With Dark Shadows opening this weekend, vampires are once again on our minds. Is their behavior safe? Dr. Kent Sepkowitz on the health risks of sipping from the river of life.
That first scent of summer in the air can mean only one thing—vampires. Lots and lots of vampires: in books, on HBO, coming once more to the silver screen. This week, Tim Burton’s tongue-in-cheek Dark Shadows opens; it’s the latest installment of a franchise reaching back almost 200 years—which means that our enjoyment of the genre is almost as old as Count Dracula himself.
The vampire phenomenon is well studied across several academic and commercial disciplines, but its appeal remains poorly understood. For example, the joyful panic we feel watching attractive young people sink their teeth into each other’s tender necks has been analyzed by shrinks. Consumer psychologists have puzzled over just what we are responding to (here’s a hint: sex) and how they can reproduce the buzz. And cultural historians have laid a weighty tome or two on the unsuspecting. But none of them have dug deep into the heart of the matter, to elucidate the core issue of vampirism: what’s the deal with drinking blood? Is it safe? Can you get germs? Is it something I might want to empower myself to do? Do certain health plans cover it?
As a public service to those desperate not only to experience every available vampire product but also to read every article that relates to the same vampire products they are experiencing, I offer the following careful analysis on hematophagy, aka, blood sucking.
First, the good news. Hey, we do it all the time—ever get a bloody nose or bite your lip hard on that awful piece of gristly steak you are chomping down with the in-laws? Then you know the peculiar warm salty taste of human blood—though, granted, it’s your own. Maybe you even enjoyed the taste a little – or a lot. But that’s OK, too. We are not here to judge anyone.
Plus, blood let from large edible animals such as cows and pigs and sheep is a delicacy in every country but the U.S. and across all religions but Judaism and Islam (which still share a charming small-town fussiness about various foods). Fancy a little blood sausage? It’s nothing but a big clot of congealed blood; the French version, black boudin, is the same. Trotting around the globe you could meet and eat blood soup, blood stew, Swedish blodplatter pancakes, and seal blood straight up. It makes sense—before Feosol was available on every corner, menstruating women had a need for digestible iron to replenish the loss. What better way to juice up than to chow down on some of that blood dripping off the just-dead animal hanging outside your hut?
Moving on past the yuck factor, you may wonder whether drinking blood might cause some indigestion. In fact, it seems to: patients with bleeding stomach ulcers typically complain of severe nausea and vomiting, and york up blackish blood clots said to resemble coffee grounds. Ingested, non-vomited blood turns feces the same black color. Back in 1939, when medical students were little more than docile serfs eager to satisfy the whim of any Dr. Strangelove, a dozen were asked to guzzle a tumbler of their blood. Clinicians were trying to understand just how large an internal bleed was necessary to turn the feces the characteristic black color, a condition referred to as melena. So each student drank and waited; drank some more and waited some more until the answer—about 70 cc or the amount of a double shot of scotch—became evident.
Well then, what about blood incompatibility—you know, the A, B, O system of typing blood so essential to prevent severe reactions when blood is being transfused? What if, for example, a blood type A vampire went to work on a blood type B young lady—would that create problems? Probably not – those red blood cells almost certainly would not enter the vampire’s blood stream. After all, we (and, presumably, vampires) have digestive systems accustomed to processing foods far more elaborate than blood. So unless the vampire himself were suffering from a bleeding ulcer (and there’s so much stress being a vampire, you wouldn’t believe it) thereby allowing a bunch of intact red cells to cross into the vampire network of veins and arteries, he need not worry.
Finally there is infection. Here the news is not so good. After all, lots of infections course through the blood—viruses and bacteria and fungi. Would a stomach full of microbes cause trouble? It depends on several factors. First is the concentration of infectious particles in the blood of the sucked victim. In general, bacteria (and fungi) in the bloodstream—Staph or strep or E coli—make us extremely sick even at relatively low concentrations. Plus, most bacteria we eat are killed in the very acidic milieu of the stomach. So unless the Count is popping Tums or the purple pill, it’s likely that he’d avoid trouble from blood-borne bacteria.
Viruses are another story. Most viruses—influenza, colds—don’t travel in the bloodstream much, so would not be an issue. However, three potentially deadly viruses circulate at wildly high levels making them a risk to vampires and sexual contacts alike: HIV, hepatitis B and hepatitis C. Persons with these infections can feel fit as a fiddle with a million viral particles per milliliter of blood (a teaspoon consists of 5 milliliters) occupying their blood.
Here’s my recommendation, vampires: limit your contacts and pick your partners well, includingassessing a target’s HIV statuspre-blood-meal.
Is that enough to transmit infection? Maybe. HIV is efficiently (and tragically) spread via breast milk, so we know that swallowing HIV-infected fluid can result in infection. Granted a newborn baby has neither the immune system nor the stomach acid production of a 1500 year old vampire, but caution still should prevail. Hepatitis B and hepatitis C don’t appear to be transmitted through breast milk so may be less risky to ingest. Yet dentists, who themselves can resemble vampires in so many ways (courteous, dangerous, a haunting smile, and of course sadistic delight at the proceedings) used to contract hepatitis regularly from patients’ bloody gums as they drilled and scaled and scraped. Vampires therefore would be wise to stand clear of those infected whenever possible.
In fact, vampires would be well-advised in general to pick their marks carefully and not let the urge to just, um do it¸ get in the way of careful selection. As such vampires are just like every other horny guy or girl out looking for a little action—perhaps explaining the vampire’s continued universal appeal in its most elemental terms. So here’s my recommendation, vampires: limit your contacts and pick your partners well, including assessing a target’s HIV status pre-blood-meal. These days, consider a rapid HIV test for your victim before diving in; except for the first two weeks immediately after new HIV infection (called the window period), these tests are very accurate. Call it safer vampiring, a variation on the tenets of safer sex: common sense with a dash of libido control. After all, what’s your hurry—you’ve got forever to find the perfect mate.