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Plague is a disease in RimWorld which can be caught by your colonists. As of Alpha 16, the Plague is significantly more deadly than it used to be, and having a somewhat skilled doctor and medicine on hand is critical to one's survival. The Plague also causes a strong penalty to colonist mood as it causes a considerable amount of pain, along with the standard 'Sick' thought. It can be caught in any biome randomly, and you must make sure that afflicted victims get treatment ASAP, and that they remain in bed while developing immunity. The bonus immunity gain speed could mean the difference between life and death.

As the plague progresses at an alarming rate, it can kill an untreated colonist in a mere 1.5 days from discovery.
Good treatment can slow the disease to the point where it takes 6 days to kill.

It takes around 2.121 days to develop immunity to the plague; 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 40.


These are the following stages in which the Plague will progress through, and the effects it has on the victim:

Minor (Hidden) - Severity: 0.01 - 0.39

  • No effects on the affected colonist
  • Buildup to the initial 40% disease head start that the plague has

Minor - Severity: 0.4 - 0.59

  • +20% Pain
  • -5% Consciousness
  • -5% Manipulation

Major - Severity: 0.6 - 0.79

  • +35% Pain
  • -20% Consciousness
  • -20% Manipulation

Extreme (Initial) - Severity: 0.8 - 0.9

  • +60% Pain
  • -30% Consciousness
  • -30% Manipulation

Extreme (Advanced) - Severity 0.91 - 1

  • +85% Pain
  • -30% Consciousness
  • -30% Manipulation
  • -15% Breathing


  • When not immune, severity increases by 0.4 per day.
  • When immune, severity decreases by 0.2 per day.
  • Immunity increases by 0.3 per day when sick.
  • Treatment slows progression by a maximum of 0.3 per day.
    • This means the disease will progress by 0.1 per day at this rate.

Defeating the Plague

As with any other disease, you'll want to ensure colonists afflicted with the plague get as much bed rest as possible. You can prioritize this on colonists by designating a bed as a medical bed, selecting the afflicted pawn, right clicking the bed, and selecting 'Rest until Healed'. You'll want to ensure that the affected colonist(s) get the best medical treatment they can possibly get - don't be afraid to use that Glitterworld Medicine if you have some laying around.

You can also administer Penoxycyline, which boosts the immunity up to 61% (As of Alpha 16).

Treating Normal People (<40 Years Old)

You need at least 40%+ average treat quality to slow the Plague's progression down sufficiently so that it doesn't kill the victim.

The following combinations of doctoring skill and medicine are capable of achieving 40% treatment quality (assuming a perfectly healthy, unmodified doctor, the patient is rested and well-fed at all times, below the age of 40, and treatment is administered immediately) - you'll generally want to aim above these thresholds for safety though; these combinations are just the bare minimum required, and aren't guaranteed to work out:

Treating the Elderly (80+ Years Old)

It's notably more difficult to treat the elderly as they only gain immunity at 80% of the standard rate - unless they have improved blood filtration. Your doctors will need to be capable of administering an average of 65%+ treatment quality in order for your elderly to survive. Again, this is the bare minimum figure and doesn't take into account the time to reach the medicine and the patient - so you'll generally want to aim above this.

The following combinations of doctoring skill and medicine type are capable of administering 65% treatment quality:

  • Level 3 Medicine skill and glitterworld medicine
  • Level 8 Medicine skill and standard medicine
  • Level 15 Medicine skill and herbal medicine

If high quality treatment is not available, consider administering luciferium to the patient, which will dramatically boost their blood filtration and thus rapidly achieve immunity.