From the Guidelines
Glanders is a serious infectious disease caused by the bacterium Burkholderia mallei that primarily affects horses, donkeys, and mules, but can also infect humans through direct contact with infected animals or contaminated materials. The disease manifests in several forms, including respiratory, cutaneous, and systemic infections, with symptoms ranging from fever, cough, and nasal discharge to skin ulcers and abscesses in lymph nodes. In humans, glanders is rare but potentially fatal without proper treatment, as noted in the study published in Clinical Infectious Diseases in 2005 1. Some key points about glanders include:
- It is mainly a disease of solipeds (e.g., horses and mules) but can infect humans through inhalation or skin contact 1.
- Pustular skin lesions and lymphadenopathy with suppurative nodes can be a prominent feature 1.
- Treatment typically involves aggressive antibiotic therapy, with a recent laboratory-acquired case successfully treated with imipenem and doxycycline for 2 weeks, followed by azithromycin and doxycycline for an additional 6 months 1. The most effective treatment approach is to use a combination of antibiotics, such as imipenem and doxycycline, for at least 2-4 weeks, followed by oral antibiotics for 3-6 months. Prevention focuses on avoiding contact with infected animals, using personal protective equipment when handling potentially infected animals, and proper sanitation measures. Glanders is considered a potential bioterrorism agent due to its high mortality rate and ability to be aerosolized, making awareness and prompt recognition crucial for healthcare providers, as highlighted in the 2014 update by the Infectious Diseases Society of America 1.
From the Research
Definition and Overview of Glanders
- Glanders is a highly contagious and often fatal zoonotic disease, primarily of solipeds 2.
- It is caused by the bacterium Burkholderia mallei [(2,3)].
- Glanders has been eradicated in the developed world, but it remains a concern due to its potential use as a biological weapon 2.
Symptoms and Transmission
- The disease is characterized by ulcerating nodular lesions of the skin and mucous membrane 3.
- Generalized symptoms include fever, malaise, depression, cough, anorexia, and weight loss 3.
- Burkholderia mallei can invade its host through mucous membranes, gastrointestinal tract, and the integument 3.
Treatment and Countermeasures
- Treatment regimens for glanders typically involve the use of multiple antibiotics, such as ceftazidime, meropenem, trimethoprim/sulfamethoxazole, and amoxicillin/clavulanic acid [(4,5)].
- A study demonstrated the effectiveness of a 12-week treatment protocol using enrofloxacin, trimethoprim, and sulfadiazine, followed by doxycycline 5.
- Countermeasures against glanders include early detection, quarantine measures, testing, and safe destruction of infected carcasses 3.