Is there any medical foundation to the vampire legends? Are Count Dracula's descendants really out there, turning up in A and E every now and then to pick up an emergency blood transfusion? Armed with silver stakes, strings of garlic and the odd cross, the Patient QI medical detectives have been out in force this week hunting down any medical conditions that may cause a vampire syndrome. We backed up our research with some epidemiological evidence, always on the lookout for any medical condition that was prevalent in Count Dracula territory, the Balkans. Unfortunately it was quite difficult to find any real vampires so patient inclusion was limited. We did however come up with a new theory...
The Pernicious Vampire
The oldest and the most obvious explanations revolve around different types of anaemia. Our favourite is vitamin B12 deficiency. The pale coloured skin with dark shadows under the eyes and drawn look seem to fit well. The swollen tongue and bleeding ulcers in the mouth would mean that the person could not eat and could only drink fluids and this would lead to weight loss. The blood and liquid in the mouth could easily give the impression that the person had been drinking blood. The latter stage of the untreated disease involves serious complications of psychoses and possible catatonia. Even the traditional name 'pernicious' anaemia seems to fit. However, pernicious anaemia is not big in the Balkans.
A Porphyritic People
In 1985 Canadian biochemist David Dolphin published a paper that suggested that Porphyria may be the illness behind the vampire legends. The evidence was based on symptoms such as light sensitivity and the teeth appearing to stick out due to tightening of the gums over the teeth. The treatment for Porphyria is to give the blood component haem, intravenously. The paper postulated that a requirement for haem would give patients a desire for blood and that they would take to drinking it. The same could be said of the different types of anaemia but we found no evidence that having anaemia gives people the urge to drink blood - crave a nice rare steak maybe. Porphyria is big in India and Scandinavia but not big in the Balkans.
In 1998 Spanish neurologist Dr Juan Gómez-Alonso suggested that rabies played a role in the creation of the vampire legend. His theory is based on the fact that the legend circulated at a time when there was a preoccupation with rabies. Rabies causes hypersensitivity to taste (avoidance of garlic) and sensitivity to light and insomnia (becoming nocturnal) and increased sexuality which are all characteristics of vampires according to the legend. The theory is backed by historical writings that state ' a man is not rabid if he can look at his own reflection' so linking to the legend that vampires have no reflection. Bats have always been associated with vampires and they are one of the transmission routes for rabies. The disease makes victims bite others and have bloody froth coming out of their mouths. Our historical epidemiology research showed there was an epidemic of rabies in Europe in the early 1900's, around the time that the legend became more widely known and there was a big cluster in the Balkans. However, vampire bats are not big in the Balkans.
The Cullen Boys.
In November 2010 the UK paper, The Daily Mail, ran a story about two boys Simon and George, who suffer from Hypohidrotic Ectodermal Dysplasia (HED). Coincidentally they have the surname Cullen. There are many types of ectodermal dysplasias, and all have symptoms that affect the skin, hair, teeth and nails. People suffering from HED cannot perspire and have to avoid anything that could make them overheat, such as sunlight. Another of the symptoms is oligodontia which means they are missing at least six teeth and these are most commonly the incisors and premolars (rarely the canines) and give them the appearance of vampires. The pictures published in the paper certainly made the children look like little vampires. The children were reported as saying that the Twilight books had made them a big hit with their friends which made up for the other people who made fun of them and stared at them. There is a plan to use bone taken from Simon's thigh and use it to reconstruct his jaw so that he can have teeth implants and finally feel that he can smile. HED is extremely rare, slightly more prevalent in Scandinavia and definitely not big in the Balkans.
New Boy Ben
Our epidemiology research provided us with an interesting new suspect, Ben. Balkan endemic nephropathy (BEN) is a chronic disease that causes kidney damage and it occurs in Romania, Bulgaria, Serbia, and Croatia. Symptoms include anaemia with pale skin and a slight copper colouration over the cheek bones (very Twilight), fatigue with excessive night time urination (turning nocturnal). The illness usually develops over a long period of time with symptoms appearing at the age of 30-40 years of age. Recent research has suggested that because the illness is so localised in certain areas it may be due to the locals eating the toxic Aristolochia weed seeds that have got into the wheat crop. Our blood- thirsty Balkan searches also threw up some information on the Scythians, a fierce people who settled in the Balkans in the 4th century BC. This fierce group of people were said to 'drink the blood of their enemies on the field of battle' and according to historical documents were 'the most able to power and are the peoples with the greatest might'. We propose a theory that the young superhuman blood drinking fighters gradually ingested too much Aristolochia which caused BEN and the combination of the two is the basis of the vampire legends. BEN is really big in the Balkans.
So, if you do bump into any vampires tonight, forget the garlic - serve a Bloody Mary laced with Vitamin B12 and suggest they cut down on the Aristolochia.