“Ah! Let go of me!”
The halfling cleric shouted in pain and frustration as the necromancer’s gaunt, talon-like fingers tightened around her wrist. She struggled against his grip as he left her aloft, tears of rage welling up in her eyes as her blood began to dribble out from beneath his fetid fingernails. He smiled a wicked, gap-toothed smile as a sickly green glow began to surround his hand, casting his face in long, eerie shadows. The cleric’s face grew pale. Not from fear, though she was nearly paralyzed with it, but with a queasy, vomitous ache in the pit of her stomach.
Her senses began to stretch. The world went into soft focus, and sounds became muffled and quiet. She vaguely comprehended movement to her left, then a flash of steel in front of her. The necromancer’s bony face twisted into fear, and then into pain. A gout of hazy red shot up in front of her face, and she fell suddenly to the ground. The shock snapped everything suddenly back into focus.
“She said ‘let go,’ monster,” the fighter said. She flicked the necromancer’s blood from one of her scimitars and spat upon his corpse. The cleric caught her casting a tentative glance up at the undead horde her allies her fighting, then, assured that she was safe for a moment, turned towards the cleric and knelt down, putting a callused hand upon her chest. “Hey,” the fighter said, “Are you okay?”
The cleric gagged as another wave of queasiness traveled up her guts and into her throat. “Y-yeah,” she stammered, fumbling for the holy symbol around her neck. “I don’t know what’s happening,” she gasped, struggle to hold back her morning rations.
“Your wrist,” the fighter muttered, worry spreading across her face. “It won’t stop bleeding. Oh, gods. Your blood, it’s so thick. It’s like jelly!”
The cleric struggled to focus her hazy vision on her bleeding wrist as the fighter desperately searched for a cloth to staunch the bleeding. The halfling wracked her brain, thinking of what spell could possibly have caused something like this. Then it struck her.
“It’s a disease,” she muttered. “Slimy Doom.”
The fighter looked at her companion and stifled a giggle. “Come again?”
“It’s a magical contagion. It hasn’t taken root yet, though. There’s still time to… Ah!” The cleric muttered a quick prayer and pressed her glowing holy symbol to her wound, casting a lesser restorative charm to purge the magical poison from her body. She looked up at the fighter, warmth returning to her cheeks. “Good as new. Lathander keeps us safe from all ills, does he not?”
The fighter laughed and held the halfling close for a brief, joyous moment, then set her down. “Grab your mace,” she said, glancing at the necromancer’s plague-ridden undead creations. “This isn’t over yet.”
Contagion used to be one of D&D’s most polarized spells. A lengthy online debate raged around this spell since the release of the Player’s Handbook in summer 2014. The reason was that its rules, while interesting, weren’t clear. There were two valid readings of the spell’s text: one that made the spell wickedly powerful, and one that made it practically useless. A recent errata made a small but elegant and impactful change to the spell, transforming it from a spell that sparked furor across the internet to one that now fills a comfortable niche in any cleric or druid’s spell list.
The Woes of Old Contagion
Contagion is a 5th-level spell typically cast by clerics and druids. In short, it infects a single target with a magical disease that will really ruin your target’s week. When you cast the spell, you were presented with six diseases to choose from, corresponding to each of the six ability scores. It seems simple on paper, but there’s a wrinkle: the spell didn’t properly explain how it worked. Here’s the controversial part of the spell’s original text:
“Your touch inflicts disease. Make a melee spell attack against a creature within your reach. On a hit, you afflict the creature with a disease of your choice from any of the ones described below.
At the end of each of the target's turns, it must make a Constitution saving throw. After failing three of these saving throws, the disease's effects last for the duration, and the creature stops making these saves. After succeeding on three of these saving throws, the creature recovers from the disease, and the spell ends.”
It seems fairly innocuous, but there’s a big problem there. It doesn’t specify when the disease takes effect. One way to read it suggests that the spell instantly causes the target to suffer the effects of the disease, and it must make three successful Constitution saving throws to shake it off before it accumulates three failed saves, otherwise it is stuck with the disease for seven full days. When interpreted this way, contagion is a really potent spell, especially when paired with the Slimy Doom disease, which gives the target disadvantage on Constitution saving throws, making it harder for afflicted creatures to resist the encroaching disease.
The other reading of this spell, however, is less impressive. If one assumes that the disease doesn’t instantly take effect when the spell is cast, then contagion ultimately asks you to spend a 5th-level spell slot to do nothing for at least 3 rounds. Then, if the target fails three saving throws before making three successful ones, the disease takes effect for seven days. But, by that point, the battle is probably already over.
The real issue here is that if you interpret contagion charitably, its effects were ridiculously overpowered. If you appraised contagion less highly, the spell was essentially useless in combat. Most fights would be finished by the time the disease took root, and that’s assuming the target failed its saves at all! Its most effective use under this reading was as a slow-paced, out-of-combat spell, used for secretly infecting NPCs with a disease that would slowly ravage their bodies.
Fortunately, this all changed.
The New, Shiny Contagion
Contagion got some special attention in a recent update to the rules released in November 2018. It’s not distinctly a buff or a nerf, since it makes one reading of the old rules better and one reading worse. What it does quite successfully, however, is clear up any confusion on how this spell works. Now, when the spell is cast, the target creature is poisoned. While poisoned in this way, the creature must make a Constitution saving throw at the end of each of its turns. If it gets three successes before three failures, it resists the disease and the poisoned condition ends. If it gets three failures first, however, the disease kicks in.
This errata solves contagion’s biggest problems by sucking out any ambiguity in the original rules. The “weaker” version of contagion in the old rules has been highlighted as the proper reading of the spell, and that version has been given a tidy buff in the process. But then, if you were playing with the more powerful version of contagion before, you might feel like your favorite spell was just knocked down a few pegs. Ultimately I think it’s for the best; contagion still has a clear niche that few other spells occupy, and now it won’t cause nearly as many arguments at the table.
But it’s not perfect.
Contagion’s Awkward Shortcomings
Contagion has always had a pretty serious weakness. Namely, it’s easy to cure diseases in D&D, especially by the time contagion, a 5th-level spell, is being used against you. A simple casting of lesser restoration is enough to scrub the sickness away. Trading a 2nd-level spell slot for a 5th-level one is a great trade for the heroes, but it’s a pretty raw deal for the villainous necromancer who cast it in the first place. And it’s not hard to become immune to disease, either. Paladin’s gain that power at 3rd level through their Divine Health feature, and the periapt of health grants disease immunity for only the cost of an uncommon magic item.
As a point in contagion’s favor, however, most characters won’t be ravenously hunting for a periapt of health, since diseases are generally not a major problem in D&D. Poisons are dangerous, traps are deadly, and monsters are an omnipresent challenge, but diseases don’t turn up too often. Overcoming a disease (typically) isn’t the stuff of heroic fantasy in the same way that monsters and poisoned daggers are. So many characters will be caught off-guard if this spell is used against them, and precious few Dungeon Masters will remember to give their important villains a periapt of health, just in case.
The new version of contagion, however, makes things a bit more difficult by introducing the poisoned condition into the mix. First of all, curing poison is no harder than curing disease; a simple lesser restoration will still do it. And if you can get rid of the poisoned condition, the afflicted creature doesn’t have to keep making saving throws against the encroaching disease, and the spell ends. So far, nothing has really changed.
The big problem is immunity to poison. By introducing the poisoned condition into its process, contagion has suddenly become a lot less useful for player characters, while remaining similarly effective for Dungeon Masters. While most player characters aren’t immune to poison (who’s buying a periapt of proof against poison, anyway?), a lot of monsters are. Undead, fiends, celestials, elementals, constructs—practically all creatures who fall under these categories are immune to the poisoned condition, along with a handful of aberrations and monstrosities, and a smattering of other random creatures.
Now, even though these creatures aren’t immune to diseases, their immunity to poison prevents contagion from ever taking root. Generally speaking, it makes sense that you can’t infect fiends, celestials, elementals, undead, or constructs with a disease anyway, so even though they could be infected by rules-as-written (RAW), a DM should be fully empowered to rule that they’re immune. But some of the edge case creatures, like the hardy dire troll is immune to being poisoned simply by virtue of its mutations and its strong stomach. A disease that causes blindness or that enflames the mind shouldn’t be edged out by this paltry immunity. The same goes for green dragons, who are immune to being poisoned by virtue of their poisonous breath. Surely that shouldn’t grant it immunity to disease.
This is a rules quirk that may stymie players who take RAW as gospel. I’ve seen many such players in the D&D Adventurers League. Ultimately, however, it is the role of the DM is to adjudicate the rules in a coherent manner. If a creature is immune to being poisoned because it lacks blood or living flesh, then it makes sense that it’s also immune to diseases and thus, the contagion spell. If it is immune to poison because it employs venom or poisonous gas in its attacks, then it should be affected by contagion’s “poisoned” effects as usual.
Even if you’re DMing an adventure in the D&D Adventurers League and feel bound to follow RAW, recall the first major piece of advice: You’re Empowered. You can bend the rules to suit the story, and to make the world make a bit more realistic. Don’t break the rules into tiny pieces, but don’t feel constricted by them, especially when they don’t make sense.
Have you used contagion in your D&D game? How do you like the update to this spell in the latest errata? Let us know in the comments!
James Haeck is the lead writer for D&D Beyond, the co-author of Waterdeep: Dragon Heist and the Critical Role Tal'Dorei Campaign Setting, the DM of Worlds Apart, and a freelance writer for Wizards of the Coast, the D&D Adventurers League, and Kobold Press. He lives in Seattle, Washington with his partner Hannah and their sweet kitties Mei and Marzipan. You can usually find him wasting time on Twitter at @jamesjhaeck.
Since its called Contagion, it should be contagious...
So have it spring from target to target every 2 or so turns, to a max of 4 creatures, and for each additional level spellslot when casted at higher levels, add 2 more creatures that can be affected by the Contagion.
If a DM feels ending the poisoned condition with lesser restoration shouldn't necessarily end the possibility of contracting a disease, the following phrase-- or something similar-- can be added to a modified version of the spell:
"Casting lesser restoration on the target ends the poisoned condition, but the target must keep making the saving throws to see if it becomes subjected to a disease."
Another possible addition: "At the caster's option, the chosen disease can be highly contagious. Any creature that touches an affected target becomes poisoned and must make the saving throws. For secondary targets, the saves are made with advantage. After three failed saves, a creature contracts the same disease for 7 days."
My biggest issue has always been its level for what it does even at the better interpretation. There are just better uses of the spell slot for the same conditions at lower levels. It has RP flavor sure but a higher spell slot tax for flavor doesn’t make sense and it’s effects just don’t feel powerful enough in the CR ranges where level 5 slots occur.
Wow, I love that. That could have some amazingly nasty uses in siege warfare or on an unsuspecting town also. Great RP/investigation opportunities: "The townspeople on the border of the kingdom begin to suddenly become ill. You have been tasked by the King to try and find out what is happening, but also contain the outbreak before it threatens the whole kingdom".
Thanks for bringing this column back!
Good read!
I've not used it, but I'll be looking for an opportunity to do so, now!
I'm using this suggestion, not to alter contagion, but to homebrew a different spell. Imagine a spell like Confusion or Enemies Abound where it might compel a target, maddened by a rabid disease, to try and make a melee attack against any creature who's nearest to it potentially spreading the disease. Hard to balance so I might just chicken out and make it a monster ability rather than a spell.
Honestly, it's reasonable as a 3rd level spell in its current format. The At Higher Levels line can begin to serve us here as well.
At Higher Levels. When you cast this spell using a spell slot of 5th level, the disease becomes virulent and contagious. Whenever a non-infected creature touches an infected creature, it must make a Constitution saving throw or contract the disease. When you cast this spell using a spell slot of 7th level or higher, the magical disease ignores any immunity a creature has to the poisoned condition, though such creatures make their saving throws with advantage. No magic short of a heal, greater restoration, or wish can remove the disease once it has taken root.
I think it's the game's best spell if you interpret it generously; Slimy Doom is insane. Stun on-hit...? If you slapped an Ancient Dragon with it (and they can't Legendary Save), and at least one party member hits the dragon each round, it never gets to take a turn. It's 'land a melee spell attack, the opponent does nothing for three rounds *minimum*'.
Saveless effects are exponentially better than saveable effects, given Legendary Saves make saveable spells pretty worthless in the fights that matter most.
One player in my campaign said to me... It is clearly written... And he was right... It clearly said... If the hit succeed... It is infected ! Thus it is infected as soon as you hit. Otherwise the spell would require 4x the saves to succeed. The spell only failed and was talked about because of players either wanting it to be good by ignoring how it was written. While others didnt want a 5th level spell to be stopped so easily.
Re read the text of the original... It clearly states that if you hit... The creature is infected ! So i really dont know where that argument steamed from... But i will say... The spell was already easy to counter... So it needed the powerfull effect. So why did they nerf it even more by weakening it even more is beyond me.
Someone else, probably caught this already, but just in case, I think there's a small mistake in your introductory story. In the third paragraph you wrote "... the undead horde her allies her fighting..." I'm pretty sure you meant to write "were fighting".
tidy buff?
What's most baffling to me is that Contagion got a rework, and yet they haven't touched the dreadful Slimy Doom? Target getting stunned every time it takes any damage is ridiculous at best, and not absolutely overpowered at worst.
I love your spell spotlights, James Haeck. Can you do one on Wall of Force, Please?
As I see it, the problem isn't with Contagion. It's with Lesser Restoration.
Having Lesser Restoration wipe out diseases of any sort with automatic success trivializes disease as a mechanism, story point, whatever. It would be like having Dispel Magic automatically dispel any magic effect. But looking to Dispel Magic as inspiration, it seems the fix is pretty easy:
Diseases have effective spell levels for the purpose of curing. Diseases above level have effective DCs to cure them with Lesser Restoration. Want to be sure about ridding yourself of a disease? Upcast Lesser Restoration.
Lesser Restoration in my game functions like that. Common diseases are, effectively, level 1. And like Dispel Magic, Lesser Restoration automatically cleans up diseases of level 1 or 2 (common cold, flu). Nastier diseases like plague, rabies, etc. have level 3 or 4. Contagion, being a 5th level spell, inflicts a 5th level disease (unless a real jerk cast it with a higher level spell slot). And also house-rule: if you try to cure a disease with a level 2 LR and fail then the victim can't be cured by a level 2 LR for a day. They can try again with a level 3 LR. Then level 4 LR. Etc.
Disease should matter. Contagion is fine. It's the cure that needs a touch of the nerf-wand.
the spell could be used to do more than effect the players, for instance if a paladin where to be targeted they wouldn't be harmed but they would become a carrier of the disease. you and your party could leave an important town that you are stationed in only to find that it has been quarantined because of you.
I completely agree with DnDPaladin and BySavras.
1) The original description is clear.
2) When I prepare spells I think about what creatures I might be facing that day, however, most of the time I have no clue what enemies the day holds. As the article states, many creatures are immune to poison. So unless I am for sure going to be facing an enemy that I know will be affected by poison, then I am a lot less likely to prepare Contagion.
3) Furthermore, I agree with BySavras. Not only is it risky to prepare for reason '2)' but the new description gets outclassed by other 5th level spells.
Contagion was fine the way it was (tweak the diseases if necessary, but otherwise the spell was logically written), the new description narrows the scope of use such that it will be very risky to prepare, and the nerf makes other 5th level spells relatively better (thus further decreasing the chances of Contagion winning out over other spells when deciding what to prepare).
Great article, terrible change.
The change I would make is to specify that being poisoned is simply a condition of being subject to the disease. Immunity in this case prevents the poisoned condition from taking effect, but still requires the saving throws to prevent the disease from taking hold (unless the creature is immune to disease as well).
Another "fun" (loose definition of fun here) change might be related to the spread of the disease as some people have suggested. Once the disease takes effect, you can make a saving throw once a day (at the infected creature's discretion) on the disease. The DC starts at 45. You also gain 7 "charges". Once per day, you can spend 1 "charge" to spread the disease to 2 additional people you have come in contact with who do not already have the disease (this is treated like a new Contagion spell was cast on the new individuals, who must save or be poisoned and eventually infected with the same disease as the initial creature). This lowers the DC by 5 for every charge spent. On the 7th day, after the 7th charge has been spent, the DC is 10 to save on the final day of the infection. Anyone who is infected by the spell knows of these charges.
And yes, this is intended to introduce a moral dilemma here. Spread the disease to potentially cure yourself faster? Or let it continue for the full duration and save those around you. And is infecting the enemy really the best thing to do if this could be the road they take?
Spells that can cure the disease are still a problem, of course.
I disagree that the original text of the spell was unclear about when the disease takes effect:
The above passage is written so that the first sentence is just descriptive, but the two subsequent sentences are undeniably mechanical. The word "afflict" has no special meaning in Fifth Edition, so we have to just treat it by its English definition. So, you are suffering the effects of the disease after a single successful attack roll.
The problem was never that the spell was unclear: it's that the spell was broken. Adding the poisoned condition just makes the spell even less useful (for the reasons outlined in this post): it essentially turns Contagion into a 5th level spell that does nothing. But another issue is that "Diseased" is not a condition in 5e, so monster stat blocks don't include any specific disease immunities, hence the reliance on the Poisoned condition as a rough surrogate.
Here's my proposed fix:
Slimy Doom is still absurdly overpowered (essentially instant death in a fight), but now any afflicted creature will have 3 turns to deal with it, while also being very heavily impacted by the initial attack. This gives DMs the opportunity to have an afflicted Big Bad escape to fight another day, and gives the party a week to find him before he returns with a Periapt of Health as a reasonable counter against the spell.
The end result is that the players feel like the spell is useful when they use it, and like it's a genuine threat when it's used against them. The DM also has enough leeway to allow the disease effects to function without worrying that they'll end a climactic encounter with a single attack roll.