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Disease has always been joined at the hip to superstition and fantasy - the term "influenza" once referred to the influence of unfriendly stars - but there's something especially, horribly otherworldly about the flu epidemic of 1918-1920, which claimed over 50 million lives. Invisible to the microscopes of the era, the Spanish flu was a phantom terror, its spread censored to shore up morale in the closing stages of the Great War. Where other outbreaks had ravaged children and the elderly, this one bizarrely reserved its worst excesses for hearty young adults: its effects included "cytokine storms" that turned stronger immune systems against themselves, drowning the afflicted in their own bodily fluids. With no cure forthcoming, many sufferers fell back on folk remedies and occult treatments, lining their nostrils with salt, tying ribbons to their arms and burning brown sugar or sulfur to chase away evil miasmas. It's from this tangle of science and myth, monsters of the imagination versus the monsters of the laboratory, that Dontnod's long-in-development Vampyr takes its cue.

Vampyr is an odd beast, the kind of cheesy yet high-concept fare Dontnod seems to specialise in, but its appeal and potential shortcomings are easy to summarise: it's one kind of game eating another kind of game alive, a third-person RPG-brawler with its fangs sunk into the neck of an open-ended, dialogue-driven adventure game. Brooding, hirsute protagonist Jonathan Reid is boss doctor at a London hospital in 1918, charged with the well-being of 60 fully fleshed-out civilian characters, from flu patients and recovering soldiers to the crooks, shopkeepers, scholars and charlatans in the pubs and alleyways beyond. He's also, however, a closet vampire who spends his leisure hours duffing up would-be Van Helsings and other, less sociable varieties of undead, and he needs plenty of blood to unlock and improve his abilities.

You'll steal a few mouthfuls of gore from opponents in combat, all of whom appear to be generic characters that can be slain with impunity, but the most bountiful sources are the civilians in your care. It creates a rather dramatic conflict of interest - and a potent balance of player priorities, with the consequences writ large both in the number of plot threads available and the ambience of this region-based open world. Are you just another mindless plague in a plagued city, reducing hard-up districts to flame-licked wastelands devoid of friendly presences, tearing the very narrative fabric of the game apart as you thin out London's ailing society? Or will you try to discriminate between the deserving and undeserving, or even do without those precious level-ups entirely?

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