Contagion

"Outbreak!"
Entity ID	5.100.466
Character Appearance
Item Pool	Treasure Room Treasure Room
Collection Grid	(page 4, column 1, row 6) (page 4, column 2, row 6)

Contagion is a passive item added in The Binding of Isaac: Afterbirth †.

Effects

• In each room, the first enemy killed will release a gas explosion and poison nearby enemies.
  • Poisoned enemies will also release gas upon death, spreading the effect.
    • Poisoned enemies do not need to die while the poison is still active to spread the effect.
  • The effect will also activate if a shopkeeper is destroyed before killing any enemies.
    • Re-entering a room and destroying another shopkeeper inside it will trigger the effect for a second time.

Notes

• The initial gas explosion deals 5 damage, and the poison deals Isaac's tear damage per tick, for 6 ticks.
• The gas explosion and poison can damage friendly enemies.

Interactions

• Dr. Fetus: Bomb damage does not apply to poison damage.
• Epic Fetus: Missile damage does not apply to poison damage.
• Ipecac: Ipecac only applies a 2x multiplier as opposed to +40 to poison damage.
• Poison tears: No effect. Gas explosions will only be triggered by poison caused by Contagion
• Second Hand: Poison duration is not affected.

Trivia

• Its sprite is a recolor of Toxic Shock.
• This item may be a reference to the movies Contagion and Outbreak, or the game Plague Inc..