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Citizens that are in poor health have a higher chance of developing sickness than citizens in good health. Good health can be maintained through a varied diet of fruits, vegetables, grains, and meats. If a good diet cannot be attained, herbalists can collect herbs that will help increase health and make up for the poor diet.

If sickness does occur, hospitals can be used to reduce the spread and length of the disease. Trade with merchants as well as inviting nomads into a town can temporarily increase the chance of disease.