Rabies and Beyond: How Dracula has Informed Common Conceptions of Disease and Infection

James Hanton
17 min readNov 3, 2020
Image Credit: Helgi Halldórsson // Wikimedia Commons

Discussing the metaphors attached to acquired immune deficiency syndrome, or AIDS, Alcorn (1998: p.69) bluntly surmises that “if AIDS is a disease of sex, then sex must be equated with death”. This combination of sex and death is embodied in one mythical creature more so than any other — the vampire. Count Dracula, the creation of Gothic author Bram Stoker, is the most famous of them all.

This essay will focus on Dracula - the novel, the character and the idea - to discuss how he has come to influence widespread perceptions of disease and infection. Firstly, a brief history of the vampire’s origins will be accounted for, more specifically how it is the symbolic realisation of fears surrounding another devastating human disease - rabies (Wasik & Murphy, 2012). The majority of the essay will focus on three key themes emerging from the original novel and cinematic adaptations of it, and how these served (and continue to serve) to inform the understandings of HIV/AIDS - foreignness, sexuality and liminality. The latter theme represents a new way the vampire metaphor can be used to understand infection in a way not considered by previous interpretations. However, it will be emphasised that the link between Dracula and disease is a culturally specific association, and counterexamples - both ethnographic and textual - will be highlighted to show this.

The Vampire and Rabies:

Stoker would not have been referring specifically to HIV/AIDS in his novel, but was almost certainly playing on the terror of rabies. Rabies is transmitted through bites and gradually devours the brain, driving its host into a fit of animalistic aggression, meaning that the dying days of the victim will be spent foaming at the mouth and engaging in insanity-driven attacks (Wasik & Murphy, 2012). Rabies is an example of how “one’s original substance is drained out, and replaced by another, a ‘loathsome parasite’” (Chaudhuri, 1997: p.189) which triggers otherwise inexplicable changes in behaviour. Rabies gradually eats away at the self.

The vampire emerged as a frightening embodiment of rabies. Both drain the ‘substance’ out of their victim and trigger a change in their behaviour as the infection (or possession) takes hold. Both spread their contagion through bites, and vampires could historically transform into dogs at will - dogs being the animal most commonly associated with the virus (Wasik & Murphy, 2012). This metamorphism is described by Van Helsing, Dracula’s nemesis:

“He can transform himself to wolf, as we gather from the ship arrival in Whitby, when he tear open the dog, he can be as bat, as Madam Mina saw him on the window” (Stoker, 2011: p.223).

This echoes the changing association between vampires and animals - the bat replaced the dog as the creature of choice. Wasik & Murphy (2012) note that this occurred after the discovery of bloodsucking bats from South America, named vampiros by Spanish conquistadors - Spanish for ‘vampires’ - which also spread rabies. The sources and characteristics of this virus clearly fed into Dracula’s creation and evolution.

There are similarities between rabies and HIV/AIDS. Both are zoonotic diseases, originating from animals (Wasik & Murphy, 2012). HIV, like rabies, can also be spread through bites (CDC, 2017) and both leave visible skin marks that indicate contraction of these fatal diseases. Mina in Bram Stoker’s Dracula (2005) is inflicted with a skin lesion as her vampirism takes hold, which draws parallels not only with a rabid bite but also with the skin markings that can characterise AIDS affliction, famously seen on Tom Hanks’ character in Philadelphia (Reed, 2010). Rabies and HIV/AIDS share some key characteristics with relation to Dracula, which would be key for the vampire’s association with rabies to be displaced over time with the new metaphorical relationship with AIDS, like how the bat displaced the dog.

The Infectious Outsider:

The fear of contagion spreading through migration is a strong link between Dracula and infection. It is common for Westerners to believe that diseases such as AIDS or rabies are a thing of the past for, and such afflictions are limited to what is generalised as the Global South (Rosenberg, 1989), a clear example of evolutionist thinking. As a result, “foreigners were consistently associated with germs and contagion” (Markel & Stern, 2002: p.757) in Western societies like the U.S.A. and Britain. The arrival of diseases such as AIDS sparks fears of what Arata (1990: p.623) calls “reverse colonisation” whereby “the ‘civilised’ world is on the point of being colonised by ‘primitive’ forces” or believes that this will happen. The ‘foreign body’ is accordingly seen as a vessel of infection (Harper & Raman, 2008) which threatens the health of Western society, and a painful reminder for those living in it of how vulnerable it is to these ‘primitive’ ills.

This fear is articulated explicitly in Dracula and its adaptations. Jonathan Harker, after spending some time in Dracula’s castle, writes a journal entry that questions the security of the ‘modern’ age:

“And yet, unless my senses deceive me, the old centuries had, and have powers of their own which mere ‘modernity’ cannot kill” (Stoker, 2011: p.37).

Harker is not convinced of the Victorian era’s immunity against the “powers” which it considers itself safe from. These nerves will not be helped by Dracula himself - the ‘foreign body’ delirious with infectious intentions - talking so dreamily of going to Britain, having researched it in great detail:

“‘These friends’ - and he laid his hands on some of the books - ‘have been good friends to me, and for some years past, ever since I had the idea of going to London, have given me many hours of pleasure… I long to go through the crowded streets of your mighty London, to be in the midst of the whirl and rush of humanity, to share its life, its change, its death” (Stoker, 2011: p.22).

The way that the Count spells out the effect of diseases like AIDS or rabies in blatant terms - “life… change… death” - aligns Dracula firmly with infection. This dream of going to Britain - specifically London, the heart of the British Empire and the most populated city in Britain (Emsley et al, 2015) - would therefore be a massive cause for concern for someone like Harker. Dracula’s aim is to spread his vampirism throughout the population of Britain; a disease working its way through the ‘civilised’ world having made its way from abroad.

Adaptations of Dracula have also made this alignment between the Count and disease clear. Nosferatu (2015), a silent film adaptation of Dracula from 1922, depicts the vampire travelling with hordes of rats, and Count Orlok (Dracula under another name) assumes a rat like appearance himself with pointed ears and teeth. This deliberately associates Orlok with plague, responsible for the most devastating zoonotic disease outbreak in history, the Black Death from the 1300s, which spread through the fleas found on rodents (Wasik & Murphy, 2012). The threat to the modern way of living is again represented by a disease-ridden foreign body, which in the case of Count Orlok especially is purposely made out to be grotesque and anything but the picture of health.

The paranoia of progress being undone, resulting from the arrival of foreigners and infectious diseases into Western civilisations, was an idea picked up on in the AIDS discourse. Many Americans view AIDS as “a time bound artefact” (Rosenberg, 1989: p.10), and “the return of… a vanished world of infectious disease” (Lindenbaum, 2001: p.363) threatened to undo the ‘advancement’ of civilisation seen under industrialisation. In the same way that Dracula acts out a horror scenario where the ‘pure’ blood of English folk is polluted by ‘foul’ blood from the East (Chaudhuri, 1997), Americans disproportionately blamed Haitians for bringing AIDS to the United States as a result of pre-existing associations between Haitians, filth, disease and foreignness (Farmer, 2006). AIDS triggered “a resurgence of nativism… tied to worries about the browning of America, and drawn from decades-old stereotypes of outsiders as either acutely or chronically ill (Markel & Stern, 2002: p.775), stereotypes made evident in Nosferatu (2015) by the decision to make Count Orlok look like a plague-carrying rat. The same cultural concerns of race felt by Britain in the 1890s (Arata, 1990), which stoked concerns for the ‘health of the nation’ and are communicated clearly in Dracula, are regurgitated in the responses to the perceived danger of foreign bodies in the wake of AIDS. Foreigners, like Dracula, are constructed as an invading enemy carrying a disease that, it was believed, was a sign of ‘primitive’ times. It represented a direct, deliberate attack on the modern way of life in Western society in the same way Dracula meticulously planned and fantasised about his plan for coming to London. The same ideas are being repeated.

Sexual Deviance and Infection:

Foreigners were of course not the only group disproportionately blamed for HIV/AIDS. It is historically associated with homosexuality and promiscuous sexual behaviour - Anderson et al (2010) found that most of their interviewees believed that only homosexuals or very sexually active heterosexuals contracted HIV. This is one of many connections made between infection and lifestyle. Around the time Dracula was written for instance, cholera was seen as most likely to strike the alcoholics, greedy and filthy among the population (Rosenberg, 1989). Similarly, Alcorn (1998: p.72) notes how the media portrayed the gay community as if “lifestyle speaks contemptuously of character”, homing in on the perceived “ostentatious overconsumption of sexual partners.” Dollimore (1991) argues that this construction of a sexual deviant is a scapegoating strategy enacted by the social majority, triggered by feelings of being practically or symbolically threatened. In the case of Dracula, the ‘threat’ was directed at heteronormativity, as represented by gendered categories of the penetrator and the penetrated, as well as the relationships between bodily fluids (Craft, 1984). Such concerns can also be seen in the backlash against the homosexual community in the wake of HIV/AIDS.

Dracula is full of moments implying the risk of sexual promiscuity and transmission of fluids. Lucy Westenra, the first of Dracula’s female victims, receives transfusions of blood in the belief that this will heal her, her carers unaware that vampirism is taking its hold. The first to give blood is Lucy’s fiancé, Arthur, or ‘Art’. Dr. Seward then also donates, but as he notes in his journal, Van Helsing carefully manages this contribution:

“The professor watched me critically. ‘That will do,’ he said. ‘Already?’ I remonstrated. ‘You took a great deal more [blood] from Art’. To which he smiled a sad sort of smile as he replied: ‘He is her lover, her fiancé” (Stoker, 2011: p.121).

Seward is also warned not to tell Arthur that he has given blood to Lucy, in case it makes the husband-to-be jealous. Van Helsing here is aware of the threat to the institution of marriage that such transmission of bodily fluids represents. After both he and the American Quincy Morris have also given blood, Van Helsing has this to say when Dr. Seward comments that the transfusion of blood cemented the marital bond between Arthur and Lucy:

“But there was a difficulty, friend John. If so that, then what about the others? Ho, ho! Then this so sweet maid is a polyandrist, and me, with my poor wife dead to me… even I, who am faithful husband to this now-no-wife, am bigamist” (Stoker, 2011: p.164).

As Craft (1984) argues, the blood is a substitution for semen. Once Lucy becomes vampire herself, having received the blood (or semen) of four men, she is suddenly portrayed as a “voluptuous” sexual monster - “voluptuous… used to describe her only during the vampire process” (Craft, 1984: p.119). Before the men drive a stake through her heart, Dr. Seward describes what Lucy looks like in her coffin the night after she attacked a child:

“The Bloodstained, voluptuous mouth… the whole carnal and unspiritual appearance, seeming like a devilish mockery of Lucy’s sweet purity” (Stoker, 2011: p.199).

Dracula’s bite and the blood transfusions turn her into this beast unrecognisable as Lucy herself, who was so ‘pure’ before being penetrated four times (with a needle) and receiving the fluids of several different men. She is then destroyed - viciously - when the extent of her ‘impurity’ becomes apparent. The strong statement against sexual promiscuity is clear. Those who indulge themselves with the bodily fluids of others will meet unfortunate, gruesome ends.

Homoeroticism is also heavily implied in the novel, especially in the opening chapters consisting of Harker’s journal. Craft (1984) notes that this opening sequence draws its tension from the possibility of Dracula biting, therefore penetrating, another man. Bram Stoker’s Dracula (2005) makes this connotation blatantly obvious. Dracula shaves Harker’s face for him which in itself is a very intimate act. The Count then takes great pleasure in licking Harker’s razor clean, signifying his desire to taste Harker’s blood. If blood again substitutes for semen, an idea sustained by the phallic imagery of the razor and the Count shuddering with pleasure at the taste, Dracula blatantly desires to have a sexual experience with another man.

The Count is clearly a sexual being. He is “a man whose attitude to women is driven by unslakable, quasi-sexual (or literally sexual) appetites” (Wasik & Murphy, 2012: p.85) but clearly this impulse is not solely directed at women. Dracula challenges “the gender-based categories of the penetrating and the receptive” (Craft, 1984: p.109); men penetrate, women receive. Dracula not only wants to bite and drink the blood of men, rendering men as ‘receivers’, but in spreading his vampirism and sexual nature among women, they become ‘penetrators’ - an example of “sexual inversion” (ibid: p.115). The Count infects and drains the essence out of anyone he wishes in a bid to quench his thirst. This sexual inversion emphasises the carnal driving force behind the vampire’s libido and threatens heteronormativity in the same way HIV/AIDS was perceived to do. Deviance, bodily fluids and contagion all intersect in the figure of the Count and in the narrative surrounding AIDS.

Sexual activity is another way rabies and HIV/AIDS are connected through Dracula. Rabies, as Wasik & Murphy (2012) observe, has the peculiar effect of triggering hypersexual behaviour in its sufferers. Lucy in Bram Stoker’s Dracula (2005), instead of being infected solely with a vampire bite, contracts her illness through both this and having sex with Dracula, who at the time adopts a wolf-like appearance. This scene makes the link with rabies clear given the virus’ connection with dogs. However, it also unmistakably connects it with fears of HIV/AIDS being spread through sex (Rich, 1992) as well as a (disease-ridden) bite on the neck, which itself is a sexually charged action. Dracula’s sexual appetite - which he, crucially, chose to bring with him to London - is the trigger for the infection that overcomes Lucy. This fear surrounding sexual promiscuity and “the possibility that humans might actually choose to engage in unprotected sex” (Fink, 2010: p.420) was one factor stoking the backlash against the homosexual community in the wake of AIDS.

The parallels between the vampire and infection obviously proved too significant to be ignored by public sexual health campaigns. In the same year the film was released, a campaign in Illinois used Dracula as a way to promote HIV awareness. The message from Dracula read:

“Stop living in the dark - get the facts about AIDS. When I learned about AIDS, I changed my ways. If I can control myself, so can you. Beware of fly-by-night relationships” (Bak, 2007: page xxiii).

The adoption of the vampire imagery - residing in the dark, previously uncontrollable behaviour, and night-time flight - is undeniably a commentary on the portrayed lifestyle of HIV contractors. As Chaudhuri (1997: p.194) comments, “AIDS science and vampire logic become mutually reflective; cross-fertilising each other, they exchange fluids/metaphors”. The message is that those who engage in short-term sexual relationships with numerous people as Dracula does, are very ‘active’ at night as Dracula is and fail to rein in their lust for pleasure will contract AIDS. This was the ideology preached by the likes of playwright Larry Kramer, who saw “AIDS… as the inevitable consequence of the gay lifestyle” (Alcorn, 1998: p.72). In the same way that foreignness was seen as a threat to the health of the nation, the narrative of Dracula “render[s] people living with HIV/AIDS as threats to those who are or appear to be ‘healthy’, enlisting metaphors of otherness and contagion to represent disease” (Fink, 2010: p.416). The homoeroticism and promiscuity that feature so heavily in Dracula’s broader themes of sex and gender roles were adopted into the AIDS discourse in order to, following Dollimore (1991), control the threat to the ‘healthy’ population who engaged in restrained heteronormative behaviour, promoting negative stereotypes of HIV contractors and their lives. The fact that this happened so directly in the case of Illinois is testimony to the strong presence of these ideas enshrined in the figure of Dracula.

Betwixt and Inbetween, Life and Death:

Dracula undoubtedly was used to fuel negative perceptions of HIV/AIDS and those living with it. However, a third crossover between the two may help to shed light on understandings of the disease yet to be considered. Anderson et al (2010) explain how HIV/AIDS and other incurable illnesses are thought to disrupt the way that everyday life is experienced, and the knowledge used to navigate this experience. The individuals are placed in a state of liminality and being unable to affirm a sense of self. This was the conclusion of Cayless et al (2010) from their study of prostate cancer sufferers. It is summarised as “ontological death… the known self was going to die or in the process of transformation into another as yet unknown self” (Anderson et al, 2010: p.1496). Liminality took hold as the patients entered a “state of confusion and uncertainty, of being ‘betwixt and between’ identities” (ibid: p.1496). AIDS renders the immune system incapable of distinguishing what is of the self and what is not (Chaudhuri, 1997). AIDS sufferers are caught in a liminal state between selves once realisation of the disease takes hold.

The point about liminality made by Anderson et al (2010) however is underdeveloped. Using the metaphor of Dracula allows this argument to be taken further. Van Helsing discusses with his ‘crew of light’ more details about those creatures known as vampires:

“They cannot die, but must go on age after age adding new victims and multiplying the evils of the world; for all that die from the preying of the Un-Dead becomes themselves Un-Dead, and prey on their kind” (Stoker, 2011: p.200).

The vampire is not referred to as alive or dead, but ‘un-dead’. Van Helsing sees Dracula as occupying a space between life and death, and he cannot be identified readily with either. He “imperils… his victims’ personal identities” (Arata, 1990: p.630) with his bite, forcing others to join him in this state of being neither dead or alive. Sexual encounters resulting in “the erasure of the conventional and integral self” (Craft, 1984: p.107) are central to Dracula’s plot, since Dracula is symbolically (or perhaps literally) performing sexual acts on his victims. Bram Stoker’s Dracula (2005) modifies the Count’s character to suggest that his own self is uncomfortable with this liminality. When he is on his deathbed, he asks Mina to “give me peace”, suggesting that being balanced between living and dying is almost too much to bear, as it was for the patients studied by Anderson et al (2010) and Cayless et al (2010). Dracula too is between identities - specifically between being dead or alive.

It is here that Dracula highlights a shortcoming of Anderson et al (2010). It is noted that the patients were “between identities” and “incompatible with ‘culturally established categories’” (ibid: 2010: p.1496) but it is not stated what these identities or categories are. Using Dracula, it becomes clear that the identities and categories in question could well be the most fundamental binary of human existence - life and death. Life could not continue as normal for those diagnosed with HIV - yet this idea is communicated by a person who, medically speaking, is still ‘alive’. The comparison with Dracula speaks for their state of being between life and death… ‘un-dead’, like the Count. While more solid accounts of patient experience are needed to test this suggestion more rigorously, it nonetheless identifies a similarity between Dracula and HIV patients, and in doing so takes a step not made by previous studies.

Other Vampires:

It should be noted however that Stoker’s novel represents a very specific position both in literature and ethnographically. As Reed (2010: p.305) points out, “Stoker essentially wrote ‘Victorian England’s Dracula’”, highlighting the cultural particularity of the Count’s relationship to infection. Wasik & Murphy (2012) note several instances from Romania where vampires could turn into cats, wolves and donkeys among other animals - bats, interestingly, are not on the list. Furthermore, “the vampire’s bite - so key to our understanding of him today - is largely absent from folkloric accounts of vampires” (ibid: p.83), yet it is a trope so fundamental to Dracula’s association with infection. Romanian folklore also overwhelmingly saw the vampire as a way to navigate the line between what was culture and what was nature (Balinisteanu, 2016). The link to disease is undeniably dependent on an ethnocentric conception of vampires.

Even Western conceptions of the vampire are very different today than in the 19th century. Vampires in Octavia Butler’s Fledgling, as opposed to draining life from human hosts, form an HIV-positive community of vampires who exchange bodily fluids for sexual pleasure and to support their own well-being (Fink, 2010). Deep emotional attachment, as opposed to sexual promiscuity, is s a common trait of the modern Western vampire. Edward Cullen in Twilight (2009) falls in love with a human girl and is very reluctant to suck blood out of her for fear of causing her pain. Let the Right One In (2009) is a teenage vampire film about coming of age and ‘discovering’ the opposite sex, as opposed to implying uninhibited sexual encounters. In detaching the vampire from ideas of unhindered sexual promiscuity, ideas which were used to demonise the homosexual community and “gay lifestyle” (Alcorn, 1998: p.72), the negative ideas of HIV/AIDS are shown to be drawn from a source ultimately locked in its own temporality.


Public understandings of infection have clearly been informed by Dracula. Dracula was the product of fears surrounding human susceptibility to a deadly virus, and in time came to be re-appropriated as a means of talking about and framing another disease almost 100 years after Dracula was first published. As Wasik & Murphy (2012: p.67) put it, the vampire is “contagion: a malevolence that creeps from victim to victim, spreading through bites, kisses, licks”. It is very clear how a powerful association with Dracula and HIV/AIDS came to be understood in terms of foreignness and sexual activity, but there is also much potential for shedding light on the liminal state of HIV/AIDS sufferers. Any future application of the Dracula metaphor however should be mindful of how Stoker’s creation is very culturally and temporally specific, and many other examples of vampires exist that have very different relationships with sex and infection. What this emphasises is that Dracula can be re-adopted to serve a new purpose with relation to disease, one which does not view HIV/AIDS sufferers as threats to the health of the nation (Harper & Raman, 2008) or the individual (Fink, 2010), but instead a way to investigate more deeply the lived experience of disease. ‘Enriched’ may not be the appropriate term to understand how this artistic, imaginative creation has influenced understandings of infection, but 120 years after Dracula’s publication, the potential is certainly there.

Originally written in December 2017.


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James Hanton

I write mostly for Outtake Mag, The Indiependent, The Wee Review and Starburst Magazine UK. I have also been published in The Guardian and The Quietus.