At-will, std, touch; you infect subject with a bloodborne pathogen. Choose one of the following effects:

• Hemophilia: slashing or piercing damage causes ongoing medium internal damage (Con ends).
• Sickle-cell: subject suffers debilitating pain, causing wracked (Con ends).
• Anemia: subject suffers disadvantage to all Str, Dex, and Con checks and saves, and has half movement rate (Con ends).

Talents:

• Enhanced Pathogen: you can choose two of the above effects when you cast this power.
• Virulent Strain: when you infect a target, you can also cause them to infect one additional target within 5 feet of them. The new target must make a Con save against your spell DC or suffer the same effects.
• Persistent Infection: the effects last until cured by a remove disease spell or similar magic, rather than ending on a successful save.