Glanders

A bacterial infection that causes a chronic debilitating disease of equids (horses, mules, and donkeys) as well as some members of the cat family and is transmissible to people. The bacterium responsible for glanders is Burkholderia mallei (formerly called Pseudomonas mallei).

Glanders attacks the mucous membranes of the nostrils, producing increased secretion and discharge of mucus, and enlargement and induration of the lymph glands of the lower jaw. Hence, the name glanders from the French glandres meaning glands.

Glanders occurs in central and southeast Asia, the Middle East, parts of Africa, and possibly South America. It usually is acquired through direct skin or mucous membrane contact with infected animal tissues. The incubation period is 1 to 14 days. The clinical presentation varies; skin inoculation can result in localized infection with nodule formation and swollen glands. The disease often manifests as pneumonia, bronchopneumonia, or lobar pneumonia, with or without bacteremia (bacterial blood stream infection). There may be liver and spleen involvement.

Antibiotics such as trimethoprim/sulfamethoxazole have been used to treat humans. The mortality from this infection was approximately 95% before the use of antimicrobial agents; however, except when bacteremia develops, better diagnosis and more appropriate therapy have lowered mortality. No vaccine against this infection is available. — The General Accounting Office, the investigative arm of the US Congress, in a 1999 report considered glanders to be a “potential” biologic threat for terrorism, but noted it is difficult to acquire seed stock of the agent (Burkholderia mallei) and moderately difficult to process and disseminate it. The agent is very stable. Its lethal effects were deemed to be “moderate to high.”