Based on the popular mobile app, the strategy table-top version of the Plague Inc game created by Ndemic Creations has certainly had people talking. Have you played the app? I haven’t myself, but I’ve known a few people who have, as well as seen YouTubers, and they’re all quite addicted. You play as a disease with the intent of wiping out human kind, now that has quite the opposite premise you would see from a family game huh?

In order to kill via infection, players must face each other and develop into great plagues and see who is more lethal. Can you infect the world? Or better yet, is it worth playing? From the gate the creativeness and bleak style of the game really gets you hooked. Though personally I needed some more persuasion to get into it, hearing “ill” and “game” together doesn’t really peak my interest, though there are excepts like Operation.

The box looks cool and sci-fi like, yet has a creepy feel with its intent, like you’re holding something that’s radioactive, a nice smaller sized box for easy carry. I wouldn’t blame you if the theme of this game isn’t your thing or it might be off-putting, apocalypse and illnesses can really bring up a wall for some people. But for those of us into it, is it worth the premise of chaos and mayhem?

Buy Plague Inc


What Do You Get?

  • 64 Plague Tokens (16 of each colour)
  • 62 Trait Cards
  • 49 Country Cards
  • 28 Event Cards
  • 4 Bacteria Evolution Slides (Virus on reverse)
  • 4 DNA Point Markers
  • 1 Card Mat (Single Player Mat on reverse)
  • 1 Death Dice
  • 1 End Game Bonus Card
  • 1 World Board

How Do You Set It Up?

  1. Place the World Board in the centre of the table with the Card Mat, Bonus Summary Card and Death Dice next to it.
  2. Give each player a set of 16 colored Plague Tokens with a matching DNA Points Marker and a bacteria Evolution Slide.
  3. Shuffle the Trait cards and deal each player a hand of 5 cars. Place the remaining Trait Deck on the Card Mat face down.
  4. Shuffle the Event Cards and place the Event Deck on the Card Mat face down.
  5. Take the Country Cards and separate out the Starting Country Cards (cards with red circles on the back). Shuffle the Starting Country Cards then give one to each player.
  6. Shuffle the remaining Starting Country Cards together with Country Cards. Now set up the Country Deck by counting out the correct number of Country Cards for the number of players in your game (see table below). Discard any remaining cards face down.
  7. Place the Country Deck on the Card Mat face down. Turn the top 3 cards from the deck face-up and lay them one next to the other.
  8. All players place their Starting Country face up on the board in the correct continent zone and place one of their Tokens on a City Space (black hexagon) in that Country. You are now ready to infect the world!

How Do You Play?


You are all deadly diseases! Infect Cities to spread across the world, score DNA Points and evolve new symptoms to customize your pathogen as you battle against other players to wipe out humanity and become the ultimate plague!

Object of the game:

Each player is a different disease (represented by a set of colored Plague Tokens) and must compete to score as many DNA Points as possible. DNA Points are scored by:

  • Having the most Plague Tokens each turn;
  • Killing a Country, or having Plague Tokens in a Country that is killed;
  • Winning Bonuses based on your achievements.

The player with the most DNA Points wins!

Turn order and starting DNA Points:

The person who washed their hands most recently goes first and play then proceeds clockwise. Players start the game with different DNA Point scores depending on the turn order: Player 1 starts on 0 DNA, Player 2 on 1 DNA, Player 3 on 2 DNA, and Player 4 on 3 DNA. Players place their DNA Points Marker on the DNA Points Track (outer edge of World Board).

Throughout the game, each time a player scores DNA Points, that player will advance their marker accordingly. When a player spends DNA Points – that player’s marker is moved back along the track by the number of points spent.

The Game Turn:

Each player’s turn consists of 5 phases. The player does all 5 phases in order and then the next player takes their turn.

Phase 1: DNA

Score 1 DNA Point for each country that you control.

How to control a Country:

Control: You have Control in a Country when you have the most Tokens in it (at least 1 Token).

Tied Control: If there is a tie, then all players who have the most Tokens in that Country have control.

DNA Actions:

  • Count the Countries you Control.
  • Score 1 DNA Point for each of these Countries (move your DNA Points Marker forward).

Phase 2: Country

You must pick a new Country Card and delete whether to place it on the World Board, or discard it to draw a new hand of Trait Cards instead.

Placing a Country Card means that there are more Countries that can potentially be infected by disease.

Discarding a Country Card removes it from the game and lets you refresh your hand of Trait Cards (which is useful if you don’t like your current hand).

Country actions:

Either take one of the face-up Country Cards or draw an unknown one from the top of the Country Deck. Decide if you want to place it on the World Board or discard it and draw new Trait Cards.

  • If you choose to place it, then immediately place the Country Card on the World Board in the correct continent Zone.
  • If you choose to discard it, then discard that Country Card. You must now also discard all Trait Cards in your hand and draw 5 new Trait Cards from the Trait Deck.

If you take a face-up card, immediately replace it with a new card from the top of the Country Deck (there must always be 3 face-up cards visible).

You can’t place a Country Card if it’s Continent Zone is full. If it won’t fit on the World Board you must discard it and refresh your trait cards.

Phase 3: Evolution

Your Evolution Slide displays the Traits that your disease currently has. Traits are represented by colored bars and change the way your disease behaves. You start the game with Core Traits on your Evolution Slide and five Trait Cards in your hand. You will add additional Traits to your disease as the game progresses by evolving and adding Trait Cards onto your Evolution Slide.

How to evolve a Trait Card:

To evolve a Trait Card, you must place it on one of the 5 spaces on your Evolution Slide (the space must not already have a Trait Card on it).

There is a DNA Cost in the top left of the Trait Card. To evolve, you must pay this cost using your DNA Points Track. Move your DNA Points Marker backwards by the cost number. You may only evolve if you have enough points to do so.

IMPORTANT: The cost of evolved Trait Cards on your Evolution Slide is added back onto your score at the end of the game.

You can remove Trait Card that you previously evolved.


Trait Cards can have 6 types of Traits. Some cards have multiple Traits but cost more DNA Points to evolve.


Some spaces on the Evolution Slide have Abilities printed on them (e.g. Bonus DNA). These let you do special actions or get bonuses. You can use each of these Abilities once per turn throughout the game as long as they are still visible. If you place a Trait Card on top of them, you can no longer use them.

Evolution actions:

  • Decide if you want to evolve a Trait Card. If you don’t, move to the next phase.
  • If you do, move your DNA Points Marker backwards by the number shown on the top left of the Trait Card you want to evolve and then place the Trait Card on an empty space on your Evolution Slide.

You can only evolve one Trait Card per turn. If at any time there are not enough Trait Cards left in the Trait Deck, shuffle and reuse the Trait Discard Pile.

Phase 4: Infection

Every Country contains Cities (black hexagons). You infect Cities by placing a Token on an empty City space. Your Infectivity Traits on your Evolution Slide control how many Tokens you must put down each turn. For example if you have 3 Infectivity Traits, then you must put down 3 Tokens (if possible).

IMPORTANT: You can only infect a City if your disease is both:

  • Climate Resistant to it
  • And connected to it

Requirement 1: Climate Resistant

You may only place Tokens on a City if you can resist its climate. You are always Climate Resistant to Neutral Climate Cities but to be Climate Resistant in a Hot/Cold City, you must have evolved the Heat/Cold Resistance Trait on your Evolution Slide.

If you devolve Hot/Cold Resistance, then Tokens that are already in Hot/Cold Cities stay, but you cannot infect new Hot/Cold Cities.

Requirement 2: Connected

You may only place Tokens on Cities if your disease is Connected to them. You can be Connected in three ways:

Connected rules are recalculated each time you place a Token. E.g. you can infect a Country with a Seaport and then use the Seaport in the same turn.

Infection actions:

  • Count how much Infectivity you have on your Evolution Slide.
  • Place this number of Tokens on Cities where you are both Climate Resistant and Connected.
    • You must place all the Tokens if possible.
    • Some Cities may be inaccessible because you are not Climate Resistant and/or Connected to them.

If you run out of Tokens or can’t place all of your Tokens then move onto the next phase.

Phase 5: Death

During the final phase, you must try to kill any Country that you Control which is also Fully Infected. You roll the Death Dice for each Country and compare the results against your Lethality Traits.

Control is determined in the same way as during the DNA Phase. You Control a Country by having the most Tokens in it (including a tie).

Fully Infected Countries:

A Country is said to be Fully Infected if there are no more empty City spaces left in that Country (This happens as the game progresses and more Cities are Infected).

Death actions:

If a Country you Control is Fully Infected, then you must try to kill it using the Death Dice.

  • Say the name of the Country you are trying to kill;
  • Count how much Lethality you have on your Evolution Slide (in the same manner as Infectivity);
  • Roll the Death Dice:
    • If you roll a number that is less than or equal to your Lethality – then you kill the Country!
    • If you roll a number greater than your Lethality – then you fail to kill the Country and must try again next turn.
  • Try and kill each Country that meets the Criteria, then end your turn.

What happens when a Country is killed?

When a player kills a Country:

  • All players score 1 DNA Point for each Token they have in that Country;
  • All players in that Country draw an Event Card from the top of the Event Deck – unless they already have 3 Event Cards in their hand;
  • Tokens are returned to their respective players;
  • The Country is removed from the World Board and kept by the player who killed it for End Game Bonuses later.

How are Event Cards used?

Event Cards let a player do a specific action. The instructions shown on the card explain when and how to use it.

  • When you receive an Event Card, keep it in your hand until you want to use it (you can’t use an Event Card the same turn that you receive it).
  • You can use as many Event Cards as you want each turn (as long as criteria is met).
  • When you use an Event Card you must discard it afterwards.

At the start of your turn, you may discard 1 Event Card to score 1 DNA Point instead of using it.

If at any time there are not enough Event Cards, shuffle and reuse the Event Discard Pile.

Sudden Death Mode and Game End:

Once the final Country Card has been placed/discarded, the world begins to collapse and the game immediately enters Sudden Death Mode.

When in Sudden Death Mode, the Country Phase is skipped and the game can end in two ways:

  • Eradicated Plague – if any player has no Tokens left on the World Board, the game ends when the current player has finished their turn.
  • Unable to move – If any player can neither place Tokens nor roll the Death Dice during their turn, the game ends immediately.

Once the game has ended, final scores are calculated.

Calculate final scores:

In addition to DNA Points scored during the game, players also score the DNA Points from their Evolved Trait Cards and from End Game Bonuses (Move DNA Point Markers when DNA Points are awarded).

First each player adds up the cost of their currently evolved Trait Cards on their Evolution Slides. This cost is “refunded” and added back onto their DNA Points score.

Then award bonus DNA Points to players based on their achievements. If multiple players meet the criteria then they all are awarded the points:

  • Luck Escape: Bonus for the Player(s) with the most Tokens left on the World Board at the end of the game – +4 DNA Points
  • Continent Killer: For each Continent – bonus for the player(s) who killed the most Countries in that Continent – +6 DNA Points (per Continent)
  • Ultimate Wipeout: Bonus for the player(s) who killed the Country with the most Cities – +7 DNA Points

The player with the highest number of DNA Points wins the game! If there is a tie, the player who is first to lie on the floor and pretend to be dead wins.


Pros Of The Game

  • Easy setup and simple to learn
  • Has good layers of strategy and tactical capability, keeping you on your toes to take opportunities
  • Inspires good competition and fun with others
  • Unique style, theme and format
  • Good excitement during the high points of the game when diseases spread fast

Cons Of The Game

  • The darker theme may put some people off
  • Game boards are very flimsy
  • Certain points of the game can drag out
  • Players can team up against you frequently to take advantage, though you could do the same to them
  • Ending of the game drags out, feels like it’s winding down

Should You Get Plague Inc?

Interested in playing the villain for once? This is another game which gives that chance! This is very different from the well-known Pandemic game series, driving the competition to see which player is the greatest disease, rather than working as a team to combat illnesses. The only thing similar between them is their popularity and their fans consistent urge to play them.

One of my favourite types of game is the storytelling kind, and this Plague Inc game gives a story, albeit one not all would want to hear, but still it’s a great element to have. Gameplay lasts about an hour, which feels like the right amount of time for a game of this type.

The components for the game are ok, nothing major. The DNA marker and cubes look really good and durable, though the cards, if made well, don’t look anything special. The boards are the worst part, they look unmemorable and are very fragile. It would have been nice to have a separate board for the solo game too, rather than be on the flip side of the multiplayer one.

For one 1-4 players, it’s easy to learn, bringing you into the action quickly, whilst at the same time there is an underlying feel of depth in the decisions you’re making, like when to focus on wiping out more of humanity or when to increase the lethality of your disease. Too much spreading and you might not be strong enough to kill people, too much getting stronger and you might not have time to wipe out anybody.

You get five trait slots for trait cards, which is a good amount to have some fun and work out what your plague will be doing. You can remove a trait on your board and will get points back for each trait at the end of the game, but you’ll want to drop traits eventually to stay in the game and spread quickly around continents.

The replay value here is when you can have some countries removed each game, not to mention there are two different styles of play, where you can play either as a bacteria or a virus. Top that with a large deck of trait cards and there is little repetition.

Your tactical prowess will show as you try to take advantage of opportunities and grab chances, playing the right cards at the best times so you can get one over on your opponents. There’s room to learn and improvise each time you play.

The excitement of the action can dip at times with this game. Though turns are quick and there are great moments of plague’s spreading fast leaving a trail of madness, there can also be moments where you’re just bopping along turn to turn. When players have the traits they want there’s less to aim for, and if the country deck doesn’t give you much then you’re just waiting a while until you get heat or cold resistance. Funnily enough the video game had these kinds of issues where you’re just waiting around for your disease, only with the board game if you have a good array of traits then you’re just chilling during certain periods.

The pacing issues don’t take away the enjoyment of the game, and it doesn’t keep you thinking to the point your brain is fried. It has a good mixture of engagement and fun, great for socializing and just having a laugh if you’re not tearing each other’s hair out when in the thick of it, maybe have a couple of drinks first before playing!

On a competitive level you will be drawn in from the get go. Beware, players can team up against you at times to get an advantage, so this isn’t necessarily a friendly game at certain points.

There is a virus expansion for the game, which plays as bacteria but with a couple of differences in its rules. The possibilities and replay ability potential can vastly increase if more expansions were added to the mix, providing more trait cards and event cards.

As mentioned, I understand the theme can deter certain people, the death and ailment concepts aren’t too welcoming, especially for families. I would recommend you give this a try though if you can get past the barrier.

Plague Inc also provides a solo mode, where you face off against the Plague Bot. A fascinating puzzle which gives its own type of challenge, you’ll find it either frustrating or a welcome addition to the overall experience. Chances are it will beat you constantly. If you want that extra difficulty you can get it here, you’ll certainly feel good if you beat the bot. But to be honest, the rivalry that ensues from multiplayer is one of the games core strengths, making it a lot more fun, leaving you playing solo mode very little often.

Although there is a story, the ending does leave some to be desired. You go into sudden death once all of the country cards have been used, and it all ends once a player doesn’t have any cubes left, when they cannot roll the death dice, or they cannot infect any cities. This pretty much brings the game to a crawl as it reaches the end, giving little impact with no drama or suspense. The video game way like this too and could have been tweaked, maybe have players race to see who infects the last country first and when they do, then count the final scores.

A fun experience which translates well from the app to the table, I’m interested to see where this goes and what more they can do with the franchise. It has its place and can be a nice detour from the usual.

Overall the Plague Inc game has been a success for me, I certainly recommend for its tactical and head-to-head elements. An immersive hand management game with a unique theme and provides good competitive motivations, it’s a cool take on strategy gameplay, handing you plenty of choice whilst ensuring you don’t go too far ahead winning or you’ll take yourself out, making balance key.

It has a morbid presence, so it isn’t everyone’s cup of tea. Plus, there can be stretches where you don’t do much, especially at the end, making patience a factor. But when the game hits you, it hits well, and makes the waiting worth it. If you too have a darker way of thinking, this is up your alley.

Social groups and individuals will get a kick out of it. It’s aimed at those more who like the moody aspects, like a bit of a longer game, and can stick with it during the lesser parts, enjoying it at its best. I’d avoid at any costs playing whilst you’re unwell though, you don’t want to start thinking you have the worst epidemic.

Thank you for reading my Plague Inc game review! How did you find the game? Challenging? Does it drag out for you at times? Do you like the dark theme? Have you played the solo game? Do you prefer the board game or the mobile game? Any and all comments are welcome!

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Scott Board Game Reviews

4 Replies

  1. Afternoon Scott,

    First off, great to meet you and comment on your article, a fellow fan of the gaming realm I see like myself, reason enough why I pin-pointed your website article. So what are we talking here, yep. . . illness, like you said a daunting idea for a board game but why not, as you mentioned, ‘Pandemic’ by ‘Z-Man’ games was a successful hit.

    I’m one that has heard of ‘Plague Inc’ as an app, never played it and never knew it was ported over to cardboard. I’ve kind of been happy enough with ‘Pandemic’, although a while back I did own a spin off card game called ‘Contagion’ similar to the concept in ‘Plague Inc’. I’m sure you’re already aware too, that in the ‘Pandemic’ expansion, ‘On The Brink’ you can be a Bio-Terrorist role, which is the closest that the main ‘Pandemic’ game offers.

    I thought your article was certainly informative and I believe you’ve covered all headings well, giving your audience and players a taster of the game. As with your summary, you’ve really covered all the details, pros and cons and are transparent to your audience giving them full information in order to make a decision if this game is for them. Really impacting front page and colour scheme too – what theme are you using?



    1. Hi Steve, thank you very much for the kind words! Good to meet you also, always nice to meet a fellow game fan. I wouldn’t be surprised if Plague Inc. was inspired by Pandemic but intended to have their own spin for it. I’ve known a few people play the game on the app, it looks quite addicting, they expanded well bringing over to the table. Ah yes I know about ‘On The Brink’, putting one player against the rest as the bio-terrorist, that probably is the closest thing and really adds more challenge with a darker feel that can relate to Plague Inc. I hope it helps and can inform enough for people to make a decision on whether the game is something they might like. I’m using the Creativeily theme for my site, it really stood out to me whilst searching for one which suited the feel for the content I was providing. Hope you’re gaming well!

  2. WOW! What a great in-depth article. I wish there were direction, perspective, and instruction like this for every game.

    While I have not played yet, this overview will certainly inspire me to check it out.

    I especially liked the honesty of “The excitement of the action can dip at times with this game” and “It has a morbid presence, so it isn’t everyone’s cup of tea.”

    I also now know the type of gamer this is for, “Social groups and individuals will get a kick out of it. It’s aimed at those more who like the moody aspects, like a bit of a longer game, and can stick with it during the lesser parts, enjoying it at its best. ”

    Excellent article. I’ll be checking back to see what’s next.

    1. Cheers Bill! Glad it gave enough to help you make a decision with the game. The more detail and honesty the better informed you are, I hope I’ve been thorough and clear enough in what I’m saying. If you like the darker tone and challenge I’d say give it a go, wish you all the best!

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