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In fifth edition D&D, do any of the manuals specify that a creature (besides players) can be immune to all diseases or is this left up to DM discretion?

Say for example that the party comes up against an iron golem and one party member wants to cast Contagion on the golem. Is there something somewhere that states that all nonliving things or constructs or creatures in some other category are immune to all disease or is that up to my judgment as a DM so that I can rule that, for example, unicorns are immune to all disease but iron golems can suffer from a disease that I made up called Rust Mange?

What I'm looking for is at least one instance of blanket disease immunity for a non player creature in the PHB, DMG, or MM or an indication that none can be found.

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  • \$\begingroup\$ Have you read the Monster Manual? \$\endgroup\$ – mxyzplk says reinstate Monica Sep 2 '15 at 11:55
  • \$\begingroup\$ I have. I couldn't find anything myself but I think I could be missing something. \$\endgroup\$ – Tophandour Sep 2 '15 at 11:58
  • \$\begingroup\$ Have you looked in the DMG? The other place to look is in the general description for constructs in the MM, not just in the description of each of the individual monsters. I see your point on how the condition immunities do not spell out "disease" as an immunity for a given construct. \$\endgroup\$ – KorvinStarmast Sep 2 '15 at 12:14
  • \$\begingroup\$ I'll check all of my books again when I get home and if I find anything and there's not a better answer, I'll answer my own question. I just figured that this would be a useful question because several of my players and some DM friends of mine have wondered this as well but didn't want to disrupt the game to look and never revisited the issue. \$\endgroup\$ – Tophandour Sep 2 '15 at 12:26
  • \$\begingroup\$ How about giving a NPC a couple of Paladin levels? (The 5e Pally class is much more flexible than its predecessors, and applying class levels to a sentient NPC is not at all unheard-of in D&D) \$\endgroup\$ – Shalvenay Sep 4 '15 at 0:48
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There is no disease condition or damage type in D&D 5e as noted here in this Stack Exchange question. Hence no corresponding immunities, etc.

A case could be made that if a monster is immune to poison they are also immune to disease as two mechanics are similar when listed as an attack or effect. But in the RAW text no monsters and very few other things (land Druids, Monks, Paladins) are explicitly immune to disease.

It is my opinion that it is somewhat of an oversight as they are pretty consistent with other types of attack in what is immune and what is vulnerable.

As a final comment remember that rules in D&D 5e (or any RPG for that matter) are a means to help you, the referee, adjudicate what the players do as their characters in an imagined setting. The point of the game is the experience the players have as their characters in that setting. The point is not to play out the rules as written like it would be for chess, monopoly, or Settlers of Catan. So when the rules conflict with the logic of the setting (in D&D's case a fantasy setting) then the referee should use whatever the setting's logic dictates over the strict letter of the rules.

For most it doesn't make sense for a undead skeleton to be hit with a fever. So likely any ruling will be that skeletons are immune. In another example, it may make sense for a flesh golem to be effected by disease, but not for a stone golem.

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    \$\begingroup\$ I would lean away from treating Diseases the same as Poison/Poisoned, as this is THE most resisted/immune damage type/condition in the game and dramatically alters the usefulness of spells like Contagion and Harm, particularly in situations where a creature would/should be vulnerable to diseases, such as Yuan-Ti. \$\endgroup\$ – Zourin Apr 7 at 6:16
  • \$\begingroup\$ @Zourin see the paragraph final comments. \$\endgroup\$ – RS Conley Apr 7 at 14:05
  • \$\begingroup\$ FWIW, per the Wayfarer's Guide to Eberron, Warforged have advantage on saves vs. poison, have resistance to poison, and are immune to disease. \$\endgroup\$ – Davo Apr 8 at 19:39
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    \$\begingroup\$ @Davo which makes sense in terms of how they are described in the Eberron setting. \$\endgroup\$ – RS Conley Apr 9 at 17:27
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None. Disease is neither a damage type, nor condition, it's a special category of conditions that can theoretically affect any creature; humanoids, beasts, aberrations, blessed and accursed planar entities alike, although like real diseases, they have preferred targets and can have unaffected carriers.

It's fair to house-rule that Objects, constructs, undead, and particularly nasty demons are likely immune to most 'diseases', but the wonderful world of magic and mystery may yet find names for eldritch conditions that can infect, infest, or debilitate iron golems and undead. Off the top of my DM's hat, I could come up with a particular eldritch fungal infection that could attack the enchantments of certain animated creatures at the joints, reducing their effective dexterity. Very old undead could suffer bone rot and end up with reduced strength until they can no longer stand or function. There's a lot of creative opportunities.

Be up front with your players about any restrictions you put on this, as it can turn certain spells into trap choices like Harm and Contagion, depending on your campaign. Diseases typically involve Constitution saves, and unless your campaign revolves around the Feywild, odds are that as the game progresses, the players' opponents will develop progressively ludicrous constitution scores, as most creatures have this as their default saving throw proficiency and enough base CON to survive being hit by a truck going 60mph.

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  • \$\begingroup\$ The original question exempted 'Players' and focused on 'creatures', so I omitted Paladin (Divine Health) and Monk (Purity of Body) player classes in the answer. \$\endgroup\$ – Zourin Apr 8 at 16:38
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    \$\begingroup\$ Ah, I see what you did there. Good. Got it. +1 \$\endgroup\$ – KorvinStarmast Apr 8 at 16:46
  • \$\begingroup\$ I was worried I had mentioned Paladins being immune to poison, which would have been incorrect. Just Monks and Purebloods. \$\endgroup\$ – Zourin Apr 8 at 16:49

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