Death Toll

4th-Level Necromancy (Pestilent)
Casting Time: 1 action
Range: Self
Components: V, S
Duration: Concentration, up to 10 minutes

You conjure a shadowy bell in front of you and ring it with an ominous, ethereal tone. Any living creature within a 30-foot radius of you must succeed on a Wisdom saving throw or become frightened for the duration. Viewing you as a specter of death and impending pestilence, it takes the Dash action and moves away from you by the safest available route on each of its turns, unless there’s nowhere to move. If the creature ends its turn in a location where it doesn’t have line of sight to you, it can make a Wisdom saving throw. On a successful save, the spell ends for that creature.

All living creatures in the radius of this spell have disadvantage on death saving throws and on Constitution saving throws to resist disease or necrotic damage, even if they succeeded their saving throw to avoid being frightened, for they are still influenced by the necrotic malevolence of the bell. 

Malaise

1st-Level Illusion (Pestilent)
Casting Time: 1 action
Range: Touch
Components: V, S, M (a scrap of handkerchief from a fever victim)
Duration: 10 minutes

You craft an illusion around a living creature, creating phantom symptoms of a disease. The target must make a Wisdom saving throw. On a failed save, you can choose any or all of the following symptoms for the target to manifest:

• An illusory fever where the target feels feverish and hot to the touch.
• The target has a persistent, scratchy throat, prompting a cough.
• The target sees minor spots or has blurry vision at their periphery.
• The target’s skin manifests illusory spots, boils, or rashes, and they may itch.

While affected by malaise, the targeted creature has disadvantage on all ability checks. At the end of each of the target’s turns, the target can make a Wisdom saving throw. On a successful save, the spell ends. If the target fails the save three times in a row, however, the spell lasts for its full duration.

Additionally, at GM discretion, looking diseased in plague-ridden areas may have its own consequences.

At Higher Levels. When you cast this spell using a spell slot of 4th level or higher, the duration is 1 hour. If you use a spell slot of 7th level or higher, the duration is 24 hours.

Panacea

Abjuration Cantrip (Pestilent)
Casting Time: 1 action
Range: Touch
Components: V, S
Duration: 1 round

You touch a living creature affected by poison, disease, or exhaustion. Until the beginning of your next turn, this spell suppresses the effects of exhaustion and any condition caused by poison or disease. This does not cure any condition, and effects that do not directly hinder or penalize actions continue (so a poison may continue to deal hit point damage, for example).

At the GM’s discretion, continuing to act while under the effects of panacea may make the masked condition worse when it wears off (increasing exhaustion or giving disadvantage on future saving throws, for example), and immediately take effect when panacea ends.

Plague Doctor’s Call

1st-Level Divination (Pestilent) (Ritual)
Casting Time: 1 action
Range: Self
Components: V, S, M (a parcel of dried flowers and herbs)
Duration: Concentration, up to 1 hour

You inhale deeply of the herb-and-flower parcel and attune yourself to the ebb and flow of pestilent spirits. For the duration, whenever you are within a mile of an active epidemic (a contagious disease currently affecting 10 or more creatures within 1,000 feet of each other), the scent of the herbs and flowers intensifies. This scent becomes stronger when you are pointed in the direction of the nearest victim of the epidemic and for as long as you continue moving in its direction. The scent vanishes and the spell ends automatically once you are within 30 feet of a victim of an epidemic you sensed with this spell.

Plague Hysteria

6th-Level Necromancy (Pestilent)
Casting Time: 1 action
Range: Touch
Components: V, S, M (ashes blown in the direction of the target)
Duration: 1 day

Your touch curses a living creature with the symptoms of a disease (either from the list of diseases caused by the contagion spell or from the Random Disease Table). The target must succeed on a Wisdom saving throw or become convinced it is suffering from a disease, including manifesting physical symptoms. However, it suffers no actual damage, conditions, or penalties from this disease. All symptoms are superficial and vanish at the end of the spell’s duration. This is a curse, not a disease, and as such, spells and effects that cure or detect diseases have no effect.

However, while the target manifests symptoms, it emits an aura of hysterical fear. A living creature who sees the target and comes within 60 feet of it must succeed on a Wisdom saving throw or become frightened. The creature remains frightened while it can see the target or is within 60 feet of it. While frightened by the target, the creature must use its movement to move to the nearest safe spot from which it can’t see the target. If the creature moves more than 60 feet from the target and can’t see it, the creature is no longer frightened, but the creature becomes frightened again if it regains sight of the target or moves within 60 feet of it.

At the GM’s discretion, the creature might also be hostile toward the target without approaching it, causing a stir, yelling, hurling curses, throwing rocks, and so on.

Plague Walk

3rd-Level Necromancy (Pestilent)
Casting Time: 1 action
Range: Self
Components: V, S, M (a vial of pus)
Duration: Concentration, up to 1 hour

You conjure a trail of sickly yellowish-green miasma that follows in your footsteps and lingers on your trail. This miasma is visible as a mist hovering above the ground and is no wider than your personal space (usually 5 feet wide). While you leave this trail, wherever you go until the end of the duration, the miasma only lingers behind you for 10 minutes before fading. (Note that your feet must touch the ground as part of your movement to leave a trail.)

Nonmagical plants that are not a creature wither and die in your wake. A living creature that crosses the plague walk trail must succeed a Constitution saving throw or be sickened, gaining a level of exhaustion. The creature must make an additional saving throw for each round spent in the plague walk trail or each time it re-enters it. Creature’s immune to poison are immune to this spell’s effects.

At Higher Levels. If you cast this spell using a spell slot of 4th level or higher, your plague walk trail lingers for an additional 10 minutes for each spell slot level above 4th (to a maximum of 1 hour).

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