Plagues in 3 games

Disease is a terrifying enemy.  It’s both real and intangible, a totally invisible killer.  Adding something one to a video game is tricky, because it’s a threat that can’t be defeated with guns or swords.  Recently I played 3 games that each prominently feature plagues in their setting and gameplay.  In this article I wanted to take a closer look at the diseases in each, and what kind of effects they have on gameplay.


Dishonored – Rat Plague


As its name implies, the rat plague is spread by rats, but also by contact with the infected.  Symptoms from the Dishonored wiki:

“Symptoms of the plague include discolored skin (particularly on the face and chest), weight loss, and thinning of the hair. As the disease progresses, the lungs and brain become more damaged, leaving its sufferers with a chronic cough and a significant decrease in cognitive ability.

Late-stage symptoms include subconjunctival hemorrhaging, which causes blood to drip from the eyes, and infestation by parasitic stinging insects.”

Prevention of the disease comes in two forms, Sokolov’s Elixir and Piero’s Spiritual Remedy.  The price of these has risen, and with them so has the production of bootlegs preventatives.

How does this affect gameplay?  The game kicks off with you returning from a mission of traveling to nearby countries and asking for aid with the epidemic.  After arriving home, the Empress is killed and you are thrown in jail.  At this point the plague becomes mostly a prominent background feature, especially early in the game.


You will pass through plague districts, marked with warning crosses, infested with rats and infected people.  The infected are referred to as Weepers, due to blood dripping from their eyes.     These act as an uncommon type of enemy within the game, only appearing in plague districts.  They are less aware of their surroundings than other enemies, making them very easy to sneak past.  If they do manage to catch you they can deal heavy damage.  The other plague bearing enemies are rats.  Unlike real rats, these will attack humans in large groups.  You also have a couple of powers that interact with rats, like rat possession or swarm summoning.

Despite coming into contact with infected and rats throughout the game, Corvo will never become infected.  This is pretty easily explained because Sokolov’s Elixir is the health potion, and Piero’s Remedy is the mana potion.  You’re drinking them constantly throughout the game, so you are pretty much immune.  None of the characters you talk to throughout the game will ever catch it either.  The only character who seems to care about the plague after the main plot gets going is Sokolov (even Piero doesn’t mention it much).

Bloodborne – Scourge of the Beast


The plague of Bloodborne is less explicitly detailed than the rat plague.  Exactly how it’s contracted and specific symptoms are not spelled out.  But its effects are much more widespread.  The most obvious symptom is turning people into beasts.   It seems to affect different people in different ways.  There are many enemies that are only partly beastlike, longer limbs, more hair, and very aggressive.  Others have become entirely beastly, extremely large wolves with vaguely humanlike builds.  These seem to imply that the plague takes time to set in, and the longer you have it the more beastlike you become.  But some enemies, like Father Gascoigne, simply go from mostly human to more beastlike instantly.  During your fight with him he seems to be struggling to keep the beast at bay.  Vicar Amelia demonstrates an even more drastic transformation, going from a woman to a giant beast in a matter of seconds.  This plus other evidence, like the Cleric Beast, shows that members of the church turn into much larger and dangerous beasts.

This is probably due to the Church most likely being the source of the plague.  Blood Ministration is the injection of blood provided by the Healing Church, which heals all wounds and cures all diseases.   Information on blood ministration, and the types of blood used is guarded by the church.  This miracle cure quickly spread out amongst the population of Yharnam.  But eventually beasts began to appear within Yharnam, and the hunts began.   It is implied that the source of beasts comes from the usage of blood.  The practice is so widespread that the hunting won’t end until everyone in the town is dead.


The plague serves an important purpose in gameplay, which is to create enemies.  In the early stages basically everything is a plague victim.  The details of how the plague works are left vague intentionally so they can throw many different kinds of enemies, but with a single explanation.   Later on there are many enemies that were not infected. Some seem to be strange experiments by the church (church guard guys), horrors within the world (snakes), and horrors from somewhere else (kin).

Your character receives blood ministration at the beginning of the game.  Its stated that your character traveled to Yharnam for this purpose as they are infected with an unstated disease. Cured of your original ailment, you now have the beastly plague.  Your character never turns into a beast throughout the game, which lends some credence to the idea that it takes time for symptoms to fully manifest. (Miyazaki also mentioned that it’s your Humanity that keeps you from turning into a beast.  The stronger your initial resistance to it, the more twisted you become once you succumb) But if you look at your stat page you will see one called beasthood.  This stat scales with a couple of beast related items you can use, blood pellet and beast claw.  There are even other items like Beast roar allowing you to make use of your beastly side.


Pathologic – Sand Plague


pathologic-classic-hd-an-infected-districtThe sand plague is not a part of the background, or an excuse to make monsters in Pathologic.  It is the entire reason for the game.  The story revolves entirely around it, as do many of the mechanics.  It is a game about an epidemic, and your fight to stop it.  The sand plague does have some similarities to the rat plague, mostly in the way it spreads.  Rats and infected humans can pass it on, but so can miasma clouds within the plague districts.  According to the kickstarter for the remake “It affects the neural and the blood-circulating systems, crippling both body and mind”.

There are a few ways to avoid the plague.  Taking immunity boosters can help prevent you from contracting it if you come into contact with a carrier.  Wearing heavy clothing and other preventative measure help with miasma.  But these will only help if you keep your exposure to it to a minimum.  If you contract the disease you can use anti-biotics to slow its progress, but they cannot stop it. There is one known cure, the schmowders.  These are balls of many different drugs mashed together by children playing plague games.  Consuming one will purge the plague from your system, but will leave you in a poor state afterwards.


The plague is extremely important to gameplay.  Each day the plague will spreads, taking over entire districts of the town.  Entering the districts, you will encounter the rats, miasma clouds and infected people.  Guards are posted outside the districts and will attack infected to keep them within.  Your character runs the real possibility of becoming infected.  This isn’t just represented by the infection bar on your stats screen, there are real mechanical implications:

“At first the symptoms will be infrequent, but the worse it gets, the more it’ll interfere with your functioning. Symptoms of the Sand Plague include: Wobbly camera, slowed movement, screen dimming, and occasional blackouts.

The plague is going to constantly eat away at your health and immune system, feeding off of them to grow. When you’re walking about, it might not be noticeable, but when you sleep you can see just how much health you lose per hour, and how much it grows.”

The plague can even infect important NPCs.  If you cannot find a cure for them they will die and no longer be able help to you.




In addition to all featuring diseases, these games all feature similar settings.  Each game takes place in a roughly late 1800s to early 1900s fictional European inspired city.  Most of the plagues in these games seem to be based on the bubonic plague. But its worst outbreak in Europe was in the 1300s. The time periods used did still have their own issues with disease, influenza being an especially prominent one.  But when people think of an especially devastating epidemic, the plague is probably the first thing that pops into their minds.  There are also lots of visuals that just by seeing them make you think of disease, like rats, plague doctors, and carts full of corpses.



There are some other games I missed. I intentionally avoided any game about zombies, although Bloodborne’s is similar to a zombie outbreak (turning people to monsters).  Another one I missed is Dishonored 2 features a new disease called Bloodfly Fever, but I haven’t played that game yet.  I wanted to take a look at non-digital games, but the only 2 I am aware of are Pandemic and Pathologic board game.  Pandemic’s 4 diseases don’t have any real lore behind them, they are purely mechanical.  As for Pathologic board game, I don’t have it (yet).


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