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Contagion is a passive item added in Afterbirth †.
- 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 initial gas explosion deals 5 damage, and the poison deals Isaac's tear damage per tick, for 7 ticks.
- Dr. FetusTears are replaced by bombs that benefit from bomb-enhancing effects and slide a fixed range after being fired.: Bomb damage does not apply to poison damage.
- Epic FetusIsaac's tears are replaced with guided missiles, like those used by the Doctor's Remote.: Missile damage does not apply to poison damage.
- IpecacReplaces tears with explosive and poisoning projectiles fired in an arc from the mouth.: Ipecac only applies a 2x multiplier as opposed to +40 to poison damage.
- Poison tears: No effect.
- Its sprite is a recolor of Toxic ShockUpon entering a room, poisons all enemies, dealing double Isaac's tear damage. Killing enemies leaves a small, short lasting pool of green creep on the ground..
- This item may be a reference to the movies Contagion and Outbreak, or the game Plague Inc..
- A contagion is a disease spread by close contact.