Ghoul Fever Condition in Kobos | World Anvil

Ghoul Fever

"We hit the bandits hard, and we thought the element of surprise and the larger size of our party were responsible for our success. We camped inside their walls after dumping them into a mass grave, and it wasn't until midnight that we figured out why the fight had been so easy: They'd all been suffering from ghoul fever. The whole bandit camp clawed its way out of the grave and attacked us, we had to defend the walls we'd just breached. We lost most of our number, but we won anyway. We burned the bodies, of course, theirs and ours.   "On the way home, Sterick and Weene started getting the chills. They'd both been hurt, one bitten and the other scratched, you see, and both were sick with the ghoul fever. Doc tried to fix them up, and Sterick got better. Weene got worse. In the end, we put him down, then we torched the body."   ~Witchfinder General Kill-Sin of The College of Questions

Transmission & Vectors

Ghoul fever can be spread through the bite or scratch of a ghoul, and can be contracted by eating flesh of ghouls or by drinking water infected with ghoul blood.   When exposed to ghoul fever, a character must make a DC 14 Constitution save to avoid contracting the illness. Once contracted, it begins to reveal itself within 8 hours.


Ghoul fever starts with fever and chills. The chills go away eventually but the fever remains and slowly increases for the entirety of the infection. After the chills go away, the weakness begins followed by a ravening hunger. This hunger is intense but otherwise normal in the beginning, but eventually thoughts of food turn to cannibalistic daydreams and a desire for human flesh. The last stages of the disease, the sufferer is too weak to even move anymore, and their stomachs reject all food but the flesh of their own kind.    On a long rest, the sufferer of ghoul fever must make a DC 11 Constitution save or take one level of exhaustion. The sufferer cannot recover exhaustion from rest while the disease lasts.


A poulticed prepared from an herbalism kit can relieve the symptoms and aid in recovery, as can a remove disease potion.   A remove disease spell has a chance of removing the disease, provided the caster is skilled enough.   On receiving aid in the form of an herbalism kit or a potion, the sufferer gains advantage on their next Constitution save to avoid exhaustion. If they succeed, the fever breaks and they begin recovering as normal.   When casting remove disease, the caster must make an Arcana or Religion check DC 14. Success instantly cures the disease, failure aids the sufferer as described above.


With treatment, the sufferer will most likely recover but not always. Without treatment, the chance of recovery for any but the most hearty specimens is slim.


A person that dies while infected with ghoul fever rises as a ghoul the next midnight.    Additionally, there is a small chance that after recovery a sufferer can pass on the taint to their bloodline, potentially producing a Dhampir as a descendant.


If the potential victim has eaten in the last hour, they have advantage on saves against contracting ghoul fever.

Cultural Reception

Sufferers of ghoul fever are treated with a mixture of wariness and terror, especially in the later stages.


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