Smallpox

General Information

Strategy Guides

"Patient zero is infected with a strain of variola major that escaped from a lab. Humanity eradicated it 30 years ago. They have detailed knowledge about it and powerful vaccination programs. Will this be able to stop one of the deadliest diseases humanity has ever known?" — Plague Inc., Smallpox introduction paragraph.

Smallpox is one of the available scenarios in the game. The scenario starts off with a virus pre-evolved with Droplets 1, Nausea, Fever, Sweating, Coughing, Sneezing, Pneumonia, Pustules, Systemic Infection, Skin Lesions and Rash. Due to the severity of pustules and lethality of systemic infection, it is hard to keep a low profile within the start of the game. Also, a new government action labeled "(Country name) starts Smallpox vaccination programme" is available and is tagged red in the News. Vaccine Shields can be evolved to increase effectiveness in vaccinated countries.

Scenario Attributes

It starts with Droplets 1, Nausea, Fever, Sweating, Coughing, Sneezing, Pneumonia, Pustules, Systemic Infection, Skin Lesions and Rash already evolved, but can be devolved.

Transmissions

• 
  Air 1 - 2: Increases Pathogen's Infectivity, specially in Arid Climates and through Airplanes.
• 
  Blood 1 - 2: Pathogen spreads through blood and other body fluids, increasing Pathogen's Infectivity, specially in Poor Countries, and Mutation.
• 
  Insect 1 - 2: Insects become sources of contagion, increasing Pathogen's Infectivity, specially in Poor Countries, and Mutation.
• 
  Livestock 1 - 2: Livestock animals become sources of contagion, increasing Infectivity, specially in Rural Countries, and Mutation.
• 
  Extreme Hematophagy: Pathogen uses host lymphocytes to replicate. Increase in infectivity, especially in poor regions and mutation chance
• 
  Water 1 - 2: Increases Pathogen's Infectivity, specially in Humid Climates and through Boats.
• 
  Droplets 1 - 3: Uses particles of body fluids in order to spread, increasing Infectivity, specially Airplane transmission.
• 
  Fomites 1 - 2: Virus spreads through surfaces. Increases infectivity in Urban and Rich Countries.
• 
  Extreme Bioaerosol: Pathogen bypasses air/water filters due to adaptive cellular shell. Increase infectivity, especially in humid & arid climates and plane/ship transmission.

Symptoms

• 
  Nausea: Irritated stomach lining leads to discomfort. Slight chance of infection when kissing
• 
  Coughing: Chance of infection by spreading pathogen into surroundings, especially in high density, urban areas
• 
  Rash: Flat red spots start in the mouth then spread to the rest of the body. Slight increase in infectivity
• 
  Vomiting: The expulsion of infected material through projectile vomiting increases the risk of infection
• 
  Pneumonia: Serious fluid build and discharge from the lungs. People in cold climates especially vulnerable
• 
  Hyper sensitivity: Increases likelihood of allergic reactions which can distract the immune system. Rich regions particularly vulnerable
• 
  Sneezing: Fluid discharge through sneezing greatly increases infection rates
• 
  Abscesses: Pockets of infected flesh are painful and act as breeding grounds for the pathogen, increasing infection rates when burst
• 
  Sweating: The loss of fluid through sweating also increases infection rates due to poor hygiene. More dangerous in cold countries
• 
  Diarrhoea: Pathogen active in digestive tract, causing infection through faeces and potentially lethal dehydration. Poor countries v. vulnerable
• 
  Pulmonary Oedema: Potentially fatal heart abnormality causes breakdown of respiratory system, releasing pathogen into the air
• 
  Inflammation: Inflammation obstructs bodily processes. Swelling can obstruct breathing and be fatal
• 
  Immune Suppression: Pathogens attach to lymphocytes, suppressing immune system and allowing significantly greater freedom of mutation. Can be lethal
• 
  Systemic Infection: Pathogen affects multiple organs and tissue types, causing body-wide infections that spread fast and can be fatal
• 
  Fever: Increase in temperature, contagiousness and severe dehydration, which can be fatal
• 
  Skin Lesions: Lesions on the limbs and face become raised and sores break open in the mouth, significantly increasing infectivity
• 
  Internal Haemorrhaging: Arterial membranes break down, causing rapid internal bleeding and death
• 
  Dysentery: A complete breakdown in the digestive system causes infected sewage, dehydration, starvation and death
• 
  Total Organ Failure: Catastrophic cell death of multiple tissue types causes body-wide organ failure and rapid death
• 
  Coma: Neuropathic effects in the brain stem cause loss of consciousness and sometimes death. Significantly harder to cure
• 
  Necrosis: Large swathes of infected tissue lose blood supply and become fatal sources of gangrene. Decomposed bodies remain a vector of transmission
• 
  Hemorrhagic Shock: Severe loss of blood volume causes oxygen deprivation, loss of consciousness and death
• 
  Corneal Ulceration: Pustules form on the surface of the eye, causing inflammation and can trigger blindness. Severe and slows work on cure
• 
  Osteomyelitis: Pathogen infects bone and joints, causing limb deformities and potentially lethal sepsis
• 
  Acute Encephalitis: Multiple inflammatory lesions in the brain cause severe neurological damage resulting in death
• 
  Pustules: Highly recognisable raised pustules form - filled with thick opaque fluid which can transmit infection if burst
• 
  Subconjunctival Bleed: Bleeding underneath the conjunctiva turns the eyes red
• 
  Purpura: Purple spots and patches form under the skin as blood vessels leak throughout the body. Can be fatal.
• 
  Haemoptysis: Coughing up blood from inflamed bronchi increases infectivity and is fatal in extreme cases

Abilities

• 
  Heat Resistance 1 - 2: Virus withstands higher temperatures easily, increasing Infectivity in Hot Countries.
• 
  Cold Resistance 1 - 2: Virus withstands lower temperatures easily, increasing Infectivity in Cold Countries.
• 
  Environmental Hardening: Pathogen develops hardened coating - becoming highly weather resistant and extremely comfortable in both hot and cold climates
• 
  Drug Resistance 1 - 3: Virus resistant to all Antibiotics, increasing Infectivity in Rich Countries.
• 
  Genetic ReShuffle 1 - 3: Virus reassembles its DNA and creates new strains, increasing the work required for a cure.
• 
  Genetic Hardening 1 - 2: Virus harder to analyze in laboratories, increasing the work required for a cure.
• 
  White Pox 1 - 2: Virus regress to the milder strain Variola minor. Reduces Severity and Lethality.
• 
  Black Pox: Significant decrease in coagulation factors and platelets gives ability to develop highly lethal haemorrhagic smallpox
• 
  Vaccine Shield / EJ2 / EJ7 / EJ13 Vaccine Shield: Introduces key genetic variations that render normal Smallpox vaccines ineffective.

Advantages

Smallpox starts with high initial infectivity and base lethality, making spreading the disease and killing its host far easier and faster. It also has high severity so that you can get quite a few DNA points from red bubbles - Smallpox is almost as fast as Bacteria!

Disadvantages

On the other hand, really high severity in the start making it easily noticeable and countries with react quick against it. In addition to cure, it also need to defend itself against vaccination with relatively expensive vaccine shields. Reducing the base lethality of the disease also require evolving White Pox, as well as constantly devolving any lethal symptoms. Smallpox doesn’t have Bird 1 or Bird 2, which makes it a bit difficult to spread.

Achievements

	Achievement Name:		Complete Smallpox
	Achievement Description:		Score 3 biohazards in the Smallpox scenario
	Value:		Difficulty:	Any

Trivia

• The name of the virus in this scenario is Varíola major, as the disease was caused by most virulent and aggressive strain of Smallpox virus.
• In real life, the WHO certified the global eradication of Smallpox in 1979, making it the only human infectious disease that has been completely eradicated to this day, unlike Black Death, which still has existing vaccines.