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Pathogenesis (second edition)

Playtime: 30-60 minutes

Teach time: 15 minutes

Game difficulty: Medium

Players: 1-4

Key educational concepts: human-pathogen co-evolution
Rulebook: link

Favorite rules video: Dice Tower- Preview


In Pathogenesis, you evolve a menagerie of pathogens to defeat a human host’s immune system.  Players start with a weak generic bacteria and viruses which struggle to overcome the bodies’ defense barriers.  As the game progresses, you craft more deadly pathogens that specialize in one of the major body tracts that frequently encounter exogenous pathogens: the respiratory system, the gastrointestinal system, and external tissues (i.e., skin). Sexually transmitted infections are added in the expansion.  The core gameplay is based on deck building and can be played cooperatively and competitively. Can you defeat the human host’s immune system before it responds?



This game is played over a series of turns, where players build the perfect deck of pathogens to attack the host’s immune system and organs. Deckbuilding. Each player spends the ‘genetic’ values of their starting cards to acquire new cards from the ‘gene pool’ (a tableau of powerful cards for evolving your pathogens).  Players can also play cards for the action list on each card. If a pathogen, players place it in front of them to make it active.  Play other types of cards to evolve an in-play pathogen’s toxicity, add traits to it, or modified its environment (giving it special abilities). Attack. After using cards, pathogens attack the body in two stages.  First players focus on Immune System Barrier cards. Once defeated, the body’s aggressive Immune System comes raging in defense.  Once this occurs, most player’s pathogens will be wiped out.  At this point is where the evolutionary arms race begins, you can start to counter the Immune System by adapting your pathogens to overcome the Immune System’s tricks.  Often this results in an Immune Response that triggers a Fever, introducing ‘Fever’ cards to your deck.  These cards act as junk, and when drawn into a player's hand, reduces the number of quality cards a player has available that turn. Try to avoid your pathogens being tagged with a specific antibody token by the Immune System.  As pathogens with antibody tokens are more susceptible to subsequent Immune Response.  Continue the game, racing to overcome the body tracts by depleting health points.  Do this before the immune system fully responds (= cycling through all the cards in the Immune Response Deck) and you win. As a competitive game, players race to deal the most damage to the body before the immune system fully responds.

           Learning and teaching the game

The gameplay, once learned, is streamlined and easy to teach.  However, on the first play, due to some significant oversights in the rulebook, the game unboxing, setup, and gameplay are a bit overwhelming.  I strongly suggest that you watch a ‘how to play’ rules video before cracking open the rulebook.   After you master the gameplay and the many situation rules and game pieces, it would be reasonably easy to teach.



           Education value

This game is a wonderful resource and could facilitate a broad range of discussions on the coevolution of the human immune system and pathogens. Being a cooperative game, students could work together to overcome the immune system. Cooperative games promote teamwork and are usually less intimidating to players with limited experience with modern strategy games.  I could imagine having students recording the traits of each of their pathogens and the immune system cards they encountered during their games. As homework, they could create a presentation (or essay) discussing these factors and how well they were executed in the game.



           Fun factor

The game is a lot of fun.  After I sorted out the rules and box setup, the gameplay was engaging and quick. I highly recommend this game for use in a microbiology/ molecular biology classroom.


Box cover (Image credit:  Victor van Santen)


A few of the traits cards (image credit: Loren Cunningham)


The barrier cards and body tracts (image credit: Loren Cunningham)


More trait cards (image credit: Loren Cunningham)


Game setup- can you defeat the body's immune system? (image credit: Amy Mclaughlin)

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