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Post-Apocalypse

The world was heavily nuked, with few survivors.
While you can choose any disease to infect the world with, the world has changed heavily, some examples:

1. Most seaports and airports have been closed due to the lack of government.

2. Most countries genuinely don't exist: that means they cannot close borders or try to cure your disease.

3. New countries, empires, or territories have been formed, with their own economies: who they send boats and planes to.

And there's many more!

Good luck!