Anatomy of a Disease

THESE MECHANICS ARE FOR THE 3.0 RULESET.

THE FULL DISEASE RULES CAN BE FOUND STARTING ON PAGE 190 IN THE DR: EVOLVED COREBOOK. YOU CAN DOWNLOAD A FREE COPY OF THE RULEBOOK HERE.

This page is a summary of the Disease Mechanics in the world of Dystopia Rising. I’m going to focus first on the basics of diseases and how you can interact with them. Then, I’ll go more into how to cure and treat a disease in Dystopia Rising.

Disease Basics

Each Disease in Dystopia Rising has some similar components:

  • Name - This is pretty obvious, really. Some diseases that have seen play are Blood Scourge, Bad Brain, Radiation Sickness, the Plague of the Unfinished, and Black Fungal Disease. Some of those sound pretty scary!

  • Type - While most diseases have set mechanics, sometimes a disease can change or worsen during a game. There are two ways this happens - either as an Outbreak, where the disease mutates to becomes more contagious, or when a disease is Weaponized, where someone purposefully spreads the disease. This last type is ALWAYS a CvC action if done by a player.

  • Transmission Vector - Each disease is spread in a specific way. This can include being bitten or wounded, contact with bodily fluids, consuming tainted water or food, being touched by an infected victim, use of Anomaly skills, airborne transmission, or even environment factors like exposure to radiation or some other SCIENCE! type effect.

  • Stages of Illness - Each disease has a series of Stages. Each stage compounds on the last as the disease worsens. A stage of an illness will generally have roleplay notes for the symptoms of the disease and how it should be portrayed. Most diseases have between 3 to 5 different Stages. For many diseases, the last Stage is particularly deadly and can result in a character dying or even being transformed into something like a Raider!

  • Duration between Stages - Most diseases increase in Stages at set intervals. This might be at the next 12s for fast-acting diseases, or for slow-acting diseases it could increase at the next event. Some diseases can even worsen depending on a trigger, like another exposure to that disease. It’s important to know how deadly the disease is and how much time you have left!

  • Mechanical Impact - Each disease will have some kind of mechanical impact on your character. Some diseases might prevent you from using certain Skills, cause a Fracture, prevent the use of Resolve, or even impact your total Mind or Body totals. Some diseases even give you new Traits that come with specific keywords and abilities.

  • Resolution - Each disease has some specific ways it can be cured and treated. Unfortunately, these ways to resolve a disease are hidden until they are discovered through Research in the game. I’ll cover this step in more detail in my next blog post.

Interacting with a Disease

There are a few key ways you can interact with a disease during a game::

  • Characters can identify the symptoms of the disease and the stage with the Basic Medical skill, for zero mind using “Check Status” rules. The infected character should reveal the name of the disease they are suffering from and the current Stage of that disease they are suffering from. However, this is a full engagement roleplay behavior that could end up infecting the doctor if they do not take precautions first, particularly if the disease in outbreak or is particularly contagious.

  • Characters with the Mutant Lineage (that’s Remnants, Retrogrades, and Tainted) can spend a point of Resolve to ignore a new INFLICT DISEASE mechanic call by calling “Mutated Immune System”. This prevents the character from contracting a new disease but does NOT prevent a disease you are already infected with from progressing. Additionally, Mutants cannot die from a disease unless the mechanics specifically ignore this Lineage benefit.

  • Death at any stage of the Disease generally has some impact on the character. Often, a disease is cured when the character passes through the Mortis Amaranthine, but particularly nasty diseases can persist even after death.

  • If a character is using a Helscape Deathmask or Dr. Ottoman’s Disease Control Kit, they may declare “No Effect!” to any infectious mechanics that might risk spreading the disease to them by working on an infected patient by using their gizmos. Doctors need to be careful around particularly virulent plagues!

  • The Dr. Ottoman’s Disease Control Kit can may you temporarily immune to a disease. This is one of the most effective ways to prevent the spread of a disease during an outbreak.

    • Mechanics: By spending 10 mind and performing a 10-minute Full Engagement medical procedure taking and preparing samples from a Target infected by a disease, user may make a second Target currently not suffering from the disease immune to that single disease until the next 12s (call: ‘Vaccinated, no effect’).

  • Any custom disease introduced in our game may not transfer outside the DR: TX game area for any reason. If a character leaves play before a plot-related disease is cured (like say, you leave early), the disease effects mysteriously fades over the next 12 hours. National-level diseases like Bad Brain can persist on your character sheet though, and can be taken back to a different chapter. It’s generally a bad idea to eat a Raider in any game!

  • Meals are the simplest and easiest way to treat diseases. Using the blueprint “Deep Cholesterol Fry”, even a character with Basic Culinary can add an effect to a meal of “Cure Stage 1 Disease”. While this is no help in later stages, many diseases can be stopped in their tracks with a healthy feast. You know what they say — feed a fever!

Sample Diseases

When a Disease first starts to spread in the game, there are number of ways that your character can deal with it.

Let’s look at a sample common Disease, Bad Brain, from the DR Corebook on page 206, and pay particular attention to the Resolution section at the end.

Bad Brain Disease, commonly spread by most types of Raiders

RESEARCHING A DISEASE

So your town is in the middle of an Disease Outbreak. Oh shucks. What can you do to find out how to fix it? Once you encounter a strange new Disease (like a Disease that isn’t printed in the book like Bad Brain), the first thing to do is to learn more about it!

  • When you use Basic Medical to examine a person, you can identify the Disease they are suffering from for zero mind using the “Check Status” mechanics. The infected character will reveal the name of the Disease they are suffering from and the current Stage of that Disease they are suffering from. This is the good place to start, but how do you learn more?

Luckily, the Corebook actually has a mechanic for how this works. Characters wishing to research a new Disease can do so per the mechanics on p.186 of the DR: Corebook. 

  • After 20 minutes examining the patient with Lore: Medical, a character may spend 5 Mind points to learn more about the Disease and learn ONE fact about the Disease. Each 5 Mind points spent in addition to this may learn one additional fact about the vectors of transmission, stages, or treatment conditions. 

  • If a Research Center room augment is used, the character with Lore: Medical may learn TWO facts instead of one when they spend 5 mind to research.

  • If a Doctor Ottoman’s Disease Control Kit gizmo is used, the doctor may spend 10 minutes and 5 Mind to learn more about the Transmission Vectors of a disease a patient is suffering from. This is a MUCH faster way to Research and doesn’t require Lore to use. (But what kind of doctor doesn’t have Lore: Medical?)

  • Generall, disease mechanics will see play through a series of RESEARCH CHALLENGES during our events. These will be found normally in the Research Center in the General Store. Our goal is to be able to provide these answers quickly, without making folks wait for someone at the Post Office or have to track down a Storyteller.

Treating the Disease

Let’s talk briefly about how you build a Treatment Plan. Once you understand a bit more of how a Disease impacts the patient, you can be begin testing ways to cure the Disease.

A Treatment Plan will generally consist of a few things:

  • Time - How long you need to spend treating the Disease

  • Components - Some particularly deadly Diseases also require the use of item cards to fix. This is often an item that is expended, like using Infectious Material or a healing brew of some kind. Sometimes, the cost simply requires you to have something like a Candlepin Medical Kit that is used but not expended.

  • Mind Points and Skill Use - A resolution to a Disease will generally cost some amount of Mind points to complete. Generally, this cost goes up as the Disease gets to a worse Stage. Most Diseases are cured by some combination of Lore or Medical skills.

  • Treatment Frequency - A Treatment Plan will instruct you on how often a patient needs a treatment, whether it is one treatment or done over multiple stages.

  • Stages of Treatment - Each stage of a Disease will be treated in a different manner. Generally, the challenge of treating a Disease increases as the Stage goes up.

  • Remission versus Cure - Some Diseases cannot be permanently treated, but rather sent into Remission. They are still infected, but most of the negative effects are avoided. Other Diseases can be cured completely.

  • Role-playing Requirements - A treatment will generally provide some kind of guidance for what kind of roleplay might be required during the process. Some Diseases might require a blood transfusion, while others might simply need you to eat a hearty meal.

YOU CAN ALWAYS SPEND MORE RESOURCES THAT A TREATMENT PLAN LISTS, BUT THERE WILL ALWAYS BE A MINIMUM AMOUNT THAT IS NEEDED TO BE SUCCESSFUL.

For instance, in the Bad Brain cure above, if you didn’t have all the Research completed, you might need to guess and spend 15 Mind points for the Treatment Plan. Since it’s over the minimum 10 Mind needed, the cure works but you wasted 5 Mind points that could have been used on something else! It’s important to be thorough in your Treatment Plan so you can conserve your valuable Resources.

Once you have developed a Treatment Plan, you can begin to try to RESOLVE a Disease.

RESOLVING A DISEASE

Diseases generally need to be resolved in some form or fashion. There are four main ways to deal with a Disease, and plot may add additional means to deal with a disease. Remember that Mutants can resist an initial source of Disease by spending Resolve, but once infected they still need to be treated like any other patient.

  • Treatment - Common Diseases like Bad Brain and Radiation Sickness have well known ways to permanently fix the problem of the Disease. Once a cure is known, it can be applied by any character with the right Skills and materials as part of a Treatment Plan. Often, curing a Disease will simply reduce the Stage of the Disease by one step, but sometimes a Treatment just removes the Disease completely - especially if it’s still at Stage One.

  • Remission - Some particularly deadly Diseases may not be able to be cured right away. In these cases, the Disease is simply suppressed for a short time, much like how you might temporarily relieve a Fracture. You are still infected by the Disease, but you do not suffer most of the side effects for a time. Since you are still infected, it means you might even still be contagious, so doctor beware!

    • If the Disease is somehow reactivated (like through another source of infection, or not getting timely Treatment the next game), it starts at the same Stage you were at before the Remission started.

  • Inoculation - When a Disease is particularly contagious, the most common way to stop this is to actually prevent the Disease BEFORE it infects the patient. If a Disease is in an Outbreak stage, an Inoculation is a simple procedure for any character with the Basic Medical skill. Keep in mind that Inoculation requires full contact with the patient, so that may mean the doctor simply spreads the disease further without proper precautions or checking to make sure the patient is actually uninfected first.

    • A character with Basic Medical may Inoculate an uninfected character by spending 5 mind and 5 minutes of full-engagment roleplay protecting the patient from a particular Outbreak Disease. The next time an INFLICT DISEASE effect is used on this character, they may call “No Effect, Inoculated!”. This effect lasts until the next 12s. This is only a simple treatment, so some particularly deadly Diseases might even overpower an Inoculation effect after an exposure. It’s always best to avoid the Disease source altogether!

  • Equipment - The gizmo Dr. Ottoman’s Disease Control Kit is a powerful tool when dealing with a Disease. The effect of the Master Medical use is particularly potent, as it renders a patient IMMUNE to a Disease call for a short time.

    • Requires Master Medical. User may spend 10 Mind. After 5 minutes of Full Engagement Role-Playing taking samples from a Diseased Target, user makes a 2nd Target without the Disease immune to the 1st Target's Disease until the next 12s. The protected character may call “No Effect” until the next 12s when exposed to an INFLICT DISEASE mechanic. This is superior to the Inoculation effect as it cannot be overpowered.