Sewer Plague

Sewer plague is a generic term for a broad category of illnesses that incubate in sewers, refuse heaps, and stagnant swamps, and which are sometimes transmitted by creatures that dwell in those areas, such as rats and otyughs. When a humanoid creature is bitten by a creature that carries the disease, or when it comes into contact with filth or offal contaminated by the disease, the creature must succeed on a DC 11 Constitution saving throw or become infected. It takes 1d4 days for sewer plague’s symptoms to manifest in an infected creature. Symptoms include fatigue and cramps. The infected creature suffers one level of exhaustion, and it regains only half the normal number of hit points from spending Hit Dice and no hit points from finishing a long rest. At the end of each long rest, an infected creature must make a DC 11 Constitution saving throw. On a failed save, the character gains one level of exhaustion. On a successful save, the character’s exhaustion level decreases by one level. If a successful saving throw reduces the infected creature’s level of exhaustion below 1, the creature recovers from the disease.

Magical Contagion

Fouled potions and alchemical waste can give rise to Sewer Plague, which incubates in sewers and refuse heaps and is sometimes transmitted by creatures that dwell in such areas, including otyughs and rats. Any Humanoid that is wounded by a creature that carries the contagion or that comes into contact with contaminated filth or offal must succeed on a DC 11 Constitution saving throw or become infected with Sewer Plague. A creature suffers the following effects 1d4 days after infection:

Fatigue. The creature gains 1 Exhaustion level. Weakness. While the creature has any Exhaustion levels, it regains only half the normal number of Hit Points from spending Hit Point Dice. Restlessness. While the creature has any Exhaus- tion levels, finishing a Long Rest neither restores lost Hit Points nor reduces the creature’s Exhaustion level.

Fighting the Contagion. Daily at dawn, an infected creature makes a DC 11 Constitution saving throw. On a failed save, the creature gains 1 Exhaustion level as its fatigue worsens. On a successful save, the creature’s Exhaustion level decreases by 1. If the creature’s Exhaustion level is reduced to 0, the contagion ends on the creature.