Glanders is an infectious disease caused by the bacterium Burkholderia mallei, primarily affects equidae, including horses, donkeys and mules. It can also cause infection in goats, dogs and cats. Rarely, glanders can affect humans. However, the organism could be used as a bioterrorism agent.
How common is glanders?
Human infection has not been seen in the United States since 1945 and in Illinois since 1935. Glanders is still commonly seen among domestic animals in Africa, Asia, the Middle East, and Central and South America. Sporadic cases in humans may occur in parts of the world where glanders occurs in animals but are rare. Glanders can occur in laboratory workers handling specimens from infected cases and those in direct and prolonged contact with infected domestic animals (veterinarians and horse caretakers).
How is glanders usually transmitted and who can get it?
Glanders is typically transmitted to humans by direct contact with infected animals. The bacteria enter the body through the skin and through mucosal surfaces of the eyes and nose. In addition to animal exposure, instances of human-to-human transmission have been reported in persons in close contact with cases.
Why is there a concern about glanders as a bioweapon?
The organism is considered a potential agent for biological terrorism. The bacteria that cause glanders could be disseminated as an aerosol or by direct contact with infected material. Any suspected cases of glanders or exposure to the bacteria should be immediately reported to your local health department.
What are the symptoms of glanders?
The symptoms of glanders depend upon the way the infection was acquired. The types of infection include localized, pus-forming skin infections, respiratory infections, bloodstream infections, and chronic skin infections.
Localized infections: If there is a cut or scratch in the skin, a localized infection with ulceration will develop within one to five days at the site where the bacteria entered the body. Swollen lymph nodes also may be apparent. Increased mucus production from the eyes, nose and respiratory tract can occur.
Respiratory infections: In respiratory infections, pneumonia, pulmonary abscesses, and pleural effusion can occur. Chest X-rays will show localized infection in the lung lobes.
Bloodstream infections: Glanders bloodstream infections are usually fatal within seven to 10 days.
Chronic infections: The chronic form of glanders involves multiple abscesses within the muscles of the arms and legs or in the spleen or liver.
How is glanders diagnosed?
The disease is diagnosed in the laboratory by isolating Burkholderia mallei from blood, sputum, urine, or skin lesions. Serologic assays are not available. A polymerase chain reaction test is available at the IDPH laboratory.
Is there a treatment for glanders?
Because human cases of glanders are rare, there is limited information about treatment. Specific antibiotics may be effective in treatment of glanders.
What can a person do to prevent this illness?
There is no vaccine available for glanders. In countries where glanders is endemic in animals, prevention of the disease in humans involves identification and elimination of the infection in the animal population. Within the health care setting, transmission can be prevented by using common blood and body fluid precautions.