Difference between revisions of "Infection"

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(Correct phrasing on Mechanics section that could imply that infection chance calculates on the timer expiring. Also fixed the percent chances based on values in Hediffs_Local_Injuries.xml)
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<onlyinclude><includeonly>''Main Article: [[Infection]]''</includeonly>
 
<onlyinclude><includeonly>''Main Article: [[Infection]]''</includeonly>
 
{{TOCright}}
 
{{TOCright}}
 +
'''Infection''' is a very quick disease that can be contracted from open wounds.
  
 
== Overview ==
 
== Overview ==
Infections can occur on most wounds, except missing body parts or blunt trauma. Infections are the fastest working illness in RimWorld, taking little more than a day to kill the victim if left untended. Animals can also contract infections at a reduced rate.
+
Infections can occur on most wounds. It is the fastest working illness in RimWorld, taking little more than a day to kill the victim if left untended. Animals can also contract infections, though at a reduced chance, which move just as fast.
  
General symptoms include a small amount of pain and partial loss of part function. Advanced symptoms include a small-moderate amount of pain, slight loss of consciousness and further loss of part efficiency, and shortly after: a loss of consciousness, an excruciating amount of pain, and acute part failure, along with a slight loss of breathing. Death follows not long after.
+
It is possible to have multiple infections simultaneously across different body parts. Each infection progresses at its own rate, while immunity against infections progresses at the same rate across the whole body. If the patient can become immune before the worst infection reaches 100%, that now-immune patient has beaten ''all'' their infections.
  
If left untreated, infections can kill in 1.19 days from contraction if it isn't on any vital parts. <br>
+
If untreated, '''the patient loses this race in less than a day and a half''', so any infection needs to be treated immediately and constantly. A pawn with 100% [[Immunity Gain Speed]] will become immune in around 1.5 days.
Good treatment will slow the disease to the point where it takes 3.22 days to kill, and treatment on wounds reduces the chance of a wound infection.
 
  
It takes around 1.55 days to develop immunity to an infection, assuming the affected colonist is rested in an ordinary bed for the whole time, has normal blood filtration, is well-fed, and under the age of 50.
+
===Mechanics===
 +
Any cut, bite, burn or frostbite has a chance to become infected; blunt traumas (aka bruises) do not, nor can a pawn get an infection from losing a body part (i.e. a hand cannot become infected because of a lost finger). The chance of a pawn getting an infection depends on the wound type and various other factors:
 +
*Bite, burns, and chemical burns have a 30% chance.
 +
*Frostbite has a 25% chance.
 +
*Shredding injuries have a 20% chance.
 +
*Most other bleeding wounds have a 15% chance.
 +
*Bruises, cracks or missing parts cannot be infected.
 +
*Colonists are more likely to get wound infections at higher [[difficulty|difficulties]].
 +
Treated wounds can still get infected, at a reduced chance. The multiplier is 85% at 0% tend quality, and linearly decreases to 5% at 100% tend quality. Animals have 20% of a colonist's chance to get an infection. Cleaner rooms further reduce the chance of infection. A regular room without any dirt has a 50% multiplier, a clean room with [[sterile tile]]s has a 32% multiplier, while caravans and outdoor spaces have are 100%.
  
{{clr}}
+
When a colonist has an infectable wound, the game will count down randomly from {{ticks|15000}} to {{ticks|45000}}. The game will also keep track of if the wound was tended, and, if so, what percent chance of an infection would arise from the room stats and the tend quality. Once it reaches this timer, it will decide if the wound will be infected, based on that percent chance. Once an infection sets in, it ''immediately'' becomes a life-or-[[death]] race between the infection rates vs. the patient's immunity progression; the first to a value of 1.00 (100%) "wins".
  
This disease is unique in that it only affects a specific body part, making infections curable by amputating the affected body part. It is not possible to amputate vital body parts.
+
=== Prevention ===
 +
The [[Gene#Perfect immunity|Perfect immunity gene]] {{BiotechIcon}} will completely prevent infections. However, creating a [[xenogerm]] with it requires an [[archite capsule]], so modifying every pawn with it is expensive. For pawns without the gene, the chances of infection can be severely reduced. Make sure to tend to people/animals quickly, in a clean/sterile environment. Any constructed [[floors|floor]] is better than dirt, and [[Sterile tile|sterile tiles]] are better than generic floors. You should also have pawns [[Orders#Clean|clean]] the room in question. See [[Room_stats#Cleanliness|cleanliness]] for more details.
  
== Mechanism ==
+
A triage area can be established near a killbox to tend to pawns quickly without having to trudge halfway across the map carrying the pawn to tend - the utility of this depends on the distance to a hospital and the number of pawns needing treatment. More pawns and larger distance make it more relevant, while a single pawn getting downed in the room next to the hospital would be better off taken to the clean room.
 
 
When a colonist has an infectable wound the game will count down randomly from {{ticks|15000}} to {{ticks|45000}}. Once it reaches this timer it will decide if the wound will be infected.
 
 
 
The chance of a pawn getting an infection depends on the tend quality, wound type, room cleanliness, and storyteller difficulty.
 
*Treated wounds can still get infected at a reduced chance.
 
**The chance multiplier is 85% at 0% tend quality, and linearly decreases to 5% at 100% tend quality.
 
*Different wound types have different chances to get infected.
 
**Bite, burn or frostbite wounds have a 25% chance.
 
**Most other bleeding wounds have a 10% chance.
 
**Bruises, cracks or missing parts cannot be infected.
 
*Clean rooms with [[sterile tile]]s have a 32% chance multiplier. In contrast, a regular room without any dirt has 50%, and outdoors spaces have 100%.
 
*Colonists are more likely to get wound infections at higher difficulties.
 
 
 
Animals have 20% of a colonist's chance to get an infection.
 
 
 
It is possible to have multiple infections simultaneously across different body parts. Each infection progresses at its own rate, while immunity against infections progresses at the same rate across the whole body.
 
  
 
== Stages ==
 
== Stages ==
 
+
====Minor====
====Minor - Severity: 0 - 0.32====
 
 
*+5% Pain
 
*+5% Pain
  
====Major - Severity: 0.33 - 0.77====
+
====Major====
 
*+8% Pain
 
*+8% Pain
  
====Extreme (Initial) - Severity: 0.78 - 0.86====
+
====Extreme (Initial)====
 
*+12% Pain
 
*+12% Pain
 
*-5% Consciousness
 
*-5% Consciousness
  
====Extreme (Advanced) - Severity: 0.87 - 0.99====
+
====Extreme (Advanced)====
 
*Loss of Consciousness (max 10%)
 
*Loss of Consciousness (max 10%)
 
*+85% Pain
 
*+85% Pain
 
*-5% Breathing
 
*-5% Breathing
 +
*[[Death]] at 1 severity
 +
 +
==Progression==
 +
Infection and immunity progression begin as soon as the disease is detected; the first to 100% (1.0 severity) "wins", either saving or killing the pawn. The current status of both progressions can be viewed in the sick colonist's Health tab by mouse-hovering over the word "Infection". Unfortunately, the disease progresses faster without good treatment and rest.
  
====Extreme (Fatal) - Severity: 1 ====
+
===Stages===
*Death
+
*Minor - Severity: 0 - 0.32
 +
*Major  - Severity: 0.33 - 0.77
 +
*Extreme (Initial) - Severity: 0.78 - 0.86
 +
*Extreme (Advanced) - Severity: 0.87 - 0.99
 +
*Death - Severity: 1
  
===Progression===
+
===Humans & Animals===
*When not immune, severity increases by 0.84 per day.
+
*When not immune or treated, severity increases by 0.84 per day (.035 per hr.).
 
*When immune, severity decreases by 0.7 per day.
 
*When immune, severity decreases by 0.7 per day.
 
*Immunity increases by 0.6441 per day when sick.
 
*Immunity increases by 0.6441 per day when sick.
*Treatment slows progression by a maximum of 0.53 per day.
+
*Treatment slows progression by a maximum of -0.53 per day (less with poor treatment).
**This means that the disease will progress by 0.31 per day at this rate.
+
**At 100% treatment, the disease will progress by 0.31 per day.
  
== Prevention ==
+
This means that an infection can kill less than 29 hours (1.19 days) from first symptoms. Pawns with 100% [[Immunity Gain Speed]]* constantly resting in a bed will become immune in just over 1 1/2 days.
 +
: ''(* A patient gains immunity more slowly with poor blood filtration (e.g. from a missing/damaged kidney), malnutrition (i.e. long-term hunger), or over the age of 50, so their time to reach immunity will be greater. [[#Vulnerable|Extremely vulnerable patients]] have only extreme options.)''
  
In order to prevent infections, make sure that people and animals that have open wounds are in a clean room when treated in the first place (e.g. no natural flooring apart from rock, no dirt or blood left to stay in the room, etc.). Although a clean room (or indeed sterile) won't fully nullify the chances of a wound getting infected, it will reduce the chance of an infection occurring, and is a worthy precaution to take.
+
===Case studies===
 +
:* It has been observed in patients with normal beds, a room with "slightly dirty" to "dirty" [[cleanliness]], well nourished, Medical care with skill ~6-10 and only herbal medicine (Tend quality ~40-50), will recover from their infections, even despite some few hours delay in starting treatment. It sometimes is a near thing, and may result in a longer recovery time from an end infection near/over 90% when they reach immunity, depending on the delay, their feeding schedule and the "luck" of the attending doctor. Malnutrition (from hunger) definitely slows the immunity process, as listed under [[Immunity Gain Speed]].
  
== Treatment ==
+
:* It has also been observed that a prisoner in good health (age < 50, no health issues), well fed, in an excellent-quality [[hospital bed]] with a [[vitals monitor]], and a Tend quality of 99% (high Medical skill using [[glitterworld medicine]]), gained Immunity more than 2:1 over Infection gain (from a 68 Immunity and 83 Infection, +32 v. +15).  That's not a "maximum", but it may be close to a reasonably practical one, just as a benchmark.
  
As with any other disease: Make sure that the patient is rested, well-fed, and treated whenever possible. Infections progress very quickly, and missing a treatment can be a ''very'' costly mistake. Due to the rate at which they progress, you'll need at least a competent doctor and medicine in order to ensure that the affected person survives their infections.
+
All this math also means that it will take a patient almost 3 days, or more, to go through the process of first fighting and then recovering from an infection, besides recovering from whatever wound or ailment caused the infection in the first place. Yet another reason to provide prompt, sterile treatment for all colonists' wounds to avoid this in the first place.
  
As a last ditch, if a colonist is about to die, don't hesitate to amputate the affected part. It's better to have a colonist missing a part or two than a dead one, and they won't mind if you remove their infected parts, either.
+
Once an infection is gone from the system, so is any immunity to future infections, and a new infection will cause the process to begin again from scratch.
  
=== Normal People ===
+
=== Default warning ===
 +
Toward the end of a bad infection, once the infection becomes "extreme" (80% or more), you will get a bright red warning among the other notices on the right side of the screen saying:
  
For colonists with 100% immunity gain speed, you will need at least 29% average treatment quality to ensure that one doesn't succumb to their infected wound(s).  
+
: "<mark style="background:#FF0000;"><span style="color:white;">'''Medical emergency'''</span></mark> People are at risk for [[death]] because of severe illness..."
  
=== Extremely vulnerable ===
+
This alert appears regardless of whether that colonist is currently beating the infection or not, or will do so - the game doesn't do the math to predict whether the infection or the immunity will reach 100% first, but you should be able to.  The warning is simply there to remind you that now may be the time to take drastic action, just in case you are losing the race.  The notice will disappear when immunity reaches 100% (regardless of the current level of infection), or when the victim dies.
  
For those with a base immunity gain rate of 43% or less, there is no chance that they will be able to survive a wound infection normally, even with 100% treatment quality for all treatments and rest in a [[hospital bed]] with [[vitals monitor]] connected. This includes some people with kidney and liver damage (physical or chemical).
+
==Treatment==
 +
[[Infection#Prevention|Prevention]] is the best treatment - a capable doctor and clean environment for treatment are critical to avoiding this deadly ailment before it happens.
  
To save the colonist you can do the following:
+
As with any other disease: Make sure that the patient is rested, well-fed, and treated whenever possible. Treatment is administered once every 12 hours, per infection.  Infections progress very quickly, and missing a treatment can be a ''very'' costly mistake. Due to the rate at which they progress, you'll need at least a competent doctor and medicine in order to ensure that the affected person survives their infections.
*Administer [[healer mech serum]]- instantly treats the infection
 
*Administer [[luciferium]]- if pawn has 25% or more immunity gain speed remaining initially, this gives pawn a chance to survive
 
*Amputation
 
*Part replacement
 
  
=== Amputation ===
+
If left untreated, infections kill (or destroy the limb) in a little over a day - untreated infections move ''fast''! For resting colonists with 100% immunity gain speed, you will need at least 15% average treatment quality to ensure that one doesn't succumb to their infected wound(s).
If you know that a colonist might not make it, it's best that you amputate the part. Colonists that reach 80-90% disease progression with their immune systems unable to catch up should have their infected part amputated immediately if possible.
 
  
There is a chance that an amputation will fail, however, if not amputating will result in certain death it is best to take the risk. Besides, if you are amputating a hand, what does it matter if the surgeon manages to tear off the rest of the amputee's arm?
+
This disease is unique in that it only affects a specific body part, making infections curable by amputating the affected body part. It is not possible to amputate vital body parts. It's better to have a colonist missing a part or two than a dead one, and they won't mind if you remove their infected parts, either. If the infection has progressed to over 97%, there is little to no chance your surgeons can successfully pull off an amputation in time. Amputations can fail, so try to amputate well at 80% - 90% if you have no other option.
 +
: * To amputate: Under the patient's Health tab is the Operations tab; "add a bill" to amputate the infected body part. You may have to/want to upgrade the patient's default "medicine" used for procedures - that's under Health/Overview. If an arm/leg is the target, sure to amputate the ''correct'' (left/right) limb - surgeons just do what they're told.)
  
If the infection has progressed to over 97%, there is little to no chance your surgeons can successfully pull off an amputation in time. It's better to strip the sick colonist of their clothes and leave them to die (or euthanize them to make their imminent death less painful).
+
=== Vulnerable ===
 +
For those with a base immunity gain rate of 39% or less, there is no chance that they will be able to survive a wound infection normally, even with 100% treatment quality for all treatments and rest in a [[hospital bed]] with [[vitals monitor]] connected. This includes some people with kidney and liver damage (physical or chemical). A pawn with poor treatment or little rest may also be at risk of death.
  
=== Part replacement ===
+
To save the colonist, you can do the following:
Besides amputation, you can also swap out the diseased part with a healthy one. If the surgery fails, however, you will risk another infection from the surgical cuts and stabs.
+
*Administer [[healer mech serum]]- instantly treats the infection
 +
*Administer [[luciferium]]- if pawn has 23% or more immunity gain speed remaining initially, this gives pawn a chance to survive
 +
*Amputation or part replacement
 +
*A [[biosculpter pod]]'s medic cycle {{IdeologyIcon}}
  
 
== Version history ==
 
== Version history ==
 +
* [[Version/0.7.581|0.7.581]] - Added.
  
 
At around Beta 18 infections caused a reduction in part efficiency, allowing them to kill much earlier than usual if a critically injured vital body part is infected and the infection causes the efficiency of that body part to drop below zero.
 
At around Beta 18 infections caused a reduction in part efficiency, allowing them to kill much earlier than usual if a critically injured vital body part is infected and the infection causes the efficiency of that body part to drop below zero.
Line 102: Line 107:
  
 
{{Nav/disease}}
 
{{Nav/disease}}
[[Category: Disease]]
+
[[Category:Disease]]

Revision as of 14:10, 1 December 2023

Infection is a very quick disease that can be contracted from open wounds.

Overview

Infections can occur on most wounds. It is the fastest working illness in RimWorld, taking little more than a day to kill the victim if left untended. Animals can also contract infections, though at a reduced chance, which move just as fast.

It is possible to have multiple infections simultaneously across different body parts. Each infection progresses at its own rate, while immunity against infections progresses at the same rate across the whole body. If the patient can become immune before the worst infection reaches 100%, that now-immune patient has beaten all their infections.

If untreated, the patient loses this race in less than a day and a half, so any infection needs to be treated immediately and constantly. A pawn with 100% Immunity Gain Speed will become immune in around 1.5 days.

Mechanics

Any cut, bite, burn or frostbite has a chance to become infected; blunt traumas (aka bruises) do not, nor can a pawn get an infection from losing a body part (i.e. a hand cannot become infected because of a lost finger). The chance of a pawn getting an infection depends on the wound type and various other factors:

  • Bite, burns, and chemical burns have a 30% chance.
  • Frostbite has a 25% chance.
  • Shredding injuries have a 20% chance.
  • Most other bleeding wounds have a 15% chance.
  • Bruises, cracks or missing parts cannot be infected.
  • Colonists are more likely to get wound infections at higher difficulties.

Treated wounds can still get infected, at a reduced chance. The multiplier is 85% at 0% tend quality, and linearly decreases to 5% at 100% tend quality. Animals have 20% of a colonist's chance to get an infection. Cleaner rooms further reduce the chance of infection. A regular room without any dirt has a 50% multiplier, a clean room with sterile tiles has a 32% multiplier, while caravans and outdoor spaces have are 100%.

When a colonist has an infectable wound, the game will count down randomly from 15,000 ticks (4.17 mins) to 45,000 ticks (12.5 mins). The game will also keep track of if the wound was tended, and, if so, what percent chance of an infection would arise from the room stats and the tend quality. Once it reaches this timer, it will decide if the wound will be infected, based on that percent chance. Once an infection sets in, it immediately becomes a life-or-death race between the infection rates vs. the patient's immunity progression; the first to a value of 1.00 (100%) "wins".

Prevention

The Perfect immunity gene Content added by the Biotech DLC will completely prevent infections. However, creating a xenogerm with it requires an archite capsule, so modifying every pawn with it is expensive. For pawns without the gene, the chances of infection can be severely reduced. Make sure to tend to people/animals quickly, in a clean/sterile environment. Any constructed floor is better than dirt, and sterile tiles are better than generic floors. You should also have pawns clean the room in question. See cleanliness for more details.

A triage area can be established near a killbox to tend to pawns quickly without having to trudge halfway across the map carrying the pawn to tend - the utility of this depends on the distance to a hospital and the number of pawns needing treatment. More pawns and larger distance make it more relevant, while a single pawn getting downed in the room next to the hospital would be better off taken to the clean room.

Stages

Minor

  • +5% Pain

Major

  • +8% Pain

Extreme (Initial)

  • +12% Pain
  • -5% Consciousness

Extreme (Advanced)

  • Loss of Consciousness (max 10%)
  • +85% Pain
  • -5% Breathing
  • Death at 1 severity

Progression

Infection and immunity progression begin as soon as the disease is detected; the first to 100% (1.0 severity) "wins", either saving or killing the pawn. The current status of both progressions can be viewed in the sick colonist's Health tab by mouse-hovering over the word "Infection". Unfortunately, the disease progresses faster without good treatment and rest.

Stages

  • Minor - Severity: 0 - 0.32
  • Major - Severity: 0.33 - 0.77
  • Extreme (Initial) - Severity: 0.78 - 0.86
  • Extreme (Advanced) - Severity: 0.87 - 0.99
  • Death - Severity: 1

Humans & Animals

  • When not immune or treated, severity increases by 0.84 per day (.035 per hr.).
  • When immune, severity decreases by 0.7 per day.
  • Immunity increases by 0.6441 per day when sick.
  • Treatment slows progression by a maximum of -0.53 per day (less with poor treatment).
    • At 100% treatment, the disease will progress by 0.31 per day.

This means that an infection can kill less than 29 hours (1.19 days) from first symptoms. Pawns with 100% Immunity Gain Speed* constantly resting in a bed will become immune in just over 1 1/2 days.

(* A patient gains immunity more slowly with poor blood filtration (e.g. from a missing/damaged kidney), malnutrition (i.e. long-term hunger), or over the age of 50, so their time to reach immunity will be greater. Extremely vulnerable patients have only extreme options.)

Case studies

  • It has been observed in patients with normal beds, a room with "slightly dirty" to "dirty" cleanliness, well nourished, Medical care with skill ~6-10 and only herbal medicine (Tend quality ~40-50), will recover from their infections, even despite some few hours delay in starting treatment. It sometimes is a near thing, and may result in a longer recovery time from an end infection near/over 90% when they reach immunity, depending on the delay, their feeding schedule and the "luck" of the attending doctor. Malnutrition (from hunger) definitely slows the immunity process, as listed under Immunity Gain Speed.
  • It has also been observed that a prisoner in good health (age < 50, no health issues), well fed, in an excellent-quality hospital bed with a vitals monitor, and a Tend quality of 99% (high Medical skill using glitterworld medicine), gained Immunity more than 2:1 over Infection gain (from a 68 Immunity and 83 Infection, +32 v. +15). That's not a "maximum", but it may be close to a reasonably practical one, just as a benchmark.

All this math also means that it will take a patient almost 3 days, or more, to go through the process of first fighting and then recovering from an infection, besides recovering from whatever wound or ailment caused the infection in the first place. Yet another reason to provide prompt, sterile treatment for all colonists' wounds to avoid this in the first place.

Once an infection is gone from the system, so is any immunity to future infections, and a new infection will cause the process to begin again from scratch.

Default warning

Toward the end of a bad infection, once the infection becomes "extreme" (80% or more), you will get a bright red warning among the other notices on the right side of the screen saying:

"Medical emergency People are at risk for death because of severe illness..."

This alert appears regardless of whether that colonist is currently beating the infection or not, or will do so - the game doesn't do the math to predict whether the infection or the immunity will reach 100% first, but you should be able to. The warning is simply there to remind you that now may be the time to take drastic action, just in case you are losing the race. The notice will disappear when immunity reaches 100% (regardless of the current level of infection), or when the victim dies.

Treatment

Prevention is the best treatment - a capable doctor and clean environment for treatment are critical to avoiding this deadly ailment before it happens.

As with any other disease: Make sure that the patient is rested, well-fed, and treated whenever possible. Treatment is administered once every 12 hours, per infection. Infections progress very quickly, and missing a treatment can be a very costly mistake. Due to the rate at which they progress, you'll need at least a competent doctor and medicine in order to ensure that the affected person survives their infections.

If left untreated, infections kill (or destroy the limb) in a little over a day - untreated infections move fast! For resting colonists with 100% immunity gain speed, you will need at least 15% average treatment quality to ensure that one doesn't succumb to their infected wound(s).

This disease is unique in that it only affects a specific body part, making infections curable by amputating the affected body part. It is not possible to amputate vital body parts. It's better to have a colonist missing a part or two than a dead one, and they won't mind if you remove their infected parts, either. If the infection has progressed to over 97%, there is little to no chance your surgeons can successfully pull off an amputation in time. Amputations can fail, so try to amputate well at 80% - 90% if you have no other option.

* To amputate: Under the patient's Health tab is the Operations tab; "add a bill" to amputate the infected body part. You may have to/want to upgrade the patient's default "medicine" used for procedures - that's under Health/Overview. If an arm/leg is the target, sure to amputate the correct (left/right) limb - surgeons just do what they're told.)

Vulnerable

For those with a base immunity gain rate of 39% or less, there is no chance that they will be able to survive a wound infection normally, even with 100% treatment quality for all treatments and rest in a hospital bed with vitals monitor connected. This includes some people with kidney and liver damage (physical or chemical). A pawn with poor treatment or little rest may also be at risk of death.

To save the colonist, you can do the following:

  • Administer healer mech serum- instantly treats the infection
  • Administer luciferium- if pawn has 23% or more immunity gain speed remaining initially, this gives pawn a chance to survive
  • Amputation or part replacement
  • A biosculpter pod's medic cycle Content added by the Ideology DLC

Version history

At around Beta 18 infections caused a reduction in part efficiency, allowing them to kill much earlier than usual if a critically injured vital body part is infected and the infection causes the efficiency of that body part to drop below zero.