Updated: Oct 24, 2020
If you're reading this you've surely played the co-operative game Pandemic (Z-Man Games). Working together to save the world from disease has become a board game paradigm. Pathogenesis, from WIBAI Games, turns it on its head. In this game, 2–4 players are still working co-operatively (which means the game also works as a solitaire) but this time, the players represent the diseases. They are working together to defeat a human host's immune system. As an alternative, Pathogenesis can be played competitively, with players each trying to score the most points of damage to the body.
Designers Loren and Jamie Cunningham have developed the game with scientific illustrators Somersault1824 (Luk Cox and Idoya Lahortiga) and have given it a healthy veneer of medical jargon but don't let that put you off. You don't need to be able to tell your Hyaluronidase from your Adhesin or your Clostridium Alpha toxin from your Streptococcal Pyrogenic Exotoxin B because, in practice, you're just looking at the colours and symbols on the cards. The scientific nomenclature is really just part of the flavour text: it might potentially be useful if you're a medical student playing this game as part of your exam revision but the rest of us don't need to worry about it. Pathogenesis is a deck builder in the tradition of Ascension (Stone Blade). Players all start off with a hand of weak generic bacteria that will barely inflict the sniffles but you'll be acquiring cards to mutate your germs into more deadly pathogens. As players replace their weak starter cards with those that are more powerful, so they increasingly specialise their focus of attack on one of the three of the body's metabolic systems.
On your turn, you'll be expending the genetic value of cards played from your hand to acquire new cards from the Active Gene Pool; and/or you'll be playing cards for their actions. When you play a card for its action, you place it in front of you as an active pathogen. If you have toxins or traits that match up with the symbol(s) on an active pathogen then you can add them to mutate and modify that pathogen. Active pathogens must always attack the body each turn. While the body has Immune System Barrier cards still in place, your attacks are measured against these cards and your attack value has to at least match the defence value shown on the barrier card. Whether playing co-operatively or competitively, you need to break through an area of the body's immune system barrier before you can score points by attacking body tissue. And when a player succeeds in exhausting an Immune System Barrier, this triggers a much more aggressive Immune System Response, where there's a high chance that your active pathogens will be wiped out or at least tagged with a specific antibody token. The antibody tokens can make your pathogen more susceptible to subsequent Immune Response attacks.
There are lasting and temporary effects that players can put in place; for example, playing Environment cards that can make the body more vulnerable to attack; and Immune Responses can trigger a Fever as a defence mechanism. Fever cards primarily bulk out a player's hand and so reduce the effective number of cards the player has available for use on their turn.
Players win when they have depleted the body of its damage counters (the number the body starts with varies with the number of players). In co-operative or solo mode, the player(s) lose if the Immune Response deck runs out while the body still has damage counters.
This is in fact the second edition of the game, recently funded through Kickstarter. It's generally very well produced, with good quality cards, an indexed storage box and petri dishes to store the body damage tokens. It's unfortunate that a printing error means that the body boards don't slot together as seems to have been the intention, but that doesn't detract from the game. Those who backed this game in last year's Kickstarter campaign also received the Pathogenesis STD expansion. This can be incorporated into the base game to add the genitourinary tract and an additional set of genitourinary pathogens and traits, as well as an additional Collateral Damage mechanic that works on the principle that whatever doesn't destroy your pathogen makes it stronger.
We've been impressed with the versatility of Pathogenesis. There are few games that play just as well both co-operatively and competitively, and this game also offers a variant for team play, as well as scaleable difficulty levels for all modes of play. The scientific jargon didn't put off any non-scientists but it did help to pique the interest of my medically-qualified wife who might otherwise have been reluctant to come to the table to play a deckbuilder.
(Review by Selwyn Ward)