Vampire tourism and vampirism: the darker side of travel medicine Free

Dear Editor,

The interface between travel medicine and mental health continues to gain traction,¹ with recent articles about gambling disorder and drug tourism published in this journal.^2,3 The term ‘dark tourism’ refers to the travel of individuals to destinations and sites linked to death, tragedy and the macabre. Though morbid curiosity has always existed throughout human civilisation, this specific entity was first described as recently as 1996.⁴ Journeys to Auschwitz concentration camp and other sites of mass genocide are examples of dark tourism, as are visits to the hometowns of serial killers and sites associated with the grislier myths of popular culture, such as Bran’s (Dracula’s) Castle in Transylvania. Dark tourism brings into context a relatively underrepresented facet of travel medicine, that of psychological care.

Travel to ‘high valence destinations’ (HVDs), without any association with ‘dark tourism’ such as sites of significant religious, spiritual or cultural value, has previously been associated with mental disorder including travel-related psychosis (TrP), in individuals both with and without a pre-existing psychotic or other mental disorder.⁵ Jerusalem syndrome, for example, is associated with an acute psychotic episode in tourists who visit Jerusalem and has an estimated incidence of 19.7 per 100 000 travellers. Similar psychotic episodes have been described for tourists to several other ‘non-dark tourism’ locations of cultural significance, including Hawaii, India, Nepal and Florence.⁵ The risk of mental disorder in travellers can additionally be increased secondary to distressing or traumatic events during travel—witnessing a death, being involved in an accident or being assaulted, for example. Indeed, there is a general consensus that being away from one’s familiar environment can increase travellers’ vulnerability to psychological distress and potentially mental disorder. Thus, travelling to sites considered ‘dark’ may potentially further increase the risk of mental disorder. To date, however, there are no available data examining the incidence of mental disorder in individuals engaged in ‘dark tourism’ or indeed ‘vampire tourism’.

Vampire tourism is an intriguing cultural consideration when considering travel to HVDs and any putative association with mental disorder. The vampire myth exists in many cultures, with Irish author Bram Stoker’s ‘Dracula’ being the poster child for the traditional vampire figure. In more recent years, ‘The Twilight Saga’ series has had an enduring impact on popular culture. The books and films were responsible for a boom in vampire tourism to locations associated with the series, namely Forks, Washington and Volterra, Italy. The remote town of Forks witnessed an increase in tourism from a baseline of close to zero to 70 000 a year following the release of Twilight in the late 2000s. In the following decade, up to a 100 Twilight fans have travelled to the Volterra Visitor Centre daily, leading Volterra’s local tourism office to protest, ‘We don’t want to become the city of the vampires’.⁶ The city of Brasov, Transylvania, is another well-recognized location for vampire tourism. Brasov was the site of raids led by Vlad the Impaler, the supposed real-life inspiration for Count Dracula. Vlad III—a Wallachian ruler of the 15th century was notorious for his brutality and mass killings, with stories of cruel and bizarre torture circulating in Germanic and Slavic regions for centuries in his wake. Visits to Vlad’s castle and burial site are popular among vampire tourists, bringing into focus the lurid background of dark tourism destinations.

Although vampirism is a pervasive legend, it can be associated with severe mental disorder. Sometimes referred to as ‘Renfield’s syndrome’ it is characterized by a patient’s compulsion to consume blood, their own or another’s. Indeed, vampirism and lycanthropy (belief that one is a werewolf) have been referred to as the ‘tropical diseases’ of psychiatry. Vampirism has consistently been documented in the psychiatric literature,⁶ with psychotic illnesses including schizophrenia most commonly diagnosed. The merging of reality and legend that is implied by the existence of clinical vampirism is what makes vampire tourism all the more morbid and calls into question the motivations for dark tourism—harmless morbid interest or perhaps a sort of ‘voyage pathologique’? Unfortunately, the emergence of major mental disorder including psychotic illnesses in tourists is associated with significant distress. Attaining timely and appropriate interventions is often challenging, and repatriation to one’s home country is often complex and indeed sometimes not covered by travel health insurance.⁷

It is hard to state with certainty why people are drawn to such places. Some argue that tourist visits to places associated with death allows for the philosophical examination of death, others that there is simply a thrill in the macabre. Whatever the motivation, dark tourism is a modern travel phenomenon and is therefore of relevance to the travel medicine community. There is a need for novel research that investigates the capacity of travellers, especially those with mental disorder, to cope psychologically with travel to emotionally challenging destinations.

Funding

None received.

Conflicts of interest

None.

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