Fallout New Vegas

About this mod

Need a challenge, or maybe some immersion? This mod will add 20+ diseases to Fallout: New Vegas, which you and NPCs can catch from a variety of situations. This mod also includes modified AI, Combat, and Stealth, and numerous Item edits. All edited in a way to avoid mod conflicts as much as possible.

Permissions and credits

Ever wondered why drinking out of a dirty toilet was perfectly safe, or why eating raw meat was nothing to worry about? Or how about being wounded, but not at risk of infection or other health conditions? Maybe you want something a little closer to real-life? Or maybe Fallout: New Vegas is just too easy for you, and you want a much greater challenge, filled with immersion. If so, look no further. SurvivalCore modifies many gameplay aspects, including adding its own sickness and disease system into the game through scripting. This was all done in a way to avoid mod conflicts as much as possible, but more about that later. There is a lot to cover, so we'll split this into segments.

Don't worry about remembering everything. A guide will be added to your notes when you start the game that will contain everything found here, and in more detail. You can also find the guide in the files section and on the forums.

Also please note that certain features are configurable in the Mod Configuration Menu if you find them to be too difficult or overwhelming. Everything you read here will be as if you left the mod settings on their defaults.

SurvivalCore is currently in Beta. There are still plans for more content.

Currently Planned Content For Beta:
  • MCM activated scenarios that do crazy things with diseases (like a massive Plague or Beauveria Mordicana outbreak), just for fun.
  • Smaller scale, less severe events (such as a flu season).
  • Difficulty Settings MCM Menu to fit the mod.
  • Equipment revision for some characters. (More to come)
  • Disease related player perks and traits. (More to come)
  • Mod Tooltips.

Next Update Progress:
  • A Bulk-toggle feature for many MCM options, to provide compatibility with mods that change the same things. (not started)
  • More equipment revisions for NPCs. (completed)
  • An alert which will let the player know in advance that they are going to vomit. (completed)
  • More perks/traits. (not started)
  • MCM settings for infection chances. (not started)
  • Review player infection mechanics. (completed)
  • Rebalance the Dead Money DLC. (not started)
  • Change Sleep Deprivation so that it won't drain health during sleeping. (completed)
  • Add a disease self-diagnostic item. (completed)
  • Fix MRE not giving nutrition to the player. (completed)
  • Fix irradiated fountains not hydrating the player. (completed)
  • Fix a severe bug with the Monocyte Breeder Implant infecting the player with Madre-C, S/22x, and Hemolysis. (completed)

Here is what we will cover inside the spoiler tag:
  • Disease and Sickness
  • Item Edits
  • New Action Points Mechanics
  • New Primary Needs Mechanics
  • Combat and Stealth
  • Other Changes
  • Mod Configuration Menu

Disease and Sickness

As mentioned previously, a system has been added into the game which causes, and spreads sickness (if they are contagious) through different vectors. This will affect both you and NPCs. There are 28 different illnesses/health conditions that can be caught, all have different levels of severity. Some health conditions are quite harmless, but can give you a disadvantage in some situations. Then you have the nasty ones, which will outright kill or impair you if left untreated.

These are the health conditions you can expect to encounter from this mod. Any highlighted in green means they are Player Only:
  • Insomnia
  • Parasites
  • Fatigue
  • Weakness
  • Septicemia
  • Sepsis
  • Plague
  • Concussion
  • Limb Trauma
  • Muscle Cramps
  • Fever
  • Weakened Immunity
  • Severe Chem Withdrawal
  • Cardiac Arrest
  • Common Cold
  • Psychosis
  • Wasteland Flu
  • Sore Throat
  • Food Poisoning
  • Cholera
  • Trachoma
  • Blindness
  • Leukemia
  • Hemolysis (HTR)
  • Madre-C Poisoning
  • Hal-Gen
  • Beauveria Mordicana
  • Carnispore S/9x

There are 5 different categories that a health condition can fall under in regards to how dangerous they are. These are:

MINOR - Conditions that are harmless, and have small negative effects. They don't usually risk you catching other illnesses, and can be recovered from easily without needing treatment.

RISKY - Conditions that can be harmful, but rarely lethal. Their effects can be troublesome to manage without treatment, but can be overcome without.

SEVERE - Conditions that if left untreated, can kill or severely cripple their victim. It is unlikely you will recover from these without treatment, even if you do, they will have certainly caused other illnesses to appear, some of which are also life threatening.

EMERGENCY - Conditions that are very serious, and should be treated immediately if possible. Death can occur very quickly, and other illnesses will appear almost as soon as you are affected by anything in this category. There is no chance of recovery without treatment.

BIOHAZARD - A unique category reserved for conditions that are in either the 'Severe' or 'Emergency' category, and are contagious or weaponized to kill. Biohazard detectors can help you spot these in your environment (more on that further down).

Not everything can become sick, and some types of characters are more resilient to sicknesses than others. For example, creatures such as dogs and rats are immune to some conditions that humans can get. Robots are completely immune, and feral ghouls are immune to most conditions.

You can become ill through a huge variety of ways. Eating most uncooked food, or drinking untreated water is one way. Specific items, such as a Nuka-Cola has a small chance to give you something like fatigue. You will know which consumables are risky if they are labelled as such in your inventory when you inspect them. No more binging bottles of Sunset Sarsaparilla to stave off thirst and tiredness! Even your weight encumbrance and primary needs play a factor. Some serious illnesses can be caught through fighting, so keep yourself healthy if you want to stay alive. There are also creatures that can naturally carry a disease and spread it by being in close proximity and/or attacking their victim. One example would be feral ghouls carrying the Plague.

There are ways to prevent yourself from becoming sick, this is especially important if you lack medicine items. First off, you and NPCs can protect yourselves from contagious conditions by wearing apparel that offers biohazard protection (labelled as 'Bio. Resis.' in your inventory). This can come from masks, power armor and radiation suits to name a few. The second method is to use a biohazard detector. This will alert you whenever you enter a contaminated area. The third method is to use a medicine called 'Prevent', which will reduce your chances of becoming infected if you think you are at risk of catching something. The last method is to burn infected bodies, flamethrowers are the most effective way to do this.

All four methods are not foolproof, and you can still become sick if you mishandle the situation. Different equipment offers different levels of biohazard protection; heavily contaminated areas will need better protection. The biohazard detector will only warn you when you enter a contaminated area, NOT before. So you are technically still at risk, even it is a reduced risk. Furthermore, biohazard detectors will not detect minor, contagious illnesses. The Prevent medicine can be a lifesaver, but you are going need quite of lot of these if you somehow manage to take a massive dose of a disease. Burning bodies should be done from a distance, to reduce the chances of you becoming sick.

Becoming sick doesn't necessarily mean the end of you. All (except one) conditions have an item that you can use to treat them. Treatments will very quickly cure you of the condition that you have. Letting sicknesses go away by themselves can take a while. The duration heavily depends on the illness, but it can roughly span from a few hours to an entire week (in-game time). Some illnesses won't go away until treated. You can find medicines throughout the wasteland, you can even make your own.

There are a wide variety of symptoms that you can expect to encounter. These are, but not limited to, Health damage, AP damage, Primary Needs damage, Vomiting, Knockdowns, Speed Penalties, Stats Debuffs, Disorientation, Hallucinations, and Re-animations.

Item Edits

There are a lot of them. If you are worried about mod conflicts, read the 'Conflicts' section to better understand what's happening behind the scenes and if it affects you.

  • Anything not considered a medical item, such as food, will no longer restore HP; no more healing off that shrapnel from a grenade with a tasty brahmin steak! Now you will need to rely on actual medical items, such as stimpaks if you need healing. A very small number of consumable items have had their nutritional value nerfed, such as MRE.

  • Everything, with the exception of quest items, that didn't previously have weight (think of chems or money) will now have weight. They're not super heavy, and their weight varies, but you won't want to be carrying too many of them if you are looking to be agile.

  • A large number of apparel items will offer biohazard protection. Radiation suits, hazmat suits, power armor, masks, are just to name a few.

  • Medicine for sicknesses are new items that SurvivalCore adds, but a few vanilla items have been edited to treat some conditions as well.

  • Most fire weapons are much deadlier. Those with a buffed burning DoT are much more devastating; lasting longer, doing more damage, even to limbs, and can make their victims scream and flail in agony. The Flamer in particular now has a longer range, a slightly reduced weight, and can set fire to things near the fire stream. Flamer fuel, on the other hand, is now 20 times heavier.

  • There are some new weapons that you can play with as well. Biohazard weapons that have chaotic, and devastating effects to whatever they're used on. You can find all of these weapons with just a nice short trip to Doc Mitchell's house in Goodsprings......... Just kidding, obtaining them is going to be harder than that! If you want clues on where to find them, use their names as one. If you really want to know where they are, there will be a spoilers section at the bottom of this mod page to tell you how to get them.

  • Nearly every ammunition type is now destructible. That includes, but is not limited to, grenades, missiles, bullets, and mines. Be careful storming an armory like a dinosaur on too many steroids, you might just blow yourself up.

New Action Points Mechanics

Action Points (AP) now have an extra purpose in the game. Have you found it strange that you could just run forever? Not anymore! Now your Action Points will slowly drain while moving around. The speed it drains depends on different factors. Running and swimming will deplete it much faster than walking or sneaking. How long you can move for before needing to stop depends on 3 Attributes. Strength, Endurance, and Agility. The higher these stats, the more athletic you will be. This goes the other way around too, the lower they are, the more you will need to rest. The pivot point stat for this to be determined is '5', the default value in the game for Attributes.

Letting your AP run out has serious consequences. Running out of AP can put you at risk of contracting some specific illnesses. Furthermore, if you continue to move when you are out of AP, you will start taking Fatigue damage. Ignoring this is not recommended, as you will begin to slow down from exhaustion, eventually collapsing. Being too low on fatigue is very dangerous as you can put yourself at risk to conditions such as Cardiac Arrest. Know your limits.

If you need to restore your AP, stop and rest; you will see it slowly climb back up. If you move, your AP will not regenerate. If you want your AP to restore much faster, you can choose to sit on chairs or something similar. This also applies to your 'Fatigue' stat.

New Primary Needs Mechanics

Your Primary Needs (Hunger, Dehydration, Sleep Deprivation) have more ways to be drained. In Vanilla, they would drain passively. That still exists, but they will now drain quicker while you are moving around. Just like Action Points, how you are moving determines the rate at which your Primary Needs are drained. You can slow down this drain by putting points into your Survival skill. Various sicknesses or effects can also deplete your Primary Needs. For example, if you are set on fire, you will notice your dehydration very quickly becoming a problem.

Combat and Stealth

Time to take cover, combat is much more dangerous!

  • Getting hit inflicts much more damage to both you and NPCs.
  • Damage has been tweaked in a way to still make armor useful.
  • The difficulty settings no longer have an effect on the game. Things like damage scale can be configured through the Mod Configuration Menu.
  • All explosions now have a +75% bonus to their base damage.
  • There is an Adrenaline mechanic implemented. Currently all this does is increase your chances of getting Insomnia from being in combat.
  • Specific 'skilled' NPCs such as Rangers, Great Khans, Centurions, etc... Are harder to kill than usual, and can snipe you from very long distances if they have the appropriate weapons.

You will notice that sneaking is now a little harder as well.

  • Enemies can detect you from further away.
  • Enemies are more sensitive to sound and running.
  • The UI element that shows your detection state is now removed. Trust your instincts, not your sixth sense!

Other Changes

  • Days and Nights will last much longer by default, this can be advantageous to you in-game.
  • Your passive Primary Needs drain is tied to the timescale. Shorter days will make it drain faster, longer days will make it drain slower.

  • The maximum radiation resistance achievable has been raised from 85%, to 99%.
  • The maximum damage resistance achievable has been raised from 85%, to 99%.
  • The minimum damage that's let through after resistance calculations has been lowered from 20%, to 1%.
  • You can now take fall damage from a slightly shorter falling distance.
  • Radiation accumulation has been changed from 100%, to 200%. This means Radiation sources are double dangerous.

  • Hunger, Dehydration, Sleep Deprivation, and Radiation Poisoning, have new debuffs such as Health DoT and AP damage.
  • The fatal stages for your Primary Needs and Radiation Poisoning no longer instantly kill you, and instead gives you very severe debuffs.
  • Poisons are much more dangerous. This includes both animal poisons and crafted poisons.
  • The speed penalty for one crippled leg has been increased from 85% of your normal speed, to 50%.
  • The speed penalty for two crippled legs has been increased from 75% of your normal speed, to 25%
  • Moving backwards or strafing left/right is now slightly slower than moving forwards.

  • The AI will now use antivenoms to treat poisons.
  • The AI will now use healing items outside of combat if they are hurt. They will prioritize more potent healing items if they are seriously injured.
  • The AI will now use doctor's bags or other limb-restoring items if they have crippled or heavily damaged limbs.
  • NPCs now suffer from radiation sickness when exposed. The mechanics are similar to the player's. Naturally immune NPCs (such as feral ghouls) still won't be affected by radiation.
  • The AI will now use radiation treatments, such as Rad-X and RadAway, to prevent themselves from getting radiation poisoning.

Player Death or Visual Effects
  • Dying no longer automatically reloads the game. That is up to you.
  • Dying now has a whiteout screen effect.
  • Radiation Poisoning now has special screen effects.

  • The level cap has been increased to 99 (this is optional in the MCM). This is the highest possible level without causing game instability.

  • Very subtle alterations to the camera shake effect.

Mod Configuration Menu

By default, this mod can be hard. Very hard. The 'Very Hard' of this mod is much harder than the 'Very Hard' in Vanilla. Fortunately, you can configure a handful of settings in the Mod Configuration Menu to make things much easier if you wanted to. Alternatively, you could make things MUCH harder... great if you're looking to get rid of any spare keyboards ; )

Settings such as Skill Point distribution, the level cap, AP drain, etc, can be changed at your leisure.

You might find that some visual effects in this mod are performance heavy. This really depends on your system, but if you encounter performance issues when using biohazard weapons, try disabling some of their visual effects.

If you want to disable a specific sickness for whatever reason, you can also do that.

SurvivalCore was designed in such a way to avoid as many conflicts with other mods as possible. It does this with the use of script extenders, and editing the forms through code, rather than editing the form directly in xEdit or the GECK. Doing this can result in only partial conflicts, not full ones. If that isn't clear, then read the spoiler tag below for clarification.

Take editing a piece of armor as an example. If Mod A directly edits the Health of the armor, and Mod B directly edits the DT of the same armor, then only one of those changes will apply (unless you do a merged patch). By doing the form edit through scripts, however, the form is changed at runtime. This results in only the part I wanted to change, to be changed, and leaves the rest of the form intact for other mods to edit. So now Mod A and Mod B can work together without needing to be merged.

This is done for nearly all edits, especially ingestibles and NPCs. This method does have the side effect of 'not caring' about your load order. What this means is that this mod can be one of the first to load, but the form changes will still take place and overwrite any direct edits from other mods later in the load order at runtime. These overwrites should only be partial however; if Mod A directly edited all of a weapon's stats, and SurvivalCore 'script edited' the damage value, then the damage value will be overwritten, but the rest of the edits from Mod A will remain intact.

To give an example of this in action, this mod was tested alongside Project Nevada, with all of it's modules installed. One of Project Nevada's modules does a lot of direct edits to ingestible forms. No full-form conflicts occured between SurvivalCore and Project Nevada in this regard. There may not be any full-form conflicts between these two mods whatsoever, correct me if i'm wrong.

With all that being said. That doesn't mean full-form conflicts are impossible between this and other mods. There are still some full form edits, but it's to stuff not usually touched by other mods. Some full form edits may disappear in future versions of SurvivalCore. If you find any conflicts, let me know and I will see what I can do to resolve it. Conflicting mods will be listed here when they show up in reports. To report conflicts, use the Forum tab on this mod page. Leave the bug report tab for actual bugs.

If you find a mod conflict, let me know.

Conflicting Mods:
Orange = Has Full Form Conflicts | Yellow = Has Partial Form Conflicts | Purple = Critical ConflictGreen = Concept Clash

  • Ultimate Illness Mod
  • The Ezekiel Project - This mod might crash your game when installed with SurvivalCore. Be aware.
  • BLEED - Fire and poison damage effects.


Before installing this mod, make sure you have ALL the mod requirements installed first! Make sure they are the latest versions. This is very important, you will break your game if you don't do this beforehand.

Do NOT install this mod for an already existing saved game, it is unlikely to be compatible! Install the mod first, then start a new game for optimal performance. Furthermore, by installing this mod and starting a new game, you are now fully committed to keeping the mod active for that saved game at all times. Do NOT disable the mod if you plan on continuing a save that has this mod already loaded! Any reports of bugs that have dismissed this advice, will in turn, be dismissed.

Now with that out of the way, let's begin.

If you have a mod manager, simply download this mod and install it with that like you would with most other mods. If you want to do a manual installation, follow the steps below: 

  • Download the mod from the files tab
  • Unzip the SurvivalCore mod archive.
  • Locate your Fallout: New Vegas directory.
  • Copy & Paste all the folders and files from the mod archive, into the data folder of Fallout: New Vegas.
  • If you haven't yet done archive invalidation, do that before continuing.
  • Play in Hardcore mode. Nothing bad will happen if you don't, but you won't get the mod's full functionality if you leave it disabled.
  • Enjoy! Thanks for the playing with SurvivalCore!

If you are updating SurvivalCore to a newer version, read the instructions below.

Please note that in some cases, not all updates will be save compatible. I will let you know when an update is like that, though.

1. Make sure you uninstall your current version of SurvivalCore first.
2. Once uninstalled, immediately install the updated version.
3. If you get any warnings about updating your NVSE plugins when running the game, be sure to do that before playing.

If you are looking to uninstall SurvivalCore, read the instructions below.

Do NOT uninstall or disable this mod and then proceed to play a saved game that had this mod loaded. You will almost certainly run into instability issues with that save!

If you have installed this with a mod manager, then uninstall it the way you would other mods. If you are doing a manual uninstallation, then follow the steps below:

  • Locate the 'SurvivalCore' folder in the Meshes, Textures, Sound, and Music folders. Once found, delete them.
  • Go to your 'Config' folder, delete the SurvivalCore.ini located there.
  • Go to your main Fallout: New Vegas directory, and delete anything beginning with 'SurvivalCore' there.
  • Delete 'SurvivalCore.esm' from your Data folder.
  • You have now fully uninstalled the mod.

This mod is currently in Beta. Moreover, this is my first mod release ever. This mod is large enough, that I am fully expecting there to be bugs lurking somewhere that I missed. I've done my best to fix all the bugs that were found during testing, so the mod is in a playable state. Just be advised.

If you find any bugs related to this mod, report them in the bug section. Do not report them elsewhere, they're unlikely to be seen. If you report a bug, please go into as much detail as you can. I cannot help you if your report is too vague.

If you would like some console information when testing the mod for issues, go to the 'Config' folder, inside your 'Data' folder in your FNV directory. Open SurvivalCore.ini, and change the settings under the 'Debug' section.

Known Bugs

  • None currently reported.



A Special Thanks Goes Out To:

The NVSE team - For creating NVSE, the foundation of modern mods.
jazzisparis - For creating the JIP extension to NVSE, this mod wouldn't exist without this.
carxt - For creating the JohnnyGuitar NVSE extension, making this mod became easier.
prideslayer - For allowing free-use of NX NVSE from loverslab. This used to be required for SurvivalCore prior v1.04-beta
Pelinor - For the Mod Configuration Menu. SurvivalCore should be less scary for more casual players to use, thanks to this. ; )
rehmk5 - For the very generous donations, and also for bug-finding and play-testing.
Delta1038 - For thorough beta testing of the mod.
Bethesda and Obsidian - For Fallout: New Vegas.
Everyone who downloaded this mod - Your support means a lot.

and finally...

The BBCode Team -
For making spoiler tags to contain where the weapons are from this mod for those who want to know now. heh :>

The schematics for Hal-Gen Gas can be found in the maintenance room in the BoS Bunker at Hidden Valley.
The Carnispore and Beauveria Mordicana schematics can be found in Vault 22, where you discuss with Keely about blowing up the spores, near a terminal.
The Madre-C Gas schematics are found on Father Elijah's dead body in Dead Money.


A spoiler inside a spoiler? Heresy!
The cure to Beauveria Mordicana sickness can be found at the X-22 Botanical Garden at Big MT. Look on the upper floors of the destroyed building.