Level 13 DiseaseSewer Fever

Stage 0: The target recovers from the disease.
Stage 1: Initial Effect: The target loses a healing surge.
Stage 2: The target takes a -2 penalty to AC, Fortitude, and Reflex.
Stage 3: Final State: The target takes a -2 penalty to AC, Fortitude, and Reflex. The target loses all healing surges and cannot regain hit points.
Check: At the end of each extended rest, the target makes an Endurance check if it is at stage 1 or 2.
17 or lower: The stage of the disease increases by one.
18-22: No Change
23 or higher: The stage of the disease decreases by one.

Published in Dungeon Master's Guide 2, page(s) 206.