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[[quoteright:350:https://static.tvtropes.org/pmwiki/pub/images/500px-nwbrain_7562.jpg]]
[[caption-width-right:350:Pictured: An extreme version of [[ShownTheirWork actual]] brain parasites. [[ParanoiaFuel Be afraid.]]]]

Remember ''VideoGame/{{Pandemic}}?'' That online game where you infect the world and watch it die? ''Plague Inc.'' is this concept, scarier, [[ShownTheirWork much more accurate]], and much more realistic. By the end of your infection, this will invariably [[NightmareFuel creep out some players]].
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!!General:
* The very premise. Killing off humanity in the most varied way possible with a variety of disease types.
* The music plays a huge part in making the game an unnerving experience:
** The [[https://www.youtube.com/watch?v=pAXv-VV1Htc normal music]] has creepy undertones, but not too much.
*** The [[https://www.youtube.com/watch?v=zEEuuzUbDnI version heard in Evolved]], however, sounds like it takes cues from VideoGame/{{Pandemic}}'s disease theme and makes something much creepier to hear.
** The [[https://www.youtube.com/watch?v=ukHCh8TmUt0 Neurax Worm music]] is a different story. A piano plays to an incredibly creepy bass, and for added measure, random noises that sound like worms play for ParanoiaFuel. For bonus points, with the right set of headphones/earbuds, those noises can sound like they're ''[[TheFourthWallWillNotProtectYou actually coming from inside your skull]]''.
*** The [[https://www.youtube.com/watch?v=Qk8kjm3E-qM Evolved version of this Worm]] lacks the piano theme and makes itself sound like something from VideoGame/{{Portal}}. The serenity in comparison is rather unsettling.
** The [[https://www.youtube.com/watch?v=PFDcAxbKBxQ Necroa Virus]] music. Sounds definitely like something you'd hear in a George A. Romero [[Film/DawnOfTheDead2004 film]].
*** The [[https://www.youtube.com/watch?v=FseIYjXUYNY evolved Necroa Virus]] music wouldn't be out of place in ''VideoGame/DeadSpace''.
** The [[https://www.youtube.com/watch?v=-NE-C4ZpJ64 Simian Flu]] music has interjections of primate calls, giving you the feeling that humanity is on the brink of extinction.
*** The [[https://www.youtube.com/watch?v=p1SerCnEWSM Evolved Simian Flu]] removes the drums for the first round of the song. It sounds almost peaceful the first time around, which can be unnerving to those used to the mobile version of the track.
** The [[https://www.youtube.com/watch?v=i5zKkC6yFuQ Shadow Plague's]] music, with its use of mostly orchestral instruments (including an organ, no less) and OminousLatinChanting, sounds like it came straight out of ''{{VideoGame/Bloodborne}}''. Fitting, as the theme is centered around blood and vampires.
*** Supposedly, the chanting heard in the Shadow Plague's theme is in Etymological English and has a translation... which sounds like a haunting ritual.
---->''The Blood of...\\
The Blood of...\\
The Blood...\\
[choir]\\
His grasp will choke the world\\
His gifts will perfect us\\
The shadow changes all\\
God beckons the twilight\\
He is undying, He is eternal, He is god incarnate\\
His reign carries into the absolute eternity.''
** The [[https://www.youtube.com/watch?v=7GpsP49foWM music in Cure Mode]] isn't too scary, but the gameplay helps to invoke feelings of stress, uncertainty and dread. As you're the only one who is trying to save humanity from a deadly disease, you're also trying to get the world to cooperate with you while saving people from dying. The tone does not help into making you wonder if you'll be able to develop the cure before people had enough and fire you.
* Some sound clips can play above the music, such as [[CreepyChildrenSinging children laughing and singing]], medical equipment, [[CreepyCrows the cawing of crows]], coughing... [[SarcasmMode real subtle]].
** In the Platform/{{Steam}} version of the game, occasionally you can clearly hear a child singing parts of ''"Ring Around the Rosie"'' near the end of the game (More specifically, "...ashes, ashes, we all fall down..."), and in the mobile version the sound is slightly longer (again, "Ring-a-round the rosie, A pocket full of posies, Ashes! Ashes! We all fall down...").
*** It gets even worse once you realize that the song has been frequently rumored to be about [[TheBlackDeath the bubonic plague]].
** In the Necroa Virus soundtrack, a respirator and a cardiograph provide the backbeat for the music.
* The trailers for both the original app game and ''Evolved'' are just as creepy. The [[https://www.youtube.com/watch?v=yAohn_n0hyg original trailer]] is being narrated by one of the scientists (who is clearly infected with the disease) in the form of an ApocalypticLog, explaining how humanity has fallen to the illness just moments before he presumably dies. ''[[https://www.youtube.com/watch?v=pSat_gLDXPc Evolved]]'' can be considered a prequel to that trailer, taking place during an autopsy where the researcher checks one of the deceased patients infected with the pathogen, [[OhCrap then moments later he finds that reports of the disease are spreading outside of China, requests the entire facility to be shut down and inform the authorities at once]].
* Even the symptoms are terrifying, as they are in RealLife. You get to craft your disease with such [[SarcasmMode lovely]] ailments like [[BodyHorror Necrosis, Hemorrhagic Shock, Dysentery, and Total Organ Failure]]. Combine all of them into one and you'll essentially get a CruelAndUnusualDeath combined with ThereIsNoKillLikeOverkill. [[ParanoiaFuel Just imagine if there was a real-life disease with all of these]].
* The Neurax Worm is a PuppeteerParasite taken up to eleven. At first it'll start off harmless, as described by scientists; but by the time you've upgraded, humanity won't be able to react quickly enough to stop the infection from spreading, and the cure can be stopped in a single upgrade of a symptom. The image of the plague also changes from a Petri dish to a worm sitting on a brain with tendrils extending inside it, eventually [[NauseaFuel expanding to all of the brain, turning it a sickly orange, and causing flesh bubbles to pop out]]. The worm seems almost intelligent in its symptoms, such as causing people to fly to a specific country in order to infect it, even if that country has closed off its airports (or has no airports). Another symptom involves violent attacks against anyone who isn't infected, and active attempts to stop cure research. The starting blurb mentions that the worm has been dormant for millennia only to be uncovered by excavation. Additional news mention people worshiping the worm, achieved with the Transcendence symptom. Notice how it gives a ''massive'' boost to Severity.
** While enslaving humanity is one option available to the Neurax Worm, it's fully capable of simply killing everyone like the other plagues and even has a variety of unique lethal symptoms. These include [[DrivenToSuicide driving the infected to suicidal despair]], [[ParasiteZombie forcing them to attack and kill authority figures and uninfected]], and outright [[BodyHorror digesting the hosts' brains]].
* The Necroa Virus is your typical zombie affair, except OurZombiesAreDifferent. This plague [[MultipleChoicePast can be the result]] of human experimentation gone wrong, a plague from ancient Egyptian tombs and mummies, or from the remains of Chernobyl, infecting animals. The symptoms can become reminiscent of VideoGame/Left4Dead style zombies, and the on-screen news is '''horrifying'''. To list some examples:
** Horrific slaughter in (country).
** Z-Com destroyed in (country).
** Authorities [[PoliceAreUseless can't protect]] from (disease).
** [[JustBeforetheEnd (country) declares apocalypse has come]].
* Smallpox and the Black Death are scary on their own. What's worse is they begin with high lethality, so if you don't spread quickly, you lose. The symptoms are also highly disturbing, and [[ShownTheirWork are the real deal]].
** Buboes for BD. [[BodyHorror Infected lymph nodes become swollen and inflamed]]. Bursting can aerolise contents and infect others.
* The Mega-Brutal Update brings us several terrifying Scenarios: Frozen Virus, Artificial Organs, and Nipah Virus.
** Starting off, Artificial Organs isn't terrifying on its own because it's actually a beneficial scientific development that [[ShownTheirWork isn't far off]]. What IS horrifying though, is what happens once you start evolving your disease. Once you start killing, the organs will [[http://i.imgur.com/8IiCWlX.png slow the death count]]. But if you want to be freaked out, [[SchmuckBait do evolve]] Insanity and Hyper Sensitivity after the death toll slows down. And if you do, you're treated to [[BlatantLies nothing spectacular...]] [[http://i.imgur.com/SxFUXhZ.png HOLY SHIT THEY'RE RIPPING THEIR ORGANS OUT]]
** Frozen Virus is a more apocalyptically frightening scenario. When you begin, you have to evolve DNA Repair in Abilities. When it's fully evolved, you'll [[http://i.imgur.com/HMf7rKx.png get]] the ability to [[{{Foreshadowing}} "reshape human temperament"]]. The meaning of that soon becomes clear as you start killing; one thing you'll notice is that some of the symptoms are borrowed from the Necroa Virus, leading up to [[http://i.imgur.com/WtsN2do.png this]]. For those too nervous to tackle the link, it's Neanderthal Regression, i.e. [[DevolutionDevice mutating everyone back into primates]]. The win condition for the Frozen Virus is borrowed from the Neurax Worm: Infect everybody, evolve the 2 final lethal symptoms, and watch as [[http://i.imgur.com/LtPK6gQ.png this begins]] and [[http://i.imgur.com/rppeo6J.png ends]]. It's '''not''' a pretty thing to see.
*** What's worse is that the Frozen Virus is actually called "Pithovirus", [[https://en.m.wikipedia.org/wiki/Pithovirus a VERY REAL virus.]] And [[ShownTheirWork almost everything about the Pithovirus in this game is entirely accurate to the real deal]]. Meaning this virus [[ParanoiaFuel could potentially cause a global pandemic]]. [[FearIsTheAppropriateResponse Be afraid. Be VERY afraid.]][[note]]Though in its current state, it's not capable of infecting humans.[[/note]]
* The humble Parasite's Symbiosis ability, which makes itself less severe by merging with host DNA and finally burrowing into the host's brain to escape detection, is completely horrifying. Turn Severity down to zero, get a couple of harmless but infectious symptoms like coughing and sneezing, and quietly rack up the environmental and transmission buffs until the world is 100% infected ''without the disease even being noticed''. Wait for enough DNA bubbles to get the DNA for fatal symptoms and hit the kill switch. Humanity won't be able to do a damn thing about it on any but the highest difficulty level.
* The City Cams in Evolved showing the collapse of society in many different countries. The view gets more cracked and red-tinted as a country dissolves into total anarchy... until it [[NothingIsScarier completely quiets down]] and the screen shows nothing but an abandoned, ruined city/town full of body bags (sometimes ''actual corpses'' instead) and wrecked cars. Not even animals are spared since Saudi Arabia's [[EverybodysDeadDave "No Longer Exists"]] cam shows a dead camel lying on the ground.
* Even the Christmas scenario has its dark side: for starters, the fact that [[DayOfTheJackboot the world has become such a totalitarian hellhole that just BEING HAPPY is banned]]. It's played for laughs, but try to imagine what such a world would be like in RealLife: being forced to work all the time, or having your political career ruined because you were accused of laughing--not at an inappropriate time or place, just ''laughing'', period--both of which are alluded to in the news ticker.
** Not to mention the ban on travel at the start. [[FridgeHorror How many families have been split apart because they happened to be across a border when the ban came down? And for how long?]]
** News ticker announcement: ''"Child's parents arrested over birthday party."''
*** "'Anti-fun squad'" [[TheDictatorship wins uncontested reelection."]]
** For added fun, you're playing as the Neurax Worm for this scenario. While ostensibly on the side of good, it's still quite disturbing. Not to mention the FridgeHorror behind the fact that things got so bad that the only thing that can fix things is a mind-controlling parasite...
*** And if you ''fail'' the scenario, the end-game text explicitly tells you that with the Neurax Worm extinct, '''[[DownerEnding happiness and fun will be gone FOREVER]].''' Mind-controlling everyone doesn't seem so bad now...
*** Even still, the thought of a parasite [[HappinessIsMandatory forcing everyone to be cheerful]] is... unsettling. Better than the alternative, but YMMV on how much.
* And now, with the latest update, we have the Shadow Plague... ''ho boy''. For starters, it's an amalgamation of the Neurax Worm, Necroa Virus and Simian Flu all in one, so anything scary there applies here as well. What distinguishes the Shadow Plague is the fact that the world at large initially has no idea that a vampire is causing random killings, instead associating it with a blood cult or a blood-drinking serial killer. Evolving the disease grants the ability to turn any infected into demented supporters that gladly incite revolt for you as you conquer the Earth. Getting every person on the planet infected with this condition wins the game too, just like the Neurax Worm.
** The symptoms of the Shadow Plague are outright unnatural, and even the most basic form of the pathogen causes severe bruising as opposed to being asymptomatic like other plagues. It's little wonder that the plague is seen as threatening the moment it gets discovered.
** Also, this pathogen has multiple possible origins: either deep in the Transylvanian woods, where Dracula lived, a deep Turkish cave network hosting infectious microbes which mutated the first vampire, or a sacrificial pit under Stonehenge.
** The other winning condition is consuming everyone and everything with vampires without infected minions, but the end result will be just as horrific: by slaughtering the human race, you will condemn the surviving vampires to starvation and eventual extinction, just like in the Necroa Virus.
* Mutation 15 brings us a few new official scenarios, including one called "Where is Everyone?", where the world population is ''heavily'' slashed--by heavily slashed, we mean from over 7 billion to ''a few hundred thousand''. NothingIsScarier is in full effect as we're given little more than a few vague suggestions in the scenario description as to what happened to ''99.996%'' of everyone on Earth. And everything goes FromBadToWorse as [[AfterTheEnd now]] you must [[KillAllHumans kill what's left of humanity]].
* The official scenario Fake News is funny in concept because you can [[{{Gaslighting}} create false rumours to deceive people]]. As you get further into the game, however, you eventually drive people off the rocker to the point you can make the deceived public do ''anything'' to destroy fact checkers before they expose your news as fake. You can make the deceived impersonate actual fact checkers, hire fake experts to the point of getting actual politicians involved, shuffle information to confuse the already informed public, and basically do any horrible thing to sabotage the opposition before your scandal is exposed as a farce. In the end, you succeed in driving humanity insane to the point that nothing is considered the truth anymore, and your reward for beating it is three biohazards. Part of the horror is also TruthInTelevision, with the sheer power of media, the Internet and how easy it is to forget that you shouldn't believe in everything you see or read.

!!Specific to ''The Cure'':
* Remember the "X Executes the Sick" popup that tended to happen when the shit really hit the fan? The Bio Weapon in Cure Mode lets you do exactly that with the "[[IDidWhatIHadToDo Extreme Measures]]" ability; wherever your field agents are, the infected are getting shot. If you try for a PacifistRun, good luck; the gimmick of the Bio Weapon is that its lethality and infectivity increase the more countries it infects ([[MyRulesAreNotYourRules Bet you wish it worked like that in the base game]]), so the more you let it escape its home country, the harder it will be to contain, and the more you'll wish you'd killed Patient 0 when you had the chance. It's telling that most Mega-Brutal strategies tell you to not even bother with the vaccine; just shut down the continent and place "Extreme Measures" at a bottleneck country, and then just wait for the Bio Weapon to burn itself out. The rate at which the GodzillaThreshold is crossed when you're playing the other side is frightening.
* The Prion in Cure Mode is particularly chilling, as it takes a long time for the disease to progress, but while all other plagues (barring a ramped up Bio-Weapon) have a reasonable chance of recovery, the Prion is considered a [[YouAreAlreadyDead terminal disease]], meaning the recovery chance is ''extremely'' slim. Much like [[ShownTheirWork prions in reality]], the ailment causes severe neurological symptoms and is invariably lethal once it advances to a certain point, as by that time it's already started destroying the brain. Without your cure, which the aforementioned brain-spongification will slow down considerably, the entire infected population is doomed, and they will be appropriately horrified by this fact. Adding onto this, the Prion has shockingly high infectivity, [[MyRulesAreNotYourRules unlike the player's own Prion in Disease Mode]].
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