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I don't quite follow the following:

Are you ill? - Estás enfermo (from google translate so this could be wrong)

So the verb "to be ill" is "enfermar". So not sure where "enfermo" is coming from? My understanding is that "enfermo" is the first person present conjugation.

Is this a suffix thing or a verb turning into an adjective etc.?

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    Enfermar means "to sicken" (or "to make ill"). That isn't the same thing as to be ill. – Walter Mitty Nov 22 '17 at 11:52
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The Google translation is literal and correct in this case: enfermo is an adjective that means "ill, sick, diseased". Since Google cannot guess number or gender from the English sentence, this could also be translated with enfermos (plural masculine), enferma (singular feminine), or enfermas (plural feminine).

It happens that enfermo is also the first person singular, present tense, indicative mood, of the verb enfermar. This verb is usually pronominal, i.e. it takes a personal pronoun that looks like a reflexive. In any case enfermar doesn't mean "to be ill", but "to become ill" or "to make (somebody) ill". This is not what you see in the sentence ¿Estás enfermo? - that is clearly the adjective.

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So the verb "to be ill" is "enfermar"

Actually "to be ill" is not a verb. Only "to be" is the verb; "ill" is an adjective, or a qualifier. You ask "Are you ill?" just like you could ask "Are you tired?", "Are you blonde?" or "Are you Belgian?".

With that in mind, enfermo (or enferma in feminine) is just the Spanish adjective for "ill":

enfermo, ma.
Del lat. infirmus.

  1. adj. Que padece enfermedad. U. t. c. s.

So with estás being second person singular of estar, "to be"; and enfermo being "ill", the correct translation is indeed:

¿Estás enfermo?

(Your quoted translation is missing the question marks, but you must always include them).

You're right about "enfermo" (also) being one of the conjugations of the verb "enfermar", but that verb means "to become ill". It is not used to say that you are ill.

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Are you ill? - ¿Estás enfermo?

As others have explained, "enfermo" is an adjective here.

Since Spanish requires that adjectives match gender, and show an S for a plural subject, if you ask two women this question, then yes, you will need "enfermas":

Are you [two ladies] ill? - ¿Están enfermas?

Note, enfermar does exist as a verb. For example:

Quiero acostarme temprano hoy. Creo que me estoy enfermando.

This means

I want to go to bed early tonight. I think I'm getting sick (coming down with something).

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