Glanders (Burkholderia mallei)
Resulting from an infection by the bacterium known as Burkholderia mallei, Glanders is a disease that predominantly impacts horses. There have been reports of the disease in mules, donkeys, goats, cats, and dogs. Since 1945, there have been no reports of the disease in humans in the United States. There have been very rare instances of the infection in workers in laboratory settings and individuals who worked in close proximity with infected animals.
Burkholderia mallei requires only a few organisms in order for an instance of disease to occur. This is why the bacterium is often related to infections that occur amongst workers in laboratories. Burkholderia mallei is said to be a prospective candidate to be developed for biological warfare.
Glanders is frequently found in domestic animals of South America, Africa, the Middle East, Central America, and Asia. Transmission of Glanders occurs when humans come in direct contact with animals that have been infected. Burkholderia mallei penetrates the skin or enters through the eyes or the nose. There have been reports of sporadic instances occurring in people who work with horses, lab workers, and veterinarians.
Glanders has various routes of infection that determines its symptoms. The routes of infection are: chronic suppurative infections of the skin, cutaneous infections that are localized and form pus, bloodstream infections, and pulmonary infections. General clinical manifestations include muscle aches and tightness, teary eyes, headache, light sensitivity, chest pain, diarrhea and fever.
Localized infections that occur via a scratch or a cut in the skin will develop an ulcer in one to five days. The lymph nodes can swell. If localized infection has occurred through the eyes, nose, or respiratory tract, mucous production will increase in the mucous membranes of the areas. Symptoms of pulmonary infections include pulmonary abscesses, pulmonary infections, pleural effusions, and pneumonia. Your doctor may require x-rays of the chest to examine infection of the lungs. Bloodstream infections are fatal and can kill in just a week. Chronic infections manifest as multiple abscesses in arm muscles or leg muscles. Multiple abscesses can also form in the liver or the spleen.
Glanders is diagnosed using laboratory testing of the urine, blood, skin lesions, or the sputum to isolate Burkholderia mallei. Serologic assays are not an option. Glanders can spread via contact with animals as well as person to person. Sexual transmission has been reported as well as infection of familial relations who were nursing an infected individual.
While there is no vaccine against Glanders, prevention of the disease is possible by eliminating infection in animal populations. In medical institutions, precaution should be taken against contact with blood and any bodily fluids. Information on treatment of Glanders in humans is limited because instance is so rare. The antibiotic treatment Sulfadiazine has been successful in both humans and animals. The bacterium Burkholderia mallei tends to respond to sulfonamides, ciprofloxacin, tetracyclines, novobiocin, streptomycin, gentamicin, imipenem, and ceftrazidime. It has been reported that the bacterium is resistant to chloramphenicol.