Romania is one of those former Communist Block countries whose regime all but destroyed the country and its people. This novel begins just after the fall of the last leader, when the USSR began to splinter in 1989. Part of the legacy of the deposed dictator was orphanages, overflowing with neglected, starving, sick children... many of them with AIDS, spread by the use of dirty needles.
Humanitarian aid is, of course, forthcoming, and one of the medical specialists, Kate Neuman, notices a strange case where the infant thrives when given a transfusion - including healing of weeks-old bruises. She adopts the child and takes him back to the US, where tests begin to isolate a strange version of a recessive disease, a blood condition that could hold the key to curing cancer and AIDS.
But there's more going on than she realizes. And when baby Joshua is taken away from her, she has to go back to Romania, to unravel the roots of a century-old family, perhaps the inspiration for vampires, whose progenitor is none other than Vlad Tepes, the original Dracula...
Simmons describes Romania with all the gritty realism that makes the story all the more terrifying, as one can imagine such stories being all too true. The blood disease is all too common a side effect of inbred populations and gives an underpinning of plausibility to the narrative. And, as is appropriate, much of the story takes place in the dark.