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| Glanders Disease | |
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| Other names | Equinia, farcy,[1] malleus[2] |
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| The design of the water trough inhibits the dissemination of glanders disease among the watering horses, Philadelphia, Penn., U.S., 1917. | |
| Specialty | Infectious diseases,veterinary medicine  |
Glanders is a contagious,zoonoticinfectious disease caused by thebacteriumBurkholderia mallei, which primarily occurs inhorses,mules, anddonkeys, but can also be contracted by dogs and cats, pigs, goats, and humans. The termglanders derives from theMiddle English wordglaundres and from theOld French wordglandres, which both denoteglands.[3] Other terms for the glanders disease are theLatin:malleus, theSpanish:muermo, theGerman:Rotz, and theNorwegian:snive.
Glanders is endemic in Africa, Asia, the Middle East, and Central and South America. Elsewhere, glanders has been eradicated in North America, Australia, and most of Europe, by way of the zoological observation and destruction of infected and sick animals and quarantine restrictions upon the importation of said animals. Occurrences of glanders had not been reported in the U.S. since 1945, until a laboratory accident in 2000, wherein a laboratory researcher was accidentally exposed toBurkholderia mallei bacteria.[4] In the U.K., glanders is anotifiable disease, and there have been no occurrences reported since 1928.[5]
Signs of glanders include the formation ofnodularlesions in the lungs andulceration of themucous membranes in theupper respiratory tract. Theacute form of glanders results in coughing, fever, and the release of an infectious nasaldischarge, followed bysepticaemia and death within days. In thechronic form of glanders, nasal andsubcutaneous nodules develop, eventually ulcerating; death can occur within months, while survivors act as carriers.
Glanders is caused by infection with theBurkholderia malleibacterium, usually by way of the ingestion ofcontaminated animal feed and drinking water; because glanders is infectious to human beings, theB. mallei bacterium is classed as azoonotic agent. The transmission of glanders occurs by direct contact with the infected animal's body fluids and tissues, theB. mallei pathogen enters the human body through skin abrasions, through the nasal and the oral mucosal surfaces, and by inhalation.[6]
Themallein test is a sensitive and specific clinical test for glanders. Mallein (ATCvet code:QI05AR01 (WHO)), a protein fraction of the glanders organism (B. mallei), is injected intradermopalpebrally or given by eye drop. In infected animals, the eyelid swells markedly in 1 to 2 days.
Glanders has been known since antiquity, with a description by Hippocrates around 425BCE.[7]
From the Middle Ages to the 1900s, glanders was a significant threat to armies.[8][1] Before theBattle of Blenheim in 1704, glanders may have afflicted and greatly diminished the horses of Marshal Tallard's cavalry, helping the Duke of Marlborough win the battle.[9]
Glanders was a significant problem for civilian use of horses, as well. In the 18th-century veterinary hospital at theÉcole Nationale Vétérinaire d'Alfort, glanders was the most common disease among their equine patients and the one most likely to cause death.[10]
Due to the high mortality rate in humans and the small number of organisms required to establish infection,B. mallei is regarded as a potentialbiological warfare orbioterrorism agent, as is the closely related organism,B. pseudomallei, the causative agent ofmelioidosis. DuringWorld War I, glanders was believed to have been spread deliberately byGerman agents to infect large numbers ofRussian horses and mules on theEastern Front.[11]Other agents attempted to introduce the disease in the United States and Argentina. 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. TheJapanese deliberately infected horses, civilians, and prisoners of war withB. mallei at theUnit 731Pingfang (China) Institute andUnit 100 facilities duringWorld War II. The U.S. studied this agent as a possible biological 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. Between 1982 and 1984, theSoviet Union allegedly used weaponizedB. mallei during theSoviet–Afghan War.[12]
No vaccine is licensed for use in the U.S.[13] Infection with these bacteria results in nonspecific symptoms and can be either acute or chronic, impeding rapid diagnosis. The lack of a vaccine for either bacterium also makes them potential candidates for bioweaponization.[14] Together, with their high rate of infectivity by aerosols and resistance to many common antibiotics, both bacteria have been classified as category B priority pathogens by the US NIH and US CDC, which has spurred a dramatic increase in interest in these microorganisms. Attempts have been made to develop vaccines for these infections, which would not only benefit military personnel, a group most likely to be targeted in an intentional release, but also individuals who may come in contact with glanders-infected animals or live in areas where melioidosis is endemic.
It is a well established fact that the great and terrible ravages of glanders are found in the armies; it is certain that during all the wars under which Europe has laboured for 200 years, a very considerable number of horses has been lost through this disease."
However, the incurable murrain[Footnote1] this regiment contracted whilst sharing winter quarters with the French Sommeri Regiment had already put most of the troopers on their own two feet ─ and shortly afterwards this contagion spread to the whole army under the name of the "German sickness" for want of a better diagnosis. [Footnote1] This disease was probably "glanders." Eventually it affected a large part of Tallard's cavalry. The general condition of Marlborough's cavalry at the end of the long march to the Danube contrasted very favourably with the fettle of the French.
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