Level 11 DiseaseMoon Rage

Stage 0: The target recovers from the disease.
Stage 1: Initial Effect: The target takes a -2 penalty to attack rolls as its hands begin to grow fur and claws.
Stage 2: The target gains a Strength-based claw attack that deals 1d6 damage. The target can no longer wield weapons or hold implements. This effect remains as long as the subject is diseased.
Stage 3: Final State: The target’s predatory instincts take over. When the target attacks a creature in combat, it can attack no other creatures until that target is dead or until the end of the encounter.
Check: At the end of each extended rest, the target makes an Endurance check if it is at stage 1 or 2.
15 or lower: The stage of the disease increases by one.
16-20: No Change
21 or higher: The stage of the disease decreases by one.

Published in Monster Manual 2, page(s) 159.