The Trouble With Disease

[Mad_Saulot]

The Players are on a quest to the eastern shaar in Faerun, their ship will dock at Mussum at night, the city will be in a state of festivities, the players are embraced by the people and cavorting and revelry ensue, but when the sun rises the players find that theyre nursing a hangover in a ruined and dead city, signs of plague everywhere, the festival was ghosts and phantoms reliving the last day of their lives when the plague struck, but now the players are infected by the same plague (The Cannibal Phage) which turns people into raving cannibals for a few hours before your organs melt.

Problem: The players include a Paladin, and he'll just cure the party and they'll be free to escape without a challenge, how is it that in a world where magic can easily cure disease, that disease could result in city ending plagues, surely if a city noticed a plague then all the clerics would just sort it out overnight virtually, diseases arent really a threat are they.

How could I make this story possible without suspending disbelief or denying the paladin his powers?

[firelistener]

Give the party some fights beforehand and make sure the enemies are able to deal enough damage that the Paladin doesn't have enough Lay on Hands points (5 per person) to cure everyone. You said it only takes hours to kill them, right? That should work fine since the Lay on Hands points are a long rest resource.

Also, I just don't have many clerics in my worlds. There are healers, yes, but true Clerics that are able to perform miracles to defy the normal rules of the Material Plane shouldn't be that common. Otherwise, you have to ramp up your diseases by making them extremely deadly and infectious to have any chance of spreading.

[Gignere]

The Players are on a quest to the eastern shaar in Faerun, their ship will dock at Mussum at night, the city will be in a state of festivities, the players are embraced by the people and cavorting and revelry ensue, but when the sun rises the players find that theyre nursing a hangover in a ruined and dead city, signs of plague everywhere, the festival was ghosts and phantoms reliving the last day of their lives when the plague struck, but now the players are infected by the same plague (The Cannibal Phage) which turns people into raving cannibals for a few hours before your organs melt.

Problem: The players include a Paladin, and he'll just cure the party and they'll be free to escape without a challenge, how is it that in a world where magic can easily cure disease, that disease could result in city ending plagues, surely if a city noticed a plague then all the clerics would just sort it out overnight virtually, diseases arent really a threat are they.

How could I make this story possible without suspending disbelief or denying the paladin his powers?

You can make a disease immune to Paladin powers. This was done in Never Winter Nights the video game. Just make sure you add in a way to gather reagents or materials that can provide or cure or maybe empower the Paladins LoH so it can work on this crazy disease. It would be fun, my group likes things that surprises them and it’s not denying them their power as the LoH still works on everything else.

[SaigonTimeMD]

The Players are on a quest to the eastern shaar in Faerun, their ship will dock at Mussum at night, the city will be in a state of festivities, the players are embraced by the people and cavorting and revelry ensue, but when the sun rises the players find that theyre nursing a hangover in a ruined and dead city, signs of plague everywhere, the festival was ghosts and phantoms reliving the last day of their lives when the plague struck, but now the players are infected by the same plague (The Cannibal Phage) which turns people into raving cannibals for a few hours before your organs melt.

Problem: The players include a Paladin, and he'll just cure the party and they'll be free to escape without a challenge, how is it that in a world where magic can easily cure disease, that disease could result in city ending plagues, surely if a city noticed a plague then all the clerics would just sort it out overnight virtually, diseases arent really a threat are they.

How could I make this story possible without suspending disbelief or denying the paladin his powers?

I adore this idea, and there's a lot of different ways to go about it. Here's how I see a couple of options for you:


If they're all ghosts, why not make it a ghost PLAGUE as well, so it's resistant to the paladin's powers. Instead of curing them completely, the paladin can only stave off the infection for a few hours. Now the players have a time limit to comb the city and concoct a cure before they succumb!
During the night of revelry, work really hard to get the players attached to the citizens and revelers. Build emotional ties, let the players fall in love with the town, etc. In the morning, when they learn the truth, go ahead and let the paladin cure the plague on the players, but make it crystal clear that the ghosts are doomed to eternal torment, trapped forever in the city they died within, unless a cure is found. The players should, hopefully, still want to discover the cure and put the ghosts to rest as a result. If they don't get emotionally invested, you should also get across that as long as the ghosts linger in this city, the chance for the plague to spread will continue.
Alternatively, and you could do this with either of the above options, make it not a disease at all. Make it some sort of spell or curse cast by an evil NPC that only APPEARS to be a sickness. If your players don't do well with researching cures and would rather hit things instead, this might be a better option. Killing the NPC breaks the curse, of course. Or perhaps it doesn't...?


There's a lot of things you can do in this situation. Hope this helps!

[Mad_Saulot]

I adore this idea, and there's a lot of different ways to go about it. Here's how I see a couple of options for you:


If they're all ghosts, why not make it a ghost PLAGUE as well, so it's resistant to the paladin's powers. Instead of curing them completely, the paladin can only stave off the infection for a few hours. Now the players have a time limit to comb the city and concoct a cure before they succumb!
During the night of revelry, work really hard to get the players attached to the citizens and revelers. Build emotional ties, let the players fall in love with the town, etc. In the morning, when they learn the truth, go ahead and let the paladin cure the plague on the players, but make it crystal clear that the ghosts are doomed to eternal torment, trapped forever in the city they died within, unless a cure is found. The players should, hopefully, still want to discover the cure and put the ghosts to rest as a result. If they don't get emotionally invested, you should also get across that as long as the ghosts linger in this city, the chance for the plague to spread will continue.
Alternatively, and you could do this with either of the above options, make it not a disease at all. Make it some sort of spell or curse cast by an evil NPC that only APPEARS to be a sickness. If your players don't do well with researching cures and would rather hit things instead, this might be a better option. Killing the NPC breaks the curse, of course. Or perhaps it doesn't...?


There's a lot of things you can do in this situation. Hope this helps!

I love your ideas, esp about a curse indtead of a plague.

Cheers to everyone else for your suggestions.

I wouldnt prevent a players powers from working, I'm dead set against interfering with player agency and would never block a power with an arbitray DM's caveat thats just bad storytelling.

I appreciate anyone else who posts suggestions too, I'll let you know what the players do after wednesday.

[SaigonTimeMD]

I love your ideas, esp about a curse indtead of a plague.

Cheers to everyone else for your suggestions.

I wouldnt prevent a players powers from working, I'm dead set against interfering with player agency and would never block a power with an arbitray DM's caveat thats just bad storytelling.

I appreciate anyone else who posts suggestions too, I'll let you know what the players do after wednesday.

Looking forward to hearing how it goes! Messing about with player agency is, I think, one of the hardest things to do well as a DM, and it's a good sign that you're concerned about that experience.

[Mad_Saulot]

Give the party some fights beforehand and make sure the enemies are able to deal enough damage that the Paladin doesn't have enough Lay on Hands points (5 per person) to cure everyone. You said it only takes hours to kill them, right? That should work fine since the Lay on Hands points are a long rest resource.

Also, I just don't have many clerics in my worlds. There are healers, yes, but true Clerics that are able to perform miracles to defy the normal rules of the Material Plane shouldn't be that common. Otherwise, you have to ramp up your diseases by making them extremely deadly and infectious to have any chance of spreading.

Yes, in my worlds Clerics are not necessarily part of a religious order, and not all priests are clerics, inface very few are, clerics are people who have been born with or somehow fiugured out how, or been bestowed with, a connection to a divine domain, regardless of how they got it, their connection to the domain means they are not reliant on a Deity, it is not the Deity that grants a Cleric his powers it is their connection to the domain that grants the powers and domains arent judgemental *******s.

What this means in practise is that Clerics are free, their motivations vary wildly and it is the Deities that must petition the clerics (via quests etc) for service if they want that cleric to represent them, now having said all that it is possible for a Deity to "Block" a clerics connection to a Domain that that deity oversees but if there are multiple deities with oversight over trhe same domain they might restore a clerics connection just to spite their rival. Good and Evil dont enter into it.

So clericxs are more like wizards/sorcerers/warlocks, wildcards that are relatively rare, and to come back to the original point this is why clerics are rare, for if it were easy for a deity to bestow a connection to a domain onto a mortal then every priest would be a cleric.

But still, even given the rarity of clerics in my games it would not be unreasonable to expect them to come to the aid of a city and just mass cure disease, this would be possible with virtually every conventinal plague historically, a plague would have to be unnaturally fast acting in order to destroy a city before at least one cleric made it there.

[8wGremlin]

Allow them to cure the disease with lay on hands etc, but this starts to piss off the god of disease, as they really enjoyed the whole ghost plague thing, it was good to watch people succumb to the ravages of the plague.

They are so pissed that every time the party uses this ability he sends a minor agent of his to spread it more.
The players learn about the fact that every time they have cured the disease, a new plague bearer turns up a day later and spreads the disease even more.

[KorvinStarmast]

but now the players are infected by the same plague (The Cannibal Phage) which turns people into raving cannibals for a few hours before your organs melt.

Problem: The players include a Paladin, and he'll just cure the party and they'll be free to escape without a challenge, how is it that in a world where magic can easily cure disease, that disease could result in city ending plagues, surely if a city noticed a plague then all the clerics would just sort it out overnight virtually, diseases arent really a threat are they.

How could I make this story possible without suspending disbelief or denying the paladin his powers? I am not sure why you want to kill the PC's. The whole reason they have magical powers is to deal with weird evil magics like that. I am not sure what I am missing, but you seem to be chief conductor on a rail road. Was that your intent?

You create illusions, magical diseases, and an city full of partying undead and you worry about suspending disbelief? Hehe, that made me chuckle. :smallsmile:


Yes, in my worlds Clerics are not necessarily part of a religious order, and not all priests are clerics, in fact very few are. Clerics are people who have been born with or somehow figured out how, or been bestowed with, a connection to a divine domain regardless of how they got it, Chosen by the divine powers, that fits into the Forces and Philosophy scheme in the DMG. I have a cleric in one of my campaigns who is "touched by The Storm" - a tempest cleric with no deity. It's working out pretty well.

[JackPhoenix]

But still, even given the rarity of clerics in my games it would not be unreasonable to expect them to come to the aid of a city and just mass cure disease, this would be possible with virtually every conventinal plague historically, a plague would have to be unnaturally fast acting in order to destroy a city before at least one cleric made it there.

Not necessary. It usually take some time between infection and first symptoms, which means there's time for a disease to spread before someone notices it. And then, spell slots are limited resources... level 5 cleric can cure 5 people per day. That's nothing if there are dozens or hundreds affected, and it doesn't protect from being infected again. And people in fantasy settings don't know much about disease vectors and proper prevention and quarantine.... even the clerics themselves aren't immune. And gods forbid if there's some Typhoid Mary-type person, someone who doesn't show the disease's symptoms, but can serve as a carrier....

[Sception]

In terms of in universe 'why are diseases dangerous if paladins and clerics exist', actual class leveled nocs are pretty rare. A city might have a few, sure, but not dozens. On the other hand, the city does have thousands of people intetacting constantly, maybe even tens of thousands. And diseases have incubation periods. By the time a city dweller knows they're sick, they may have infected dozens more, who have in turn infected hundreds. So the magix healers can certainly cure the first few to walk in their doors, once a plague takes hold they'll be looking at dozens or even hundreds of cases a day, and spell slots / lay on hands just can't keep up with that.

Worse, magically healed people haven't fought off tge disease themselves, so they may not have developed antibodies for it. If you magically heal a given citizen of the plague, there's no guarantee that the same citizen wont be back with the same plague within the week. Magic healing can't be mass produced either.

None of that makes a natural disease dangerous to *the player party*. The cleric & paladin don't have the healing reserves to end a plague, but they certainly have the reserves to keep their companions in the clear. But that said, if a plague & panic stricken populace catches wind that there's a magic healer in town then that could lead to its own kind of trouble, from crowds of people begging for a cure to violent mobs demanding one.

[8wGremlin]

<snip> actual class levelled npcs are pretty rare. A city might have a few, sure, but not dozens.



I believe this is an assumption
could you provide a citation
thank you.



I hear this a lot about PC, NPCs etc, also I hear that PC are the heroes and the only ones to get classes, is there anything to back this up, is it a hold over from previous editions, or is this something that has been made up and people now believe it to be true?

anyone help with finding a real citation on this?
thanks

[Zhorn]

Problem: The players include a Paladin, and he'll just cure the party and they'll be free to escape without a challenge, how is it that in a world where magic can easily cure disease, that disease could result in city ending plagues, surely if a city noticed a plague then all the clerics would just sort it out overnight virtually, diseases arent really a threat are they.

How could I make this story possible without suspending disbelief or denying the paladin his powers?

I'd rule it as the disease/plague is very fast spreading.

Yes, paladins and clerics* can cure someone easily, and a small group like a party is easy to keep in the clear.

But a larger population? I just spreads from person to person too easily and too fast. In a dense population, a paladin or cleric just doesn't have enough resources to keep the disease under control.
A large group of clerics and paladins could possibly get the job done, but that requires at least one 2nd level spell slot or paladin level per person being cured.

Then there's the matter of how long is a person immune/cured from the disease till they become susceptible again?

Finally, just to really hammer a nail into the coffin; how long after contraction till the diseased host is contagious, and how long till they start showing symptoms?
If a paladin or cleric can get to patient zero quickly, yes they can save the day. BUT that's a big if.

Let the paladin cure the party... IFF they can figure out the other players have contracted the disease (of course be heavy handed with the hints), but include a few NPCs to die as scene fodder.
Give the players a moral dilemma of trying to save the group of NPCs, or go all Culling of Stratholme in the name of the greater good.

*note for context: When I say cleric, I'm meaning any class with access to lesser restoration

[PoeticallyPsyco]

Simple: split the party. Each person wakes up in a different part of the city (possibly in pairs), and the challenge becomes a frantic race to either find the paladin or work out a cure on their own. Throw in a few environmental hazards/puzzles/monsters to slow them down, and you should be golden.

If players try to arrange a meeting point (via dancing lights in the sky, fireworks, or similar) you can have other things be drawn to the location as well, potentially forcing the party members there to flee.

[Zhorn]

While the town of partying ghosts isn't my cup of tea, the more I ready people's responses to this thread, the more I think this is a travel encounter I want to run for my players.

I'll drop the organ melting part (or keep it, won't matter where I'm going with this), and just go all troped up Dawn of The Dead.
Small isolated desert town. Party kills a small bad of ghouls outside of town while travelling in with a wagon of traders, thinks nothing of it. Either someone in the party gets infected in the combat, or some of the NPCs, don't show any immediate symptoms, get to town, start the spread.
Symptoms begin, party is able to cure themselves no worries, but they are now in a doomed town.
Can they save much of the population?
Can they halt the plague, or even just contain it?
Is nuking it from orbit the only way to be sure?

I don't know how my party will respond, but I don't want to know till the session is in play :smallbiggrin:

[Lord Vukodlak]

I believe this is an assumption
could you provide a citation
thank you.



I hear this a lot about PC, NPCs etc, also I hear that PC are the heroes and the only ones to get classes, is there anything to back this up, is it a hold over from previous editions, or is this something that has been made up and people now believe it to be true?

anyone help with finding a real citation on this?
thanks
In the end the DM makes those kind of decisions but traditionally yes PC classes have always been depicted as rare. If they weren't rare the adventurer PC wouldn't be needed now would they? And in 5e if you look at sample NPC's none of them actually have class levels they simply have a stat block and some abilities that might mimic a class. In 5e, you can only find an NPC with a class level if your DM specifically made one. The sample Evoker casts 6th level spells but only as sculpt spell. No potent cantrip or empowered evocation.

3.5 and 3.0 was probably the only edition that really dealt with this in hard numbers. As at the time NPC's and PC's all followed the same rules. So a human bandit is going to have levels in a PC class or one of the weaker NPC class knock off's. Even if he's the top dog Bandit Warlord.
Something like a Lich or a vampire was not simply a stat block. It was an NPC with class levels and a template added on top. In adventure modules X named PC would have X levels in said class he wouldn't simply have a stat block. Even GODS had class levels. They might be 20th level in four or five different classes. In the section for building a city they had charts for class breakdowns via district. Out of say 550 NPC's 50 might have a PC class or it might be fewer then 12. Depending on what the district was. And they'd likely only be level 1.
So even when all the non-monstrous races had class levels PC class levels were still considered uncommon.

[HappyDaze]

There might also be some situations where a disease is somewhat beneficial. If demons come and eat anyone not suffering from an illness, then the paladin that goes around curing those people before eliminating the demons is a jackhole.

[No brains]

Even though lay on hands/ 2nd level spells are an easy to renew resource, they are still finite. If you want to deal with a highly contagious plague, you need an immunizing or spammable solution.

Reinfection is a decent idea, but have cures/saves last for 24 hours, as they do with monster powers. This way the PCs still have some power and aren't spitefully turned useless.

Also seconding attachment to the city. Make the players want to waste time fixing stuff. Almost every group has their pet NPCs.

One life-hack you could employ is for the characters to find a non-raving cannibal cleric to defeat the infection. Purify Food and Drink is a ritual, so a dedicated cannibal could 'remove all disease' from around 144 people/ 5-foot cubes of food in a day. That number of heals could beat a plague when Hands and Restoration fail. This could even weasel around an 'it's not a disease, it's a curse' tom-foolery as this affable healing cannibal could serve a god who has domain over sustainable cannibalism.

Ultimately, I think disease is easy to cure in 5e because dying of disease is tedious. People have to deal with sickness, hunger, and feeling lost IRL, so 5e glosses over crap we're familiar with. Getting killed by a remorhaz is cool, so that gets to stay.

[KorvinStarmast]

Ultimately, I think disease is easy to cure in 5e because dying of disease is tedious. People have to deal with sickness, hunger, and feeling lost IRL, so 5e glosses over crap we're familiar with. Getting killed by a remorhaz is cool, so that gets to stay. This too. :smallcool:

[Nagog]

You can make a disease immune to Paladin powers. This was done in Never Winter Nights the video game. Just make sure you add in a way to gather reagents or materials that can provide or cure or maybe empower the Paladins LoH so it can work on this crazy disease. It would be fun, my group likes things that surprises them and it’s not denying them their power as the LoH still works on everything else.

This is true, particularly for transmitable "diseases" (Depending on canon you subscribe to) like Lycanthropy and Vampirism. Perhaps this disease/curse was transmitted to the party by sharing food with the dead, and they have to go on a sidequest to find somebody who can heal them? Perhaps a microbiologist who is able to identify the disease, then they must gather resources/magic items to help them synthesize a cure or counter-agent? This would imply it takes a few days to fully kill them, but that gives them time to discover the symptoms and notice that it's crawling closer to killing them.

[Mad_Saulot]

The party are all level 9 and consist of a Silver Dragonborn Paladin of Vengeance, a Mountain Dwarf Totem Barbarian (Bear), A Human Abjuration Wizard, A Human Old Ones Warlock.

The first scenes of the session will be the players dock their ship during an apparent city wide festival where the locals cavort and give away free booze and "herbs" burn on giant braziers across the city hotboxing everyone, I plan to have a young family embrace them and take them around the city getting drunk on free spirits and generally partying, I hope the players grow attached to them, in morning they come to in a burnt out ruin of the house where the young family opened to them, they see a child lying facedown across the room, when they check it out the child attacks, and then melts before their eyes, they recognise the kid from the festivities they will quickly realkise they were dancing with phantoms and when they venture into the city they are beset by melting cannibal natives, some of which they recognise.

After some running fights they make it to the Temple of Ilmater which has been taking in refugews and they explain thatthere is an "Evil" causing the plague and they must travel to the shadowfell reflection of the city in order to confront it and kill the plague, I'm thinking a demonlord for this but which one?

I try not to split the party and if I did the paladin can fly (long story) so regrouping wouldnt be an issue.

I dont intend for the players to die here, but I dont want them waving a hand and eliminating the threat so easily, hence the demonlord.

As far as the plague itself is concerned the infected will transmit it via contact but when they die they rise as shadows that can also transmit the disease via contact, at night the shadows become phantoms that relive the night the plague began, the day is the dangerous time with cannibals and infected shadows running amok

[1Pirate]

Unless you specifically want to try to kill the other members of the party with the disease, the paladin shouldn’t be a problem. His uses of LoH are finite(he can cure the disease 9 times at most) and if you make enough infected people, he’ll run out of healing before you run out of infected.

The same applies to clerics. Even at level 20, several clerics couldn’t keep back a disease that’s infected several thousand.

If you really need to keep the PCs there, have some refugees steal the ship(or maybe they’re infected and they contaminate the ship, so leaving would just carry the disease to the rest of the world). While it might be more complicated than you want to deal with, you could set up an encounter where the PCs have to decide between scuttling the ship or letting the plague get to the mainland.

[Mad_Saulot]

They wouldnt want to scuttle their ship, its carrying over 500,000gp worth of gold on board.

Its in the form of bars and is contained inside five large reinforced chests total weight 5 tons.

At somepoint the players will help create a nation.

[1Pirate]

They wouldnt want to scuttle their ship, its carrying over 500,000gp worth of gold on board.

Its in the form of bars and is contained inside five large reinforced chests total weight 5 tons.

At somepoint the players will help create a nation.
Eh, so more complicated than you want to deal with(of course that makes the ship even more likely to get stolen).

A ship big enough to carry 5 tons of cargo could easily get trapped in a port(it'd also need to be a deep water port. 5 tons would put a lot of hull below the waterline).

[Stone-Ears]

They wouldnt want to scuttle their ship, its carrying over 500,000gp worth of gold on board.

Its in the form of bars and is contained inside five large reinforced chests total weight 5 tons.

At somepoint the players will help create a nation.

One question, something like that would be IMMEDIATELY a target for almost everything from small gangs of stragglers looking to strike it rich to large organized criminal organizations to gold hungry dragons.

How in the heck do they have that much resources AND manage to stay alive?

A clever pirating organization could put a hole in that ship and mark the location of the ship sinking for later underwater salvaging.

[Mad_Saulot]

They got to Mussum, entered into the festivities, my wizard(Oberon) got proper into it and made friends with a local family, there was much drinking and merriment, even my warlock (Rose) who is usually quite suspicious dropped her guard and had a drink, but my paladin(Vorrash), curse his paranoid soul, refused to drink or dance and generally stood back watching, he refused to relax, and my barbarian player wasnt available this session.

Oberon awoke inside Michas residence (the friend he made) and saw a child laying face down on the flagstones, she attacked him as he approached and he witnessed her flesh melt off her bones and her corrupted soul manifest as an infected shadow, he wasted a force cage spell in panic and ran out into the street where the beautiful city from before appeared ruined impossible infected shadows stalked in the direct sunlight, allk of them went for him and he ran, the ship wasnt far.

Meanwhile Vorrash was defending the gold from 6 infected crew, they had the melting phage and in their madness had decided to get the gold, Vorrash discovered that Restoration spells and lay on hands cured the infection, he cured them one per turn as they were cutting at him with heavy cutlass, he tanked much of the damage but used most of his healing magic saving the crewmembers, Roused by the fight Rose who was in her ship quaters went out onto deck to see the ruination of Mussum and saw Oberon running from a crowd of hideous shadows, using Telekinesis she used the gang walkto block the infected while Vorrash flew over to pluck him from danger, at that point they gave up the docks and sailed out to prevent the infected assaulting the ship, then Vorrash flew the players back into the city, Vorrash had learned from the monks of the grsat temple (which was being used as a sanctuary for the hundreds of uninfected civs) that there was a Sibriex within the shadowfell reflection of Mussum, the session ended with the players poised to enter the city graveyard to find the nook, the portal to the shadowfell.

Theyve never been to the shadowfell before and I have all the monster manuals mwuhahaha

@Stone Ears: they literally just got it, though word is getting around the players know that the Calim, the Thayans, The Amnians, Cormyrians and Sembians all know about the gold (the gold is sembian)

[Kane0]

The Players are on a quest to the eastern shaar in Faerun, their ship will dock at Mussum at night, the city will be in a state of festivities, the players are embraced by the people and cavorting and revelry ensue, but when the sun rises the players find that theyre nursing a hangover in a ruined and dead city, signs of plague everywhere, the festival was ghosts and phantoms reliving the last day of their lives when the plague struck, but now the players are infected by the same plague (The Cannibal Phage) which turns people into raving cannibals for a few hours before your organs melt.

Problem: The players include a Paladin, and he'll just cure the party and they'll be free to escape without a challenge, how is it that in a world where magic can easily cure disease, that disease could result in city ending plagues, surely if a city noticed a plague then all the clerics would just sort it out overnight virtually, diseases arent really a threat are they.

How could I make this story possible without suspending disbelief or denying the paladin his powers?

- Diseases can have periods where no symptoms are displayed while still being transmissible.
- Diseases can still spread even with proper treatment available. Think of the number of patients compared to amount of cures available, and the logistics of administering to all those infected, and all the patients that go unnoticed.
- Nothing says a creature that is magically cured cannot contract a disease again (you can even explain this away like 'you didn't build up an immunity')

Yes, your party has a powerful tool to assist. That's what makes it interesting, it doesn't eliminate the problem on its own.

[Mad_Saulot]

- Diseases can have periods where no symptoms are displayed while still being transmissible.
- Diseases can still spread even with proper treatment available. Think of the number of patients compared to amount of cures available, and the logistics of administering to all those infected, and all the patients that go unnoticed.
- Nothing says a creature that is magically cured cannot contract a disease again (you can even explain this away like 'you didn't build up an immunity')

Yes, your party has a powerful tool to assist. That's what makes it interesting, it doesn't eliminate the problem on its own.

The Paladin was immune to disease and cured everyone important to the mission but I've made the disease aspect now more of a plot hook than an actual threat, soon they will enter the shadowfell which we've nevber done before, and so I have an opportunity to rain real horror down on them as their life force is subverted by the upside-down nature of the place, the bleakest stygian horror i can imagine awaits them.

The Sibriex will be the greatest monster they have faced so far and these guys are used to fighting dragons. I will record their cries...

[Tetrasodium]

Give the party some fights beforehand and make sure the enemies are able to deal enough damage that the Paladin doesn't have enough Lay on Hands points (5 per person) to cure everyone. You said it only takes hours to kill them, right? That should work fine since the Lay on Hands points are a long rest resource.

Also, I just don't have many clerics in my worlds. There are healers, yes, but true Clerics that are able to perform miracles to defy the normal rules of the Material Plane shouldn't be that common. Otherwise, you have to ramp up your diseases by making them extremely deadly and infectious to have any chance of spreading.

darker dungeons (https://giffyglyph.com/darkerdungeons/index.html) has about 5-10 pages on expanding diseases with some new mechanics for incubation/transmission/contagion types/resistance to healing/etc along with a bunch of example diaereses that might be useful