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- Deal 1 role card to each player.
- All players start in Atlanta.
- Place 1 research station in Atlanta.
- The outbreak marker starts on 0 and the infection marker starts on the first space.
- Deal player cards equal to 6-number of players to each player.
- Shuffle epidemic cards into the player pile.
- Shuffle the infection pile. Reveal 3 cards and place 3 cubes on each location, then repeat but with 2 and 1 cubes.
- On your turn, you can take 4 actions from below:
- Drive: Move your pawn one step by a red line. If it goes off the edge, it wraps to the other side.
- Direct flight: Discard a card to move to that city.
- Charter flight: Discard a card same as your location and move to any city.
- Shuttle flight: Move from a research station to another research station.
- Build station: Discard a card same as your location and build a research station there. You can only have at most 6 stations.
- Treat disease: Remove 1 cube. If that disease is cured, remove all cubes of that colour. If the cure is found and no cubes of that colour remain, that disease is eradicated. Flip the cure over.
- Discover cure: Discard 5 cards of the same colour in a research station to discover a cure for that colour. Place its cure on the board.
- Share knowledge: If two players are in the same city, give or take a card that matches the city.
- Pass: Take no other actions.
- After taking actions, draw 2 cards.
- If an epidemic card is drawn, discard it. The infection rate moves 1 space. A bottom card from the infections pile is drawn and 3 cubes are placed in that city. The discarded infections are shuffled and placed on the infections pile.
- Draw infection cards equal to the rate of infection, and place 1 cubes on matching cities. Your turn ends.
- Players have a hand limit of 7. They must discard if over immediately.
- Special cards can be played at any time, costing no actions.
- If an infection card with colour matching an eradicated disease is drawn, it has no effect.
- If a city is going to have 4 cubes of the same colour, an outbreak occurs instead. Add a cube of that colour to all adjacent cities. The outbreak marker moves one space.
- Each city can only have one outbreak in one turn, but can be affected by multiple outbreaks.
End of the Game
- If all four cures are discovered, all players immediately win.
- If there aren't any cubes of a colour when needed, all players lose.
- If the eighth outbreak occurs, all players lose.
- If the player pile is empty, all players lose.
- Contingency planner: As an action, take an event card from the discard pile and place it on his role. It doesn't count against his hand limit but only 1 card at a time can,be on it. When a card from his role is played, it is removed from the game.
- Dispatcher: As an action, move another player as it is his own or to another city with players.
- Medic: Remove all cubes of a colour when treating disease. If a disease is cured, the medic needs no actions to treat it.
- Operations expert: As an action, build a research station for free or charter flight from a research station by discarding a card.
- Quarantine specialist: No cubes can be placed on your city and all cities connected to it.
- Researcher: May give any card when sharing knowledge.
- Scientist: Need 4 same coloured cards to discover a cure.
- Number of epidemic cards: 4 for introductory, 5 for standard and 6 for heroic.
- Hands: Players may choose whether to disclose all hands.
- Roles: Players may choose whether roles are picked manually or randomly.