Stn Total Organ Failure
Total Organ Failure
Total Organ Failure
A patient suffering from total organ failure.


Catastrophic cell death of multiple tissue types causes body-wide organ failure and rapid death

DNA cost



Catastrophic (20)


Catastrophic (25)



Required Symptoms

Immune Suppression, Coma, or Pulmonary Fibrosis

Total Organ Failure is a Tier 4 symptom. It causes catastrophic cell death of multiple tissue types, which causes body-wide organ failure and rapid death. It increases severity by 20%, and lethality by 25%.


Total Organ Failure is arguably one of the most lethal symptoms in the game and once evolved, it kills rapidly. Even wealthy countries will go down if enough people are infected. However, this extreme lethality increase is a double-edged sword. This symptom can backfire if not handled correctly.

Total Organ Failure should not be evolved before most of the world's population is already infected (for example: 100% of the population, including a fair chunk of Greenland and other hard-to-reach countries). It is commonly used to kill off the world's population rapidly, and is highly recommended to be used at the end of the game to end the game quickly. However, evolving it too early can often result in a game over, as all infected will likely die before they are able to infect all healthy people.

Interestingly, this symptom loses much of its lethality in the scenario Artificial Organs, due to the organs are no longer organic and thus can barely have any effect.

In reality Edit

Multiple organ dysfunction syndrome (MODS), also known as multiple organ failure (MOF), total organ failure(TOF) or multisystem organ failure (MSOF), is altered organ function in an acutely ill patient requiring medical intervention to achieve homeostasis.

The condition usually results from infection, injury (accident, surgery), hypoperfusion and hypermetabolism. The primary cause triggers an uncontrolled inflammatory response. Sepsis is the most common cause of Multiple Organ Dysfunction Syndrome and may result in septic shock. In the absence of infection, a sepsis-like disorder is termed systemic inflammatory response syndrome (SIRS). Both SIRS and sepsis could ultimately progress to multiple organ dysfunction syndrome. However, in one-third of the patients no primary focus can be found. Multiple organ dysfunction syndrome is well established as the final stage of a continuum: SIRS + infection  sepsis  severe sepsis  Multiple organ dysfunction syndrome. Currently, investigators are looking into genetic targets for possible gene therapy to prevent the progression to Multiple Organ Dysfunction Syndrome. Some authors have conjectured that the inactivation of the transcription factors NF-κB and AP-1 would be appropriate targets in preventing sepsis and SIRS. These two genes are pro-inflammatory. However, they are essential components of a normal healthy immune response, so there is risk of increasing vulnerability to infection, which can also cause clinical deterioration.

Trivia Edit

  • You can actually evolve Total Organ Failure without Immune Suppression or Pulmonary Fibrosis, such as with this path: Cysts -> Hypersensitivity -> Paralysis -> Coma -> Total Organ Failure, however, this path is more expensive, as there are a total of five symptoms in the path, and isn’t recommended unless getting Coma was also in the player’s interest.
  • This is the only symptom which doesn't raise cure requirement.
Symptoms in Plague Inc. and Plague Inc: Evolved.
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