Marsh Fever (3.5e Disease)

Marsh fever (also known as falciparum) is a terrible bacterial disease largely carried by mosquitoes and other blood sucking creatures such as the stirge. Largely focused around the wet breeding grounds of mosquitoes, marsh fever has a terrible effect on its host. Marsh fever is a multiple stage disease, which gets more severe the longer it goes on.

Initially, the victim takes 1d6 Dex and Wis damage each day and suffers from the Murky-Eyed flaw with no bonus feat gained (this stacks with Murky-Eyed, resulting in four chances to miss). The victim may feel chills, have a fever, and uncontrolled sweating in bouts of a few hours every few days. After failing the save twice, it moves onto stage 2.

The second stage has a hemolytic crises, where red blood cells are lost via urine en masse. This results in a yellowing of the skin, vomiting, and shortness of breath, causing fatigue at the start of anything stressful such as combat. Severe headaches result in a 20% failure chance for anything requiring concentration (including spellcasting). They continue to take 1d6 Dex and Wis each day. At this stage a remove disease spell requires a CL check of 15 to be successful. After failing the save twice again, they move onto stage 3.

The third stage render the creature staggered constantly from a combination of pain and anemia. They continue to take the 20% failure chance, and take 1d6 Dex and Wis ability damage on a successful save. If they fail the save in stage 3, they instead die. At this stage, remove disease is ineffective, requiring at minimum a limited wish or greater effect, or a heal spell with a DC 30 CL check.

If at any point the ability damage paralyzes the target or drops them into a coma, they automatically fail all subsequent saving throws and quickly progress through the stages until death. Marsh Fever is cured with three consecutive saving throws, though they remain vulnerable to relapse for up to a week later, taking a -4 penalty on saves against marsh fever exposures for that time period.

Marsh fever is typically carried by bloodsucking creatures, and such primary hemophages are immune to marsh fever (but can still carry it). For non-monster creatures such as mosquitoes, mosquito-bites from marsh fever prone areas occur approximately once every 6 hours creatures are exposed unprotected to marsh fever carrying environments.