creature must make a DC 15 Stoneplague This disease targets only dwarves, and is spread by contact Constitution saving throw or become infected. One day after with cursed gold. Any dwarf that touches gold cursed with the infection, the victim will feel a strange, tingling sensation, like stoneplague must succeed on a DC 13 Wisdom saving throw that produced in the air after a bolt of lightning has struck. or become infected with the disease. Whenever an infected creature would regain hit points due Symptoms manifest 1d4 days after infections and include to a spell, they regain half as many hit points as they would development of a hard, crusty skin resembling dried mud, normally. Additionally, any damage dealt by a spell casSamplet by an file slow calcification of the eyes, and a stench like wet clay. infected creature is doubled. The creature has disadvantage on Wisdom (Perception) At the end of each long rest, the infected creature must checks that rely on sight, and on Strength and Dexterity make a DC 15 Constitution saving throw. On a failed save, ability checks. At the end of each long rest, the creature must that creature takes 5 (1d10) necrotic damage and their skin make a DC 13 Constitution saving throw. On a failure, the starts to shed in a fine dust,. This damage increases by 5 infected creature's current hit points and hit point maximum (1d10) for each failed saving throw. If the infected creature are each reduced by 1d6. If the creature's hit point maximum fails five saving throws, it is disintegrated into luminous blue is reduced to 0 by this effect, it dies. After three failures, the dust, and dies. infected creature is blinded. Stoneplague cannot be cured by magic such as the lesser restoration and heal spells. The spread of the disease can be prevented by destroying the magic rune which first cursed Arcane and Divine Magic the gold causing the plague. However, once a creature is In previous editions, only arcane attack spells have infected, no known cure exists, and only a Wish spell or the been empowered by Halruaan consumption. The direct intervention of a deity can prevent that creature's arcane/divine magic distinction has not been eventual death. continued into 5th edition Dungeons & Dragons, and as such has not been made in the disease as The Wailing Death given. A terrible, magical plague, most renowned for the destruction However, if you wish to reintroduce this it caused in the city of Neverwinter, this disease targets dimension to the disease, then the damage humanoids, causing extreme agony which drives the sufferer doubling effect will only effect bard, sorcerer, to cry out in pain, giving the disease its name. warlock, and wizard spells (including eldritch knight and arcane trickster spells). When a humanoid creature moves within 30 feet of an infected creature, or the corpse of a creature which was infected and died no more than 6 hours ago,that creature

DISEASE | GENERAL 3 must make a DC 15 Constitution saving throw or become Finding Ingredients infected itself. They must then repeat this saving throw after Once a recipe for the cure has been procured, or an NPC has every hour spent within 30 feet of an infected creature. volunteered to concoct the cure, the party may still need to Within 1d10 hours of infection, an infected creature will acquire ingredients for the cure. begin to develop extreme cramps, pus-filled sores appearing Some diseases have very particular ingredients required to on their skin. An infected creature is driven to cry out in pain cure them, such as sight rot and the Wailing Death. In many at regular intervals, and has disadvantage on all saving cases, cure ingredients are comprised primarily of plant throws. materials, which must be harvested from hard to reach At the end of each long rest, the infected creature must locations, and monstrous body parts, which often must be make a DC 15 Constitution saving throw or take 5 (1d10) harvested directly from the creature. necrotic damage. The creature's hit point maximum is Once an ingredient has been collected, you may wish to reduced by an amount equal to the damage taken. If this consider the need to preserve it. For example, the heart of a reduces the creature's hit point maximum to 0, that creature yuan-ti required to cure the Wailing Death is likely to begin to dies. decay over time, once removed from the yuan-ti. If the cure The Wailing Death can only be cured by a rare potion requires preserved ingredients (at the DMs discretion), it may concocted of an intellect devourer's brain, the heart of a yuan- be necessary to preserve the ingredients harvested until the ti pureblood, a cockatrice feather, and a lock of a dryad's hair, cure can be made. or with a Wish spell. Magic such as the lesser restoration and Preserving the ingredients could include original use of the heal spells have no effect on the disease. gentle repose spell for animal parts, storage in magical containers, or in some cases, traditional preservation Diseases in your Campaign methods such as salting, smoking, and drying may suffice. Disease and plague on this scale is rarely a peripheral element to a story. How you incorporate diseases into your Ending an Outbreak campaign is entirely up to you, but the following section Adventures which focus on ending an outbreak may overlap includes some general guidelines that DMs may wish to somewhat with Finding the Cure adventures, by requiring the consider in your incorporation of disease. players to find enough of the cure to entirely restore the Generally, a disease is likely to act either as a complication infected population, but they may instead focus on to an existing story arc, or as the driving purpose behind an eradicating a magical source of the disease. entirely new story arc. In either case, the focus of the This kind of quest may include destroying the magic rune adventure is likely to be either finding a cure, ending an which is causing an outbreak of stoneplague, or slaying the outbreak, or else escaping before the party is destroyed by demon which originated an outbreak of fury. In many cases, the plague. it is helpful to give the players a single, definitive entity or object, or set of entities or objects, which must be destroyed Finding a Cure or neutralised to end the outbreak. A quest to find the cure to a disease may either be a search for a small dose, to recover a creature that has fallen under Escape the Contagion the plague (such as a party member or important NPCSample), or it A dfileventures of this kind are only appropriate to certain may be a larger search to find enough to end an outbreak (see parties, generally ones which avoid the Lawful Good the next section). alignment. In these adventures, an outbreak of disease forces In either case, a quest to find a cure is likely to include the party to leave the area. either a search for a recipe for the cure, a search for the An adventure which began as an escape adventure can ingredients for the cure, or both. easily become a Finding the Cure adventure (if a party member becomes infected) or an Ending an Outbreak Finding a Recipe adventure (if the party decide they have a moral duty to help). In most cases, the key question, the answer to which may be Generally, escape adventures of this type will be provided the players or may need to be discovered by them, is complications to an existing story arc, rather than a new who has the recipe, or else, where is it stored? storyline in themselves. The party necessarily must survive In a smaller locality, the recipe may be in the care of a wise the disease in order to destroy the "greater evil" they were woman or witch doctor, an individual who knows the cure previously tackling, and the disease merely forces them to either from past experience, or from a tradition of knowledge. change tack. Often, the current keeper of the cure has some reason for not opening it to the public, and this can offer a challenge to the party. On a larger scale, if the disease last appeared many decades or even centuries ago, the cure may be recorded in a book or scroll, stored in a library, monastery, or a wizard's tower. A character with the Researcher background feature will find it easier to locate the cure once they have found the correct institute.

DISEASE | GENERAL 4 Frailty. The target's natural hardiness is drained from it. Cleric Domain When the target makes a Constitution ability check or saving throw, roll a d4 and subtract the number rolled from their roll. The Disease domain is a new divine domain which can be Jitters. The target's limbs shudder uncontrollably. When chosen by the cleric class at 1st level. the target makes a Dexterity ability check, saving throw, or Dexterity based attack roll, you can subtract your Wisdom Disease Domain modifier from that roll (a minimum of -1). The Disease domain focusses on altering the balances of the Lethargy. The target feels tired and drained of energy. The humours within, curing or causing disease and illness. The target's movement speed is reduced by a number of feet equal gods of disease can be cruel masters and mistresses, to twice your Wisdom modifier (a minimum of -2), and the worshipped out of fear, or passive entities merely maintaining target cannot take reactions. due balance in nature, but all offer their clerics a mastery of Slurring. The target struggles to produce coherent speech, the contagions which plague the mortal realms. Some deities communicating only in mumbles and heavily slurred phrases. have express right over plague (such as Talona, Incabulos, or If the target attempts to cast a spell with a verbal component, Morgion), but influence over this domain can be claimed by they must succeed on a Dexterity saving throw or fail to many gods of misfortune (such as Beshaba or Ralishaz) or of complete the casting. The spell slot is not lost if the target the harshest temperaments of nature (such as Silvanus, the fails to cast a spell because of this. Devourer, or Osiris). Wasting. The target suffers from weakness in the limbs. When the target makes a Strength ability check, saving Disease Domain Spells throw, or Strength based attack roll, you can subtract your Cleric Level Spells Wisdom modifier from that roll (a minimum of -1). 1st creeping rot, ray of sickness Whiteye. The target's sight is whited over as its eyes are blighted. The target is blinded and has disadvantage on 3rd lesser restoration, silence Wisdom (Perception) ability checks. 5th conjure mold, stinking cloud Divine Strike 7th blight, confusion Starting at 8th level, you gain the ability to infuse your 9th cloudkill, contagion weapon strikes with divine energy. Once on each of your turns when you hit a creature with a weapon attack, you can Apprentice of Plague cause the attack to deal an extra 1d8 necrotic or poison Starting at 1st level when you choose this domain, you can damage (your choice) to the target. When you reach 14th add your Wisdom modifier (a minimum of +1) to any saving level, the extra damage increases to 2d8. throw you make against disease. You also gain proficiency in one of the following skills: Medicine, Nature, or Survival. Master of Plague Starting at 17th level, your mastery of disease allows you to Bonus Proficiency manipulate illness and plague to your will. Also at 1st level, you gain proficiency with heavy armor. You are immune to disease. If a creature targets you with a spell or feature that would cause you to become diseased, you Channel Divinity: Revoke Disease Samplec afilen turn the disease back as a reaction. That creature must Starting at 2nd level, you can use your Channel Divinity to succeed on a Constitution saving throw against your spell draw a disease otu of a person. save DC or become afflicted by the disease caused by that As an action, you present your holy symbol and command spell or feature. the disease out of a creature. Choose any creatures within 30 In addition, creatures have disadvantage on saving throws feet of you, ending a number of diseases afflicting them equal against disease afflicted by your cleric features or spells. to your Wisdom modifier (a minimum of one). If you choose to end a magical disease, you must make a Wisdom ability check against the spell save DC of that disease.

Channel Divinity: Inflict Illness Starting at 6th level, you can use your Channel Divinity to inflict disease upon a creature. As an action, choose one creature that you can see within 15 feet of you. That creature must make a Constitution saving throw. If the creature succeeds on the saving throw, you can't use this feature on it again until you finish a long rest. If the creature fails its save, the creature is inflicted with one of the diseases described below (your choice) for 10 minutes. At the end of each of the target's turns, it must make a Constitution saving throw, ending the effect on a success. Any effect that removes a disease or otherwise ameliorates a disease's effects apply to this illness.

DISEASE | CLERIC DOMAIN: DISEASE 5