NEW YORK, Sep 21 (Reuters) -- Mistaken for blood-thirsty ghouls, 18th century European rabies victims may have been the inspiration for the vampire legend, according to a report in the September issue of the journal Neurology.

Not only do people with rabies have symptoms strikingly similar to the traits ascribed to vampires, but the vampire legend also originated in eastern Europe in the 18th century -- the site of a major rabies outbreak in the 1720s, according to the study.

Rabies, a virus usually transmitted via the bite of an infected animal, can be tricky to diagnose, the study's author, Dr. Juan Gomez-Alonso told Reuters Health in an interview. Symptoms usually do not appear for at least a couple of weeks, and by then the bite has healed. Once symptoms have appeared, antirabies treatment is ineffective, and the infection is most often fatal.

"Even now we miss diagnoses in cases of rabies," Gomez-Alonso said. Citing an example in his study, Gomez-Alonso describes a relatively recent case in which a man presumed to be a "wandering lunatic" was found to be infected with rabies during an autopsy. "These missed diagnoses probably happened much more commonly in the 18th century," Gomez-Alonso added.

A neurologist at Hospital Xeral in Vigo, Spain, Gomez-Alonso decided to investigate the rabies-vampirism connection after watching a vampire movie in 1981.

"I had never seen a vampire movie before and I was struck by the similarities," he explained.

There are many, Gomez-Alonso reports in the study. For starters, not only people, but dogs, wolves, and bats -- animals traditionally associated with vampires -- can be infected with the rabies virus. Because the virus affects the limbic system, part of the brain that influences aggressive and sexual behavior, people with rabies tend to be aggressive, may attempt to bite others, and are "hypersexual," he writes. Since rabies also affects the hypothalamus, part of the brain that controls sleep, many patients suffer from insomnia, and are up and about in the middle of the night.

Rabies causes hypersensitivity to strong stimuli, as well, so patients are often repelled by light, by bright things -- such as mirrors, and by strong odors -- including the smell of garlic. Rabies victims may vomit blood, Gomez-Alonso explains. And since the disease causes hydrophobia, or aversion to water, they do not swallow their saliva, which can froth at their mouths, flecked with blood.

The disease can also cause facial spasms, in which the lips jerk back over the teeth, in an animal-like snarl. Moreover, rabies is more common among men than women, as is vampirism, at least according to most vampire tales. Finally, rabies, like vampirism, can be transmitted via a bite, Gomez-Alonso writes. The infection, however, can also be transmitted via a scratch or across mucus membranes. Consequently, it can be contracted during sex with an infected partner, or by inhaling air in caves heavily populated by infected bats.

In addition to the medical evidence, Gomez-Alonso provides historical support for his theory. Digging through centuries-old European archives, he found records of a rabies epidemic among dogs, wolves and other animals in Hungary between 1721 and 1728, the time people first began to report sightings of "vampires." There were reports, for instance, of people "who have been dead for several years, or at least several months seen to return, to talk, to walk, to infest the villages to suck the blood of their close ones, making them become ill and eventually die."

Gomez-Alonso also found accounts of bodies, exhumed after burial, that appeared lifelike, and were filled with still-liquid blood. This also fits in with the rabies theory, he writes. When people die of collapse, shock or asphyxiation -- as is often the case with rabies -- their blood is often slow to clot. Moreover, the region of Hungary where the outbreak occurred is damp and cold many months of the year, significant because corpses take longer to decompose in the cold. "Their good appearance would also suggest the presence of saponification," he explains. "This process, characteristic of burials in humid places, transforms the subcutaneous tissues into a wax-like substance."

"Much evidence supports that rabies could have played a key role in the generation of the vampire legend," later popularized in Bram Stoker's "Dracula" and numerous other books and films, Gomez-Alonso concludes. "This would be in accordance with the anthropologic theory that assumes that many popular legends have been prompted by facts. Under this approach, saying that the vampire is 'mere fiction' may be somewhat inappropriate."

SOURCE: Neurology 1998;51:856-859.

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