Symptom Encyclopedia

A full list of symptoms and their traits is below the screenshot.

Nausea – Irritated stomach lining leads to discomfort.  Slight chance of infection when kissing.
Vomiting (Nausea)– The expulsion of infected material through projectile vomiting increases the risk of infection.
Diarrhea (Nausea)– Pathogen active in digestive tract, causing infection through feces and potentially lethal dehydration.  Poor countries very vulnerable.
Dysentery (Nausea) – A complete breakdown in the digestive system causes infected sewage, dehydration, starvation and death.
Pulmonary Odema (Coughing, Nausea)– Potentially fatal heart abnormality causes breakdown of respiratory system, releasing pathogen into the air.
Pulmonary fibrosis (Coughing)– Scarring of the lungs causes shortness of breath and extreme coughing.  Can be fatal when combined with intense exercise.
Pneumonia (Coughing) – Serious fluid build and discharge from the lungs.  People in cold climates especially vulnerable
Coughing – Chance of infection by spreading pathogen into surroundings, especially in high density, urban areas.
Sneezing  (Coughing)– Fluid discharge through sneezing greatly increases infection rates.
Immune Suppression (Coughing) – Pathogens attach to lymphocytes, suppressing immune system and allowing significantly greater freedom of mutation.  Can be lethal.
Total Organ Failure (Coughing) – Catastrophic cell death of multiple types causes body-wide organ failure and rapid death.
Fever (Coughing, Rash) – Increase in temperature, contagiousness and severe dehydration, which can be fatal.
Sweating (Rash) – The loss of fluid through sweating also increases infection rates due to poor hygiene.  More dangerous in cold countries.
Rash – The skin becomes blistered and painful, slightly increasing infectivity
Skin Lesions (Rash) – Breakdown in the epidermis causes large open wounds which significantly increase infectivity.
Necrosis (Rash) – Large swathes of infected tissue lose blood supply and become fatal sources of gangrene.  Decomposed bodies remain a vector of transmission.
Insomnia – Inability to sleep makes people irritable and less productive
Paranoia (Insomnia)– Irrational delusions and mental symptoms. Victims distrust of others makes them unlikely to seek treatment or cooperate with others.
Seizures – Random blackouts and fits reduce the patient’s ability to function independently.  Can be fatal.
Insanity (Insomnia) – Neuropathic action of the pathogen in the frontal cortex causes severe emotional and behavioral abnormalities. Significantly harder to cure.
Inflammation (Insomnia, Cysts) – Inflammation obstructs bodily process.  Swelling can obstruct breathing and be fatal.
Cysts – Painful lumps containing pockets of the pathogen.  Slight chance of bursting which can spread disease.
Hyper sensitivity (Cysts) – Increases likelihood of allergic reactions which can distract the immune system.  Rich regions particularly vulernable.
Paralysis (Cysts) – Pathogen destroys motor neurons to cause paralysis.  Significantly harder to cure and can be lethal.
Coma (Cysts) – Neuropathic effects in the brain stem cause loss of consciousness and sometimes death.  Significantly harder to cure. 
Systemic infection (Cysts) – Pathogen affects multiple organs and tissue types, causing body wide infections that spread fast and can be fatal
Abscesses (Cysts) – Pockets of infected flesh are painful and act as breeding grounds for the pathogen, increasing infection rates when burst.
Tumors (Cysts, Anemia) – Pathogen disrupts cell growth pathways, causing uncontrolled, eventually fatal tumor growth.
Internal Hemorrhaging (Anemia) – Flesh eating pathogen breaks down arterial membranes causing rapid internal bleeding and death.
Hemorrhagic Shock (Anemia) – Failure of the heart to pump effectively causes oxygen deprivation, loss of consciousness and death.
Hemophilia (Anemia) – Reduced blood clotting prevents wounds healing.  Pathogen able to spread through infected blood.
Anemia – Decrease in red blood cells or hemoglobin in the blood can lead to hypoxia in the organs.


  1. Can you make the same for abilities and transmission please

  2. Combinations like insomnia, paranoia & anemia bring bonuses too - Walking Dead for example slows down the research rate of the cure. Another combination I have stumbled across is Hemophillia & Abscesses can't remember what it is called however it increase transmission due to infected constantly bleeding. That coupled with the blood transmission and you will see your infection skyrocket.

  3. Projectile vomiting combo syndrome. Combining vomiting and coughing increases transmission

  4. Oops Combination- both diarrhea and coughing

  5. Insanity + Diarrhea = Public Defecation

  6. use of diarrhea sweating and vomitng couse people tp die super quick from dehydration. even worse in pandemic 2 than in plague inc

  7. if you just do the symptom insomnia and you do bird transmission 2 then doctors would think they are having nightmares! You will not be detected yet.

    1. I'll try this one put, having trouble with the fungi level.

    2. I'm having the same problem. Thats helpful

  8. How do you make USA nuke Russia or be nuked by them with the neuro worm

  9. Do one for the Necroa virus (and the Neurax Worm if it has different symptoms)

  10. FINALLY !!!!!! It works, start in Green Land, first invest your DNA points into Bursts, then to Cure Resistence and Water and Air, both on lvl 2 --> it's enough. Then just wait until all humans are infected, then invest your points into Coughing to get Total Organ Failure and Coma, Insomnia helps against Cure progress.

  11. I was a losing as a Parasite the other day when I noticed that the "Disease" graph has consistent units. Your three traits of Infectivity, Severity, and Lethality are on a 0-100 point scale. So I did some experimenting.

    Each symptom or transmission vector has stats. Evolving it adds those stats to your disease over the next few days (I think at a constant rate of 3pts/day). Some choices also have special abilities (i.e. most transmission vectors increase mutation chance), but I don't know how to quantify those so I haven't. Trait combos do not appear to directly affect your stats.

    You start with 2 points of infectivity and 1 point of severity (need to confirm that across all disease types).

    Transmission vectors only increase infectivity.
    Birds I +3, II +6
    Rodents I +3, II +6
    Livestock I +2, II +4
    Animal capstone ??
    Insects I +4, II +8
    Blood I +2, II +4
    Fluids capstone ??
    Air I +4, II +7
    Water I +4, II +8
    Extreme Bioaerosol +5

    Symptoms increase all three stats. I’ve listed them as (infectivity / severity / lethality). Entries with a * need to be double-checked.
    Nausea (1/1/0)
    Vomiting (3/1/0)
    Diarrhea (6/4/1)
    Dysentery (13*/17/8)
    Pulmonary Odema (5/3/2)
    Pulmonary Fibrosis (4/3/2)
    Pneumonia (3/2/0)
    Coughing (3/1/0)
    Sneezing (5/1/0)
    Immune Suppression (2/9/5)
    Total Organ Failure (1*/16/24)
    Fever (4/3/3)
    Sweating (2/1/0)
    Rash (2/1/0)
    Skin Lesions (11/4/0)
    Necrosis (10/20/13)
    Insomnia (0*/2/0)
    Paranoia ??
    Seizures ??
    Insanity ??
    Inflammation (6/3/2)
    Cysts (2/2/0)
    Hyper sensitivity (1/2/0)
    Paralysis (1/5/1)
    Coma ??
    Systemic Infection ??
    Abscesses (4/4/0)
    Tumors (2/0*/4)
    Internal Hemorrhaging (0/9/7)
    Hemorrhagic Shock (0/15/15)
    Hemophilia (4/3/0)
    Anemia (1/1/0)

    Parasite trait reduces your severity. Despite the text, it does not boost your infectivity score (although lower severity may make it easier to spread). I -4, II -8, III -10

    Coughing -> Sneezing is worth a bunch of infection points (8) while keeping your severity low (2), plus the urban bonus.
    Rash -> Sweating is nothing special (2/1/0 for each) but unlocks Skin Lesions (11/4/0).
    Paralysis (1/5/1) has poor stats for a level 3 trait. Good if you need the cure bonus, but skip it otherwise. (Coma is probably similar.)
    Total Organ Failure is the most lethal trait. (I don’t have Coma or Insanity but I assure you neither has 24 lethality points.)

  12. What about Neurax Worm, there is one that the puny humans start worshipping the worm and the zombies' symptoms?

  13. I'm working on speed runs. I can't seem to get anything under 250 days. Looking at some of the scores of other players they're just over 100. How? I've tried different variations, countries, perks, etc..

  14. I've been obsessed with speed runs and have only focused on bacteria. My best is 212 and I can't better that time. I've noticed there are 2-3 times, during the game, that I get some lags, where very little infectivity goes on for 5-7 days at a time. Not sure how to speed that up but it's really slowing down my overall time. I've searched the net for tips and tricks but have found nothing. I guess most people are not interested in this aspect of the game? I'll keep at it and see if I can finally get the right combo, to get me under 200!

  15. the walking dead and the whatever symtom can helfully killing humans

  16. they should make a possession combo, a la exorcist. Projectile vomiting and insanity.

  17. I know I'm a bit late on this conversation but thank for all the great tips everyone you guys have made game really fun for me on this. Also has anyone got a good tactic for the...uh...little robot plague...its...uhh... Nani bot or something? Anyway, does anyone have any tips for tgat on normal or harder. And I think paranoia/insanity should actively fight the cure because doctors will start fighting and destroying each others research to "beat them to the cure" it'd be the Cure Race combo lol

  18. Got any idea what the Prion's special ability does? It seems like it would slow down research, but it doesn't seem to.

  19. I will hunt you down chop off your balls and force you to eat them

    1. You ain't gonna do shit, shut up nerd.

  20. Neurax Worm's symptoms information/hints would be a huge help. I've been stuck on Mega Brutal for over a month and my results are getting worse.

  21. Neurax Worm's symptoms information/hints would be a huge help. I've been stuck on Mega Brutal for over a month and my results are getting worse.

  22. Its funny how we keep on playing a game which gives us a hint on how to eradicate humanity and maybe a few tips for all those nutjob villain like people