E-239x was first identified in Iran. A bacterial infection, it soon spread across land boarders to start infecting hundreds in surrounding countries. When the first death as a result of the infection occurred, it was hardly a blip on the WHO’s watchlist. Over the coming months, it went on to infect over half of the world’s population, kill more than a quarter, and the WHO finally paid attention and several countries worked together to devise a cure. But before it was finally wiped-out for good, E-239x had killed more people than Small Pox.

Plague Inc review img 1 Welcome to Ndemic Creations’  Plague Inc.  for Android and iOS ( Plague Inc: Evolved is currently available for Early Access on Steam, but this is a review of the original, mobile version of the game). The game’s been out for a couple of years, but is it worth the time of newcomers, like me?

Play to win or pay to win?

Many of the game’s disease choices are locked away by needing to win games with existing disease models on Normal or harder. Casual play levels offer wins, but no rewards. But playing the game on Normal or above means that you can win access to more of the game’s content… or you can pay to access this content immediately through various content packages. It’s on the nicer end of F2P models, however I did end up buying access to both the Neurax Worm and Necroa Virus diseases a.k.a. mind control worms and zombies… because I’m a horror film fan.

Watching House paid-off

Plague Inc review img 4 Yeah, so  Plague Inc. isn’t difficult to get your head round if you’ve watched all of  House or another medical series that often looked at infectious diseases. You’re put in control of various aspects of your custom disease, like how it’s transmitted or whether it makes people cough, and as you slowly upgrade these with “DNA” you earn as the infection spreads, you can make the disease resistant to things like cold climates or drugs and so on. Upgrading symptoms involves carefully balancing further means of transmission (vomit, for instance) and severity or lethality.

To win with most diseases you need to kill-off the world’s entire human population, but the humans won’t just roll-over and die. The scarier the disease (the more easily it kills or has visible symptoms) the more the world’s doctors and scientists will desperately research a cure. And if you make your disease too effective at killing, you’ll realise why Ebola outbreaks have never really been something that have become a global issue. Having to get these balances just right in order to win makes  Plague Inc. an interesting play, because of having to find strategies that shift the outcomes in your favour without spurring on a cure. It’s like setting up for a checkmate in a game of chess without anyone realising what you’re doing.

Plague Inc review img 3 While choosing a difficulty setting at the beginning of a play through affects how easy it is to win, your choice of disease also impacts your path to success. Some pathogens are easier to play with than others, meaning that balance the needs of the disease versus attempts to evade a cure are different for each pathogen. This makes the game very replayable and therefore ace for having on your smartphone or tablet. Though some diseases are far easier to play as than others.

The game could be one of the most despairing things to play, but it has a sense of humour that even House would be proud of. In-between figuring out whether you should make rats one of your most important transmission vectors or whether you want cysts to be a symptom and so on, the game pops-up with some of most ridiculous, satirical news headlines as you try to kill the world.

Worth playing?

Emgood I’ve gotten a lot of hours out of this game already and I’ve only scratched the surface of this microbiological apocalypse simulator. The way Ndemic Creations have chosen to implement their free-to-play system is not frustrating, though it can take a while to earn the extra  components in-game. There’s just something about infecting all humans with an upper respiratory disease and then evolving it to be lethal, and watching as entire nation states succumb to it that is fun and reminds me that good hygiene and tissue management can make a difference.

Plague Inc.  by Ndemic Creations is available now on Android and iOS. Our reviewer bought their own copy of the game.