With eerieplague doctors, rats, rot, insects, and the constant threat of disease, games set in the midst of various plagues can be terrifying. Whether it is a disease that kills violently or one that reanimates the dead into classic zombies, it can serve as a perfect tense backdrop for countless games.

Many games have utilized plagues as a setting, with varying degrees of success. Some games fail to capture the horror and others still never really use the setting effectively. Some games, though, manage to blend the sickly setting with a nauseous narrative to make for something exceptional. Here are the games that best use plagues (either fully fictional or inspired by real history) as a setting and a mechanic.

Epidemic - PlayStation 1 FPS game, mech suit HUD

Plague here is defined as a highly contagious disease (a pandemic), potentially inspired by the real bubonic plague or fully fictional.

8Epidemic

A First-Person Shooter To Find A Cure

The disease that rampages across civilization in the1996 classicEpidemicis called the Gigari virus. Anyone infected is killed days after the symptoms are noticed. The human race had to move underground, where society ismanaged by a computer, to avoid the fatal plague on the surface of the planet.

Players must navigate in mechanical armor to save their lover, who has been infected. While most of the gameplay follows robotic fights, the plot hinges on the incurable plague that forces humans to do horrible things.

Plague Road - Indie Game - Switch Gameplay

7Plague Road

Return To A Twisted Town

Players take on the role of a mourning Plague Doctor who returns to a town he fled when a sickness starts to spread. By recruiting survivors to work on their farms or join them in combat, players can slowly begin to make their way further into a city torn apart by disease.

The combination ofturn-based strategic combatin a rogue-like procedurally generated world makes for constant surprises as players battle against the twisted forms of creatures torn apart by sickness.

Tess and Joel in The Last of Us Part 1

The PlayStation smash-hitThe Last Of Usis remembered fondly mainly for the complex and human characters that remain beloved today. Joel and Ellie’s adventure across a post-apocalyptic wasteland is somber and special.

The apocalypse that has destroyed America is perhaps the best depiction of aunique zombiethat has been presented in video gaming, with a parasitic fungus infecting mankind and turning them into sightless rabid creatures that can quickly become nightmarish. The later parts of the game, with hordes of the undead and Joel having to confront the ethics of dealing with a disease that could end humanity, make this a tear-jerking entry to this list.

Sneaking through horrors

Another narrative that deals with the fallout of a plague gripping the world,A Plague Tale: Innocencetasks players with evading hordes of rats who carry the illness. Players will also have to sneak pastFrench Inquisition soldierswho are trying to capture and kill the young protagonists.

A sense of powerlessness, established by the constant claustrophobic pressure of the plague, is strengthened by casting the players as a young girl who has to care for her younger brother. As the plot reveals itself, the plague becomes a tool that those in power are trying to use to attain more control. The utter contempt that they show to the average people who die as a result is a perfect summary of the plague-torn setting.

outbreak map in Plague Inc.

In a completely different approach to the plague,Plague Inc.has players control the disease itself. Fans can choose which kind of sickness they would like to spread and then have to wipe out the entire human race before humanity can develop a cure.

This can become increasingly hard and players will have to work out where is best to begin, and how to cross borders effectively by evolving to have new transmission options or mutating to have new symptoms. A good balance between spreading quickly while also managing to kill the hosts has to be struck and the game rewards experimentation with countless options for differentapproaches, difficulties, and modifiers.

Dishonored sneaking up on an enemy Dunwall City

Arkane Studios’action-adventure game,Dishonoredfollows Corvo, the bodyguard of an Empress, who is charged with her murder amidst a horrific plague that is sweeping across their country. Corvo is gifted supernatural powers by a dark entity called the Outsider, who often appears Lovecraftian and ambiguous in his motivations.

Corvo himself can control the flesh-eating rats with some of his magics and even possess the rodents to infiltrate enemy strongholds. Corvo becomes an assassin in the corrupt and putrid city, eventually uncovering the plot behind the plague. His whole adventure is shadowed by death, andplayers who kill too frequently will see the effects of the plague getting worse and worse as they play.

Bloodborne-1

FromSoftware’s masterpieceBloodborneintroduces the player to the world through the eyes of one who has survived the outbreak of the horrific plague of beasts that has come to the land of Yharnam. The lore is slowly uncovered as players make their way through desolate streets and ruined buildings that have been overrun by mutated and corrupted citizens. Healing blood, distributed by the religious order that holds control over Yharnam, had adverse effects, turning many into insane creatures.

Yharnam became obsessed with blood and the horrific monstrosities that emerged invited Hunters to arrive in the city to fight their way through the fiends. The horror that accompanies many of the bloody and butchered foes, as well as the secret ending that is accessed using theumbilical cords of cosmic gods, place the plague of beasts as one of the most horrific seen in gaming.

A crow against a fence in Pathologic

A plague has come to a small remote town. Most people who beginPathologicwill give up.The overwhelming sense of hopelessness and despairthat the game creates is intentional but off-putting. Two different characters can be chosen at the beginning of the game and fans will see the story through either of their eyes, carrying out different tasks that combine to hopefully save the town.

The rising costs of food that can quickly lead to starvation as well as the constant moving forward of the clock are heart-pounding. Players will have to carry out missions before the end of the day and if they do not, some of the NPCs that they rely on for information, resources, and progression can die. The odds are stacked against the player and the game’s constant push on fans makesPathologichard to play but harder to forget.