Ghoul Fever

[Kalshane]

Any thoughts on how one would run Ghoul Fever in 5E? I'm not sure why it was removed, but its loss kind of breaks the plot of the AP I'm running, so I'm going to add it back in.

With only three diseases in the DMG and no real discussion of how disease is supposed to work in 5E, they don't give us much to go on.

I've seen other GMs say they just run it like it works in 3.x/PF, which I can do, but it ends up feeling a bit out of place compared to other status effects.

I guess, in the long run, it doesn't really matter, as the party includes a paladin who is likely to cure the infection on any PCs before it really becomes an issue (and NPCs can just succumb or not as the plot demands), but I'd still like to have some rules to work from.

[Petty Alchemy]

A rough draft based on DMG diseases:

Con DC 13, onset time 1 day (as it is originally):

While suffering Ghoul Fever, you have one level of exhaustion which cannot be removed until the disease is cured.
After a long rest, Con DC 13:
Success: Reduce the saving throw DC by 1d6, when the saving throw DC drops to 0, the creature recovers from the disease.
Fail: 1d8 necrotic damage which reduces max HP by the same amount. 3 failed saving throws results in death. A humanoid who dies of ghoul fever rises as a ghoul at the next midnight.

You can fiddle with the numbers of course, the gist is exhaustion and repeating necrotic damage which reduces max hp.

[Steve Geddes]

I like Petty Alchemy's solution a lot.

Although failing three DC13 CON saves in a row is not that unlikely, so maybe I'd drop that path to death. I want PCs to be frightened of just letting the disease run its course (which the drop in maximum hit points does well, I think), but I don't want it to be too probable.

[Kalshane]

Thanks, Petty Alchemy. That should work pretty well.

[Petty Alchemy]

Glad it can be of use!