Knox Infection

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Spoiler warning!

The following contains unhidden spoilers pertaining to the story of Project Zomboid. Proceed at your own risk.

“

The Knox Infection's final stage is one of violence.

— Kirsty Cormick

Knox Infection (commonly known as zombie infection) is a highly contagious disease contracted only by humans. This disease is very different from the common cold, food poisoning or wound infection. It is the main catalyst and antagonist for the events that unfold in Project Zomboid, dubbed the Knox Event.

History

Origin

Very little is known about the origin of the disease, other than that its first known outbreak began in the state of Kentucky, US, with the largest outbreaks specifically in the city of Louisville. There are several rumors about the origin, such as; misfolded prions in the meat of Spiffo's, terrorist attack, bioweapons testing gone wrong, and God's punishment for the sins of Man.

Initial outbreak

The exact date of the initial outbreak is unknown and estimated to be between July 2 and July 6, 1993 (one week prior to the start of the game, on standard settings). The military quickly set up an "exclusion zone" around Louisville before it managed to spread further, temporarily containing the outbreak. At first, the government portrayed the outbreak to be flu-like, causing panic and confusion among the infected. The infection is known to spread through fluid-contact: being scratches and bites.

Five days after the blockade went up, the WHO grounded all non-military or -medical international flights, which lead to mass panic throughout the nation and a disgruntled response from the President. The response and lack of clarity from the United States government led to international leaders condemning America, with the UK premier criticizing the President’s “near lack of clarity”. A photo from West Point is leaked out of the Exclusion Zone, with an image of a man covered in blood and bites, one arm missing, in a street crowded with dead.

Second wave

After 8 days, shots and explosions occur at the border of the exclusion zone, catching the attention of infected civilians, leading to hundreds, maybe thousands breaking through the blockade. Within two days, the infection spread North to Louisville, littering the streets in dead along the way. As a last resort, the military blew the bridges across the Ohio River, leaving those left in Louisville to fend for themselves.

Something is released with the wave of the dead, as people begin showing symptoms of the infection without coming into contact with any infected. The Knox Infection quickly spreads throughout the U.S.A, causing a breakdown of society, and even starts to spread across the ocean to Europe, Asia, and Africa despite the WHO's lockdown order on American flights.

Infection

Initially, the infection seemed to only spread via fluids - typically blood and saliva - and thus transmission rate was relatively low. Approximately a week into the Knox Event however, it mutates and an airborne strain develops, which then spreads much more rapidly after the incident at the exclusion zone border and the breach thereof.

Diagnosis

Those infected will suffer influenza-like symptoms for up to three days after contracting the illness, and eventually succumb - after which they will then reanimate within an hour after death.

The infection could also apparently be detected via blood tests.

Pathophysiology

The pathophysiology of the infection is never mentioned during the events of Project Zomboid, though radio interviews suggest that infected individuals become confused and fatigued prior to death and reanimation. However, it is likely of viral or prion origin, as it’s mentioned to be “flu-like” (virus) and Professor Peter Endsleigh draws a connection between Mad Cow disease (prion) and the fact that the infection is “clearly a neurological disorder”. There are no known cases of surviving the infection, and therefore the direct effects and immune response (if any) are unknown.

Immunity

Whilst select individuals (such as players) are immune to the airborne strain of the infection, there are no known cases of immunity of both, the airborne and the contact strains.

Game mechanics

Infection

The game will never outright tell the player that they are infected, and will instead develop symptoms over time. Therefore, if scratched or lacerated, you may not be able to know you’re infected until the nausea and worse symptoms start. Although some radio broadcasts mention the infection can be diagnosed with a blood test, this is not currently a game mechanic. As symptoms worsen, the player's health will degrade faster, which cannot be stopped and can only be slowed by remaining well-fed, hydrated and absence of a cold.

Infection mechanics can be customized using custom sandbox settings, allowing for adjustments to the speed of mortality and delay before reanimation.

There is no way to cure the Knox Infection once contracted, the only thing a player can do is hold out as long as possible until succumbing to the infection for good.

Traits

The time before symptom onset and death will vary between players, and is affected by some traits.

Icon	Trait	Effect
	Resilient	-25% zombification rate
	Prone to Illness	+25% zombification rate

Symptoms

Time	Symptom
Immediately	Rapid temperature increase
1—4 hours	Anxiety
5—12 hours	Queasy (stage 1): slight health loss
13—24 hours	Nauseous (stage 2): moderate health loss
25—48 hours	Sick (stage 3): severe health loss
49—71 hours	Fever (stage 4): terminal damage
72 hours	Death: zombified

Reanimation

Under standard game rules, characters who have contracted the Knox Infection will reanimate within a minute or two of their death, and will do so regardless of their actual cause of death.

Custom difficulty options can alter the amount of time before a deceased character reanimates, reducing it to as low as near-immediate or increasing it to as long as a one to two week delay. Another option can make it so that all characters carry a 'latent' or 'passive' strain of the virus which will cause them to reanimate upon death even if they did not contract the virus directly from a zombie.

Infection rate

It is only possible to contract the Knox infection by getting scratched, lacerated, or bitten by a zombie. The probability depends on the type of injury. Non-zombie related injuries will never result in contracting the infection, though they may result in conventional wound infections if not treated properly. Zombie scratches and lacerations can also become conventionally infected without contracting the Knox infection.

Transmission	Probability
Scratch	7%
Laceration	25%
Bite	100%

Hypochondriac

The disabled hypochondriac trait will cause the player to occasionally get the symptoms of the zombie infection after receiving a scratch, without actually being infected. The progression is identical to the Knox Infection, however once the 'fake infection' reaches its peak, the infection will dissipate as the player begins to recover. The rate of recovery is much quicker than the infection's progression. However this trait is currently commented out (as of Build 41.65) and cannot be added to a character without being modded back in.

Popular myths

Below are some commonly believed myths in the game, along with clarifications:

"Survival from a zombie bite is possible"

Originally in older versions, as noted in patch 0.1.6a, there was a small 4% chance to survive a zombie bite. This was changed in later updates, making a zombie bite 100% lethal.

"Recovery from infection through Rest and Nourishment"

This misconception might have stemmed from the hypochondriac trait, general food sickness, or confusion with wound infection. However, it is impossible to survive the 'real' infection once contracted.

"Disinfection can eliminate the infection"

Disinfecting a wound post-bite does not eliminate the infection. Once infected, there is no known way to reverse the condition.

"Preventing reanimation by dying prematurely (e.g., drinking bleach)"

This myth is based on a bug in versions prior to Build 41.5 where dying before the infection could set in prevented reanimation. This allowed players to retrieve their possessions without having to deal with their zombified former selves.

"Bloodied-hand zombies are more infectious"

While it may seem logical, zombies with blood on their hands are not more likely to infect through scratches. Such zombies usually have bloodied hands due to climbing through broken windows.

"Infection risk from broken glass"

Infection in the game can only be contracted through direct zombie attacks. It's not possible to get infected by climbing through broken windows without clearing the glass first, although the resulting wounds if not properly treated can become infected.

Trivia

• Infection lore is heavily based on George A. Romero zombies, with some very minor alterations.
• There is a secret government facility deep in the woods on the southern edge of the map which seems to have some medical and animal testing facilities and is a massive hotspot for the infected. Whether it is related to the outbreak or not is currently unknown.
• Children can also be infected with Knox Infection and become zombies, mentioned on day 6 and day 7 on NNR Radio, and day 6 on KnoxTalk Radio, but Project Zomboid will never have zombie children in the game itself.
• The entire planet Earth is infected and completely overrun by July 28th of 1993, according to Knox Event timeline, with currently only small groups of immune survivors remaining.