Glanders

Glanders – General Information

Glanders is a disorder caused by the bacteria which belongs to the Burkholderia species; it is characterized by the appearance of some severe and specific symptoms and signs and it also result in patho-physiologic consequences. The interesting part about this disease is the fact that it is considered to be a potential weapon in the war between some countries. In order to sustain this, the doctors say that during the World War I, the Americans spread these bacteria in the Russian army and infected their mules and horses; in addition, during the World War II, the Americans are also considered to be guilty of infecting the Japanese prisoners and the civilians as well. Nowadays, the country which is most interested in this disease is the former Soviet Union. The bacteria which cause Glanders is a nonsporulating, nonmotile, gram negative and aerobic agent and tit usually affects the animals, especially mules, horses and donkeys. The studies have shown that this disease is quite unlikely to affect humans and this is the reason why an epidemic is extremely rare. Those who present a higher rate of suffering from this disease are those who spend a lot of time in the presence of infected animals, such as the abattoir workers, the veterinarians, the laboratory personnel and the animal caretakers. The good part is the fact that Glanders is nowadays almost completely eliminated; for example, in the USA it was eliminated since the 1945s and in the next 50 years it was reported only a case of human contamination.

Glanders- Symptoms

In what concerns the ways in which this disease can be transmitted from animals to humans, the most common one is through direct mucous membrane or skin contact. Apart from the animal to human transmission, there were also reported a few cases of human to human transmission. The most common symptoms of Glanders consist of rigors, myalgia, fever, night sweats, headaches and anorexia. In addition, considering the level of exposure, other signs and symptoms can appear: cough, lacrimation, chest pain, photophobia and diarrhea. If the disease is not diagnosed in due time, the symptoms can worsen and they can result in cervical adenopathy, skin lesions, splenomegaly and hepatomegaly. The most severe complications which were reported in the case of this disease include septicemia, urticaria, cyanosis, eruptions, flushing, cellulites, regional lymphadenitis or lympthangitis, cutaneous abscesses and even some forms of ulcer. The signs and symptoms which characterize this disorder can also affect the nervous system and cause confusion and hallucinations. If the disease affects firstly the lungs, the spleen, the kidney, the parotid gland or the brainstem, it can result in shock and acidosis and it can lead to sudden death within two days. In these conditions, if you develop any of the signs and symptoms presented above, you should seek for medical advice as soon as possible. The possibility of suffering from Glanders differs a lot on the occupational settings of a person, on the general area in which he lives and on the number of direct contacts which he has with an infected animal.

Glanders – Treatment

If you notice any abnormalities in your general health condition or if you develop any of the signs and symptoms which are associated with this disease, you should consult a specialized doctor as soon as possible. In order to diagnose Glanders, your doctor will probably choose one or more of the following tests: a blood count which may indicate the presence of leukocytosis which is usually associated with this disease and it can lead to the formation of hepatic abscesses, a physic examination which may reveal the presence of anemia, renal insufficiency or skin lesions, a urine and gram stain culture, a agglutination test which usually indicated a sure result if the disease is present for more than 8 days, a hemagglutiantion test or an enzyme test. In addition to these analyses, your doctor can also recommend you some complement fixation tests or a chest radiography which can give information about cavitating lesions. In what concerns the measures which can be taken in order to prevent the transmission of the disease from another infected person, one should take the regular precautions: the usage of a face shield or a surgical mask.

After a person is diagnosed with Glanders he should be isolated in a special room in order to reduce the possibility of infecting other people, in addition those who come into contact with an infected parson should always wear a mask. The first measure which must be taken is the administration of antibiotics in order to stabilize the disease and the patient’s general condition. The most common antibiotics which are used in order to treat this disease are trimethoprim, clavulanate, sulfamethoxazole (in the case of a local disease), streptomycin and ceftazidime (in the case of extrapulmonary disease) and imipenem-cilastatin or meropenem (in the case of extreme severe cases). In the case of extrapulmonary Glanders, surgery may also be necessary in order to drain the abscesses.

After the patient is stabilized, the doctor must inform the local authorities about the presence of this disease, as it can indicate an attack. In order to prevent the appearance of Glanders it is extremely important for those who work in abattoirs and specialized laboratories and, in general, those who spend a lot of time in the presence of animals to take all the necessary preventive measures. In those areas in which the animals are highly exposed to this disease and where the risk of the appearance of this disease is quite high, the local authorities should take the necessary measures in order to identify and eliminate the causes which lead to the evolution of the disorder. In addition, those who live in these areas are recommended to use gloves and boots while performing agricultural activities. If Glanders is not treated efficiently and as soon as possible it can lead to severe complications such as meningitis, septicemia, brain abscess, splenic abscess, liver abscess and osteomyelitis. If the patient does not receive medical care not even after these complications appear, he can experience sudden death within 48 hours.