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|Other names||Equinia, farcy, malleus|
|Specialty||Infectious disease, Veterinary medicine|
Glanders is an infectious disease that occurs primarily in horses, mules, and donkeys. It can be contracted by other animals, such as dogs, cats, goats and humans. It is caused by infection with the bacterium Burkholderia mallei, usually by ingestion of contaminated feed or water. Signs of glanders include the formation of nodular lesions in the lungs and ulceration of the mucous membranes in the upper respiratory tract. The acute form results in coughing, fever, and the release of an infectious nasal discharge, followed by septicaemia and death within days. In the chronic form, nasal and subcutaneous nodules develop, eventually ulcerating. Death can occur within months, while survivors act as carriers.
Glanders is endemic in Africa, Asia, the Middle East, and Central and South America. It has been eradicated from North America, Australia, and most of Europe through surveillance and destruction of affected animals, and import restrictions.
B. mallei is able to infect humans, so is classed as a zoonotic agent. Transmission occurs by direct contact with infected animals and entry is through skin abrasions, nasal and oral mucosal surfaces, or by inhalation.
The mallein test is a sensitive and specific clinical test for glanders. Mallein (ATCvet code: QI05AR01 (WHO)), a protein fraction of the glanders organism (B. mallei), is injected intradermopalpebrally or given by eye drop. In infected animals, the eyelid swells markedly in 1 to 2 days.
Glanders has not been reported in the United States since 1945, except in 2000, when an American lab researcher suffered from accidental exposure. It is a notifiable disease in the UK, although it has not been reported there since 1928. The term is from Middle English glaundres or Old French glandres, both meaning glands; Latin: malleus, German: Rotz.
Historical cases, contagion, and potential use in war
Due to the high mortality rate in humans and the small number of organisms required to establish infection, B. mallei is regarded as a potential biological warfare or bioterrorism agent, as is the closely related organism, B. pseudomallei, the causative agent of melioidosis. During World War I, glanders was believed to have been spread deliberately by German agents to infect large numbers of Russian horses and mules on the Eastern Front. Other agents attempted to introduce the disease in the United States and Argentina. This had an effect on troop and supply convoys, as well as on artillery movement, which were dependent on horses and mules. Human cases in Russia increased with the infections during and after WWI. The Japanese deliberately infected horses, civilians, and prisoners of war with B. mallei at the Unit 731 Pingfang (China) Institute and Unit 100 facilities during World War II.
The U.S. studied this agent as a possible biological weapon in 1943–44, but did not weaponize it. U.S. interest in glanders (agent LA) continued through the 1950s, except it had an inexplicable tendency to lose virulence in the lab, making it difficult to weaponize. Between 1982 and 1984, the Soviet Union allegedly used weaponized B. mallei during the Soviet–Afghan War.
Before the Battle of Blenheim in 1704, glanders may have afflicted and greatly diminished the horses of Marshal Tallard's cavalry, helping the Duke of Marlborough win the battle.
Historian Lise Wilkinson has described the incredible difficulty of studying outbreaks of glanders in history. Glanders was a significant problem for civilian use of horses, as well. In the eighteenth-century veterinary hospital at the École Nationale Vétérinaire d'Alfort, glanders was the most common disease among their equine patients and the one most likely to cause death.
No vaccine is licensed for use in the U.S. Infection with either of these bacteria results in nonspecific symptoms and can be either acute or chronic, impeding rapid diagnosis. The lack of a vaccine for either bacterium also makes them potential candidates for bioweaponization. Together, with their high rate of infectivity by aerosols and resistance to many common antibiotics, both bacteria have been classified as category B priority pathogens by the US NIH and US CDC, which has spurred a dramatic increase in interest in these microorganisms. Attempts have been made to develop vaccines for these infections, which would not only benefit military personnel, a group most likely to be targeted in an intentional release, but also individuals who may come in contact with glanders-infected animals or live in areas where melioidosis is endemic.
- James, William D.; Berger, Timothy G.; et al. (2006). Andrews' Diseases of the Skin: clinical Dermatology. Saunders Elsevier. ISBN 978-0-7216-2921-6.
- "Glanders: Information for Health Care Workers". CDC.gov. Retrieved 8 April 2016.
- Department for Environment, Food & Rural Affairs and Animal and Plant Health Agency. "Notifiable diseases in animals". United Kingdom Government. Retrieved 8 April 2016.
- "glanders". American Heritage Dictionary of the English Language: Fourth Edition. Bartleby.com. 2000. Archived from the original on 2008-01-31. Retrieved 2007-05-13.
- Woods, Lt. Col. Jon B. (ed.) (April 2005). USAMRIID's Medical Management of Biological Casualties Handbook (PDF) (6th ed.). U.S. Army Medical Institute of Infectious Diseases, Fort Detrick, Maryland. p. 67. Archived from the original (PDF) on 2007-06-09.CS1 maint: Extra text: authors list (link).
- Van Zandt, Kristopher E.; Greer, Marek T.; Gelhaus, H. Carl (September 3, 2013). "Glanders: an overview of infection in humans". Orphanet Journal of Rare Diseases. 8: 131. doi:10.1186/1750-1172-8-131. PMC 3766238. PMID 24004906.
- Wilkinson, Lise (1981). "Glanders: Medicine and Veterinary Medicine in Common Pursuit of a Contagious Disease" (PDF). Medical History. 25 (4): 363–384. doi:10.1017/S0025727300034876.
- Heintzman, Kit (2018). "A cabinet of the ordinary: domesticating veterinary education, 1766–1799". The British Journal for the History of Science. 51 (2): 239–260. doi:10.1017/S0007087418000274. PMID 29665887.
- "Glanders: Prevention". CDC.gov. Retrieved 6 April 2016.
- Dance, David Allan Brett (2009). "Melioidosis and Glanders as Possible Biological Weapons". Bioterrorism and Infectious Agents: A New Dilemma for the 21st Century. pp. 99–145. doi:10.1007/978-1-4419-1266-4_4. ISBN 978-1-4419-1265-7.
- CDC list of articles on glanders
- Current status of Glanders worldwide at OIE. WAHID Interface - OIE World Animal Health Information Database
- Disease card
- Animal health aspects of glanders
- Center for Biosecurity Agent Fact Sheet
- Burkholderia mallei genomes and related information at PATRIC, a Bioinformatics Resource Center funded by NIAID
- Notes On Glander Disease in Horse