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Glanders
Classification and external resources
ICD-10 A24.0
ICD-9 024
DiseasesDB 5222
eMedicine emerg/884
MeSH D005896

Glanders (from Middle English glaundres or Old French glandres, both meaning glands)[1] (Latin: Malleus German: Rotz) (also known as "Equinia," "Farcy," and "Malleus"[2]:282) is an infectious disease that occurs primarily in horses, mules, and donkeys. It can be contracted by other animals such as dogs, cats and goats. It is caused by infection with the bacterium Burkholderia mallei, usually by ingestion of contaminated food or water. Symptoms 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, 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.

Burkholderia mallei is able to infect humans and is therefore 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), a protein fraction of the glanders organism (Burkholderia mallei), is injected intradermo-palpebrally or given by eye-drop. In infected animals, the eyelid swells markedly in 1 or 2 days.

Biological warfare use

Due to the high mortality rate in humans and the small number of organisms required to establish infection, Burkholderia mallei is regarded as a potential biological warfare (BW) or bioterrorism agent, as is the closely related organism, Burkholderia 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.[3] 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 Pinfang (China) Institute during World War II.

The U.S. studied this agent as a possible BW 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. The Soviet Union is also believed to have been interested in B. mallei as a potential BW agent after World War II.

References

  1. ^ "glanders". American Heritage Dictionary of the English Language: Fourth Edition. Bartleby.com. 2000. http://www.bartleby.com/61/18/G0141800.html. Retrieved 2007-05-13. 
  2. ^ James, William D.; Berger, Timothy G.; et al. (2006). Andrews' Diseases of the Skin: clinical Dermatology. Saunders Elsevier. ISBN 0-7216-2921-0. 
  3. ^ Woods, Lt. Col. Jon B. (ed.) (April 2005). USAMRIID’s Medical Management of Biological Casualties Handbook (6th ed. ed.). U.S. Army Medical Institute of Infectious Diseases, Fort Detrick, Maryland. pp. 67. .

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1911 encyclopedia

Up to date as of January 14, 2010

From LoveToKnow 1911

Medical warning!
This article is from the 1911 Encyclopaedia Britannica. Medical science has made many leaps forward since it has been written. This is not a site for medical advice, when you need information on a medical condition, consult a professional instead.

GLANDERS, or Farcy (Equinia), a specific infective and contagious disease, caused by a tissue parasite (Bacillus mallei), to which certain animals, chiefly the horse, ass and mule, are liable, and which is communicable from them to man. Glanders in the domesticated animals is dealt with under Veterinary Science; it is happily a rare form of disease in man, there being evidently less affinity for its development in the human subject than in the equine species. For the pathology see the article Parasitic Diseases. It occurs chiefly among those who from their occupation are frequently in contact with horses, such as grooms, coachmen, cavalry soldiers, veterinary surgeons, &c.; the bacillus is communicated from a glandered animal either through a wound or scratch or through application to the mucous membrane of the nose or mouth. A period of incubation, lasting from three to five days, generally follows the introduction of the virus into the human system. This period, however, appears sometimes to be of much longer duration, especially where there has been no direct inoculation of the poison. The first symptoms are a general feeling of illness, accompanied with pains in the limbs and joints resembling those of acute rheumatism. If the disease has been introduced by means of an abraded surface, pain is felt at that point, and inflammatory swelling takes place there, and extends along the neighbouring lymphatics. An ulcer is formed at the point of inoculation which discharges an offensive ichor, and blebs appear in the inflamed skin, along with diffuse abscesses, as in phlegmonous erysipelas. Sometimes the disease stops short with these local manifestations, but more commonly goes on rapidly accompanied with symptoms of grave constitutional disturbance. Over the whole surface of the body there appear numerous red spots or pustules, which break and discharge a thick mucous or sanguineous fluid. Besides these there are larger swellings lying deeper in the subcutaneous tissue, which at first are extremely hard and painful, and to which the term farcy "buds" or "buttons" is applied. These ultimately open and become extensive sloughing ulcers.

The mucous membranes participate in the same lesions as are present in the skin, and this is particularly the case with the interior of the nose, where indeed, in many instances, the disease first of all shows itself. This organ becomes greatly, swollen and inflamed, while from one or both nostrils there exudes a copious discharge of highly offensive purulent or sanguineous matter. The lining membrane of the nostrils is covered with papules similar in character to those on the skin, which form ulcers, and may lead to the destruction of the cartilaginous and bony textures of the nose. The diseased action extends into the throat, mouth and eyes, while the whole face becomes swollen and erysipelatous, and the lymphatic glands under the jaws inflame and suppurate. Not unfrequently the bronchial tubes become affected, and cough attended with expectoration of matter similar to that discharged from the nose is the consequence. The general constitutional symptoms are exceedingly severe, and advance with great rapidity, the patient passing into a state of extreme prostration. In the acute form of the disease recovery rarely if ever occurs, and the case generally terminates fatally in a period varying from two or three days to as many weeks.

A chronic form of glanders and farcy is occasionally met with, in which the symptoms, although essentially the same as those above described, advance much more slowly, and are attended with relatively less urgent constitutional disturbance. Cases of recovery from this form are on record; but in general the disease ultimately proves fatal by exhaustion of the patient, or by a sudden supervention, which is apt to occur, of the acute form. On the other hand, acute glanders is never observed to become chronic.

In the treatment of this malady in human beings reliance is mainly placed on the maintenance of the patient's strength by strong nourishment and tonic remedies. Cauterization should be resorted to if the point of infection is early known. Abscesses may be opened and antiseptic lotions used. In all cases of the outbreak of glanders it is of the utmost consequence to prevent the spread of the disease by the destruction of affected animals and the cleansing and disinfection of infected localities.


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