Disease

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Diseases are temporary and treatable ailments, that pass away after a certain amount of time or treatment.

Contract

Most diseases are contracted as part of an event. Your colony's biome determines how common diseases are, as well as how common each disease is. However, some diseases happen situationally, regardless of biome:

Note that diseases are not contagious in RimWorld. Disease does not ever spread between colonists, though disease events often simulate "outbreaks" by inflicting multiple colonists at the same time.

The drug penoxycyline protects against Malaria, Plague, and Sleeping sickness. The disease event still happens, but colonists will not be affected.

Summary

Humans and animals can get diseases. Most diseases uses the severity mechanic. As a disease progresses, its symptoms progressively get worse. If a fatal disease's severity reaches 1.0 (100%), then death occurs. Most diseases go from minor -> major -> extreme. How fast a disease progresses depends on the disease itself.

Diseases

Note: Base values of severity and immunity gain speed used in the table.
Treatment's reduction of severity depends on tend quality. 50% tend quality equals half the reduction.

  • Disease Fatal? Description Severity Treatment
    Infection Check.png Generic infection of individual wounds.
    • Fast moving and dangerous.
      • < 1.25 days to kill if untreated. <1.5 days for immunity.
    • Mild symptoms until extreme severity (>0.87). (+5% to +12% pain)
    • Severity: +0.84 / day
    • Immunity: +0.644 / day
    • Treatment: -0.53 severity / day
      (at 100% quality)
    • Bed rest and medicine
    • Amputation of infected body part
    Flu Check.png Relatively mild and common disease.
    • Severity: +0.249 / day
    • Immunity: +0.239 / day
    • Treatment: -0.077 severity / day
      (at 100% quality)
    • Bed rest and medicine
    Malaria Check.png Common in tropical biomes.
    • Severity: +0.370 / day
    • Immunity: +0.314 / day
    • Treatment: -0.232 severity / day
      (at 100% quality)
    • Bed rest and medicine
    Plague Check.png Fast moving and extremely painful.
    • Severity: +0.666 / day
    • Immunity: +0.522 / day
    • Treatment: -0.362 severity / day
      (at 100% quality)
    • Bed rest and medicine
    Sleeping sickness Check.png Very slow-moving infection. Native only to rainforests and swamps.
    • Relatively easy to treat if rested.
    • Threat is the amount of rest / medicine required.
    • Mainly lowers consciousness & manipulation (−2% to −20%).
    • Severity: +0.12 / day
    • Immunity: +0.11 / day
    • Treatment: -0.07 severity / day
      (at 100% quality)
    • Bed rest and medicine
    Scaria Check.png Drives animals to become manhunters.
    • Kills in 5 days, unless cured
    Lung rot Check.png

    Occurs after enough exposure to rot stink. Avoid rot stink to avoid.

    • Severity: +0.300 / day
    • Treatment: -1.000 severity / day
      (at 100% quality)
    • Medicine

    Resolves from:

    • Min 360,000 ticks (6 in-game days)
    • Max 480,000 ticks (8 in-game days)
    Gut worms Ex.png Doubles hunger rate.
    • Also painful (+20% pain).
    • No progression
    • Cured at 300% total Tend Quality
    • Medicine (48hr per tend)
    • Stomach replacement or removal
    Muscle parasites Ex.png Heavily impairs work.
    • No progression
    • Cured at 300% total Tend Quality
    • Medicine (48hr per tend)
    Fibrous mechanites Ex.png Very long-lasting, but improves working.
    • Severity: +0.25 / day
    • Treatment: -1.00 severity / day
      (at 100% quality)
    • Medicine
      • Prevents pain increase only

    Resolves from:

    • Min 900,000 ticks (15 in-game days)
    • Max 1,800,000 ticks (30 in-game days)
    Sensory mechanites Ex.png Very long-lasting, but improves many stats.
    • Severity: +0.25 / day
    • Treatment: -1.00 severity / day
      (at 100% quality)
    • Medicine
      • Prevents pain increase only

    Resolves from:

    • Min 900,000 ticks (15 in-game days)
    • Max 1,800,000 ticks (30 in-game days)
    Blood rotContent added by the Royalty DLC Check.png Extremely long lasting blood affliction.
    • Quest only.
    • Mild and easily treated, but can be a drain on medicine.
    • Severity: +0.40 / day
    • Treatment: -1.00 severity / day
      (at 100% quality)

    Resolves from:

    • Min 1,800,000 ticks (30 in-game days)
    • Max 2,400,000 ticks (40 in-game days)
    Paralytic abasiaContent added by the Royalty DLC Ex.png Complete immobility. Extremely long lasting.
    • No progression
    • 1% per day to instantly cure

    Always resolves after:

    • Min 1,800,000 ticks (30 in-game days)
    • Max 2,400,000 ticks (40 in-game days)
    Infant illnessContent added by the Biotech DLC Check.png Inflicted after a sick birth of a baby.
    • 4 different types of illness, from mild to grave. Switches every 1-3 days.
    • Uniquely, reducing severity to 0 cures the disease (no immunity required).
    • Starts as Major severity (0.40)
    • Severity gain depends on the type
      • From -0.25 to +0.5 severity / day
    • Immunity: +0.10 / day
    • Treatment: -0.35 severity / day
      (at 100% quality)
    • Medicine and bed rest
  • Treatment

    Most diseases can be tended to, just like an injury or ailment, by a Doctor pawn and when the afflicted pawn is assigned to Patient themselves. Tend Quality is determined by a variety of factors, including the doctor's skill and the quality of Medicine used. Generally, higher quality tends reduce the total time until recovery, though mechanics vary. How often a disease can be tended depends on the disease itself.

    There are 3 types of diseases to tend to:

    • The disease will progress over time, and treatment slows down progression. Immunity is gained over time, dependent on Immunity Gain Speed and independent of tend quality. Once immune, the disease will slowly fade and the colonist will stop being a patient. This applies to most fatal diseases, including the flu, infection, and plague.
    • The disease does not progress. Treatment must reach a total tend quality (300%) before the disease is cured. Applies to gut worms and muscle parasites.
    • The disease progresses over time, and treatment slows and even prevents progression. The disease fades only after a certain time. Applies to lung rot, fibrous mechanites, sensory mechanites, and blood rot.Content added by the Royalty DLC

    Certain diseases have specialized cures. For example, infection in a non-vital part can be cured by amputating or replacing a limb, blood rot can be instantly cured with glitterworld medicine, and gut worms can be treated by replacing the stomach. In addition, a healer mech serum immediately cures any disease.

    Immunity gain

    Some diseases are a race between the increasing severity of the disease and the increasing immunity to it. This immunity gain is controlled by several factors:

    • Base immunity gain speed for the particular disease.
    • InfectionLuck, an uncontrollable generated value that adds randomness to the diseases progression.
    • The Immunity Gain Speed stat of the patient

    Immunity Gain Speed is affected by the following:

    Note that these only apply to diseases with immunity mechanics. For example, you don't need to give a pawn with gut worms bedrest.

    Disease frequency

    Disease frequency by AI storyteller

    Disease frequency is controlled directly by the Disease frequency AI storyteller setting.

    This value can be changed in custom storyteller settings, but has the following default values by difficulty:

    Difficulty Disease interval multiplier
    Peaceful 3
    Community builder 2.5
    Adventure story 1.3
    Strive to survive 1.0
    Blood and dust 0.95
    Losing is fun 0.9

    Disease frequency by biomes

    Version history

    • 0.7.581 - Added with flu, plague, malaria, sleeping sickness.
    • 0.9.722 - Diseases can now cause vomiting.