- "Years ago, word reached us of a strange pestilence that had laid siege to a few remote villages far east. But the rumors failed to prepare us for the horror that was the Plague."
- ―Kain — Listen (file info)[src]
The Plague was a highly-devastating disease, fatal to humans. It struck several settlements in Nosgoth as early as the events of Blood Omen, including Kain's hometown of Coorhagen. Its effects were witnessed in Blood Omen: Legacy of Kain.
- "Worms and maggots fed upon his festering skin, the scent of tainted blood seeped through the wounds upon which they feasted. Pity... such a waste; good blood gone bad."
The Plague apparently originated in the far east of Nosgoth, spreading through remote villages some years before Kain's murder in Ziegsturhl. Rumors describing it as a "strange pestilence" reached Coorhagen, but the city's populace was unprepared for the horrors of the disease by the time it reached them. When Kain returned to Coorhagen following his murder and subsequent resurrection by Mortanius, traveling to Malek's Bastion, he was forced to navigate the pestilence-ridden streets and homes.[Blood Omen/4]
The Plague ate at its victims' bodies, causing the skin to fester, and tainted the Blood, turning it black. The few surviving citizens Kain encountered in Coorhagen lamented their fate, and encouraged him to leave the city before it could claim him. They cried that there was "no hope", denounced themselves as "unclean", and had deposited piles of their dead on the streets in plain view. While the living encouraged each other to bring out their dead, necromancers stalked the place, transforming corpses into loyal undead servants.[Blood Omen/4][Blood Omen/Miscellaneous]
- The Plague is analogous to the real-world Black Death, a catastrophic pandemic estimated to have killed 30-60% of Europe's population in the Late Middle Ages.