Background

Glanders is an infectious disease caused by the bacterium Burkholderia mallei. It is primarily a disease of horses, donkeys, and mules, though other animals such as goats, cats and dogs can be infected. Animal glanders was eliminated from the United Kingdom, United States of America and Canada in the early part of the 20th century, but still occurs occasionally in parts of Europe, Africa, Asia, the Middle East, and Central and South America. The organism is not found in the environment, existing only in infected animals.

Human cases are extremely rare and generally require prolonged and close contact with infected animals.

Transmission

Human infection may be acquired following close contact with infected animals, but can also occur following accidental exposure in a microbiology laboratory. It is likely that infection occurs via cuts or wounds, by direct contact with the eyes and nose, by inhalation, and possibly by ingestion.

The organism is in Hazard Group 3 and must be handled appropriately in the laboratory. Please call the Reference Laboratory for advice and confirmatory testing. Further advice on diagnosis, management and treatment is also available.

Human disease

The usual incubation period before symptoms appear is from 10 to 14 days, but may be as long as several weeks. Most cases have followed prolonged and close contact with a sick infected animal. Historically, different forms of disease in humans have been described, depending on the route of infection.
General symptoms include fever, sweats, malaise, and muscle aches.
1. Acute localised skin infection, with ulceration, discharge, and swollen lymph nodes
2. Lung infection - with pneumonia, lung abscesses or "fluid on the lung". Symptoms include chest pain, cough and shortness of breath
3. Bloodstream infection ('blood poisoning' or 'septicaemia') this is the most serious form of infection. Symptoms include very high fever, fast heart rate, and often a rash
4. Chronic infection with abscesses in the skin and muscles, or more rarely, the liver and spleen

Treatment and prevention

In the past, untreated severe disease had a high mortality rate. However, because the disease has been so rare over the past 50 years, few cases have been treated with antibiotics. Prompt diagnosis and appropriate antibiotic treatment will decrease severity of disease and improve survival.

There is no vaccine. Prevention of naturally occurring disease involves the detection and eradication of infected animal cases.

For further information on glanders in animals:- http://archive.defra.gov.uk/foodfarm/farmanimal/diseases/atoz/glanders/