glanders

Glanders: A Rare and Infectious Disease

Glanders is an infectious disease caused by the bacterium Burkholderia mallei, which can affect both animals and humans. It is a highly contagious and often fatal zoonotic disease, primarily affecting solipds (horses, donkeys, and mules) [1].

Transmission and Incubation

Glanders is spread to humans through direct contact with infected animals, typically through cuts or scrapes in the skin, as well as through mucosal surfaces of the eyes and nose. In rare cases, it can also be transmitted from person to person through bodily fluids of an infected individual [3].

The incubation period for glanders ranges from 1 day to 2 weeks, after which symptoms may appear, including fever and any of four clinical manifestations: cutaneous, respiratory, gastrointestinal, or genitourinary [15].

Geographic Distribution

Glanders is most commonly found in Asia, Africa, and South America. However, it has been reported in other regions, including the United States, where an American research microbiologist contracted the disease in 2001 [5].

Biodefense Concerns

Due to its high mortality rate and potential for transmission, Burkholderia mallei is considered a biodefense concern. Its use as a biological weapon has been documented, highlighting the need for vigilance and preparedness against this infectious agent [14].

References:

[1] Context 12 [3] Context 13 [5] Not provided (not relevant to the context) [14] Context 14 [15] Context 15

Common Signs and Symptoms of Glanders

Glanders, a disease that affects animals and can be transmitted to humans, presents with various symptoms depending on the form and severity of the infection.

• Acute Form: In donkeys and mules, glanders typically manifests as high fever and respiratory signs. In horses, it generally takes a more chronic course.
• Chronic Form: Horses infected with glanders may exhibit intermittent fever, cough, weight loss, yellow-green nasal discharge, and ulcers on the nose [1].
• Common Symptoms: Fever, muscle aches, chest pain, muscle tightness, headache, watery eyes, sensitivity to light, and nasal discharge are common symptoms of glanders in both animals and humans [2].
• Cutaneous Infection (Skin): A patient with cutaneous infection may experience swelling and sores at the site of the skin infection, along with swollen lymph nodes [7].

Symptoms in Animals

In animals, the most common sign of infection is yellow-green nasal discharge and ulcers on the nose [5]. Symptoms of acute illness include fever, weight loss, cough, and nasal discharge, which typically is thick and yellowish white. The disease progresses rapidly [6].

References: [1] - Clinical signs for the chronic form of glanders in horses include intermittent fever, cough, weight loss, yellow-green nasal discharge, and a ... [2] - Common symptoms of glanders include fever, muscle aches, chest pain, muscle tightness, headache, watery eyes, sensitivity to light, and nasal ... [5] - How does glanders affect my animal? The most common sign of infection in animals is yellow-green nasal discharge and ulcers on the nose. [6] - Symptoms of acute illness include fever, weight loss, cough, and nasal discharge, which typically is thick and yellowish white. The disease progresses rapidly; ... [7] - Cutaneous infection (skin): A patient will have swelling and sores at the site of the skin infection. The person also may have swollen lymph nodes.

Diagnostic Tests for Glanders

Glanders, a bacterial disease caused by Burkholderia mallei, can be diagnosed through various tests. Here are some of the diagnostic tests used to detect glanders:

• Complement Fixation Test (CFT): The CFT is an accurate serological test that has been used for many years to diagnose glanders. It delivers positive results within 1 week post-infection [1].
• Mallein Test: This is a sensitive and specific clinical test for glanders, which is a type 4 delayed hypersensitivity test used as a diagnosis for the disease [3]. It is caused by a bacterium called Burkholderia mallei, which is contagious for humans and other species [3].
• ELISA (Enzyme-Linked Immunosorbent Assay) Test: This test has been developed to detect glanders in various host species. A competitive ELISA with high sensitivity and specificity can be used as a diagnostic tool [15].
• Western Blot: The Western blot, using a LPS-preparation, showed a markedly higher diagnostic specificity when compared to the CFT and was used as a confirmatory test for glanders [15].
• Culture and PCR (Polymerase Chain Reaction): These tests can be used to confirm the diagnosis of glanders. Culture and PCR are considered gold standard methods for diagnosing glanders [8, 10].

Additional Diagnostic Methods

In addition to these tests, other diagnostic methods include:

• Microscopy: Microscopic examination of samples from lesions or sputum can help diagnose glanders.
• Clinical Epidemiology: Clinical diagnosis of glanders is based on the presence of nasal ulcers, complement fixation test reaction, positive mallein test, and culture and PCR [8].
• Blood Tests: Blood tests can be used to detect antibodies against Burkholderia mallei in infected animals.

References

[1] The CFT is an accurate serological test that has been used for many years for diagnosing glanders. It will deliver positive results within 1 week post-... (Search Result 6)

[3] Mallein test being performed in 1918. The mallein test is a sensitive and specific clinical test for glanders, a common bacterial disease of equids (horses, donkeys, mules). [3]

[15] The Western blot, using a LPS-preparation, showed a markedly higher diagnostic specificity when compared to the CFT and was used as a confirmatory test for glanders. ELISAs developed include a competitive ELISA with a high sensitivity and specificity that can be used in various host species [20].

Note: The references provided are based on the search results within the context.

Treatment Options for Glanders

Glanders, a zoonotic disease caused by Burkholderia mallei, requires prompt and effective treatment to prevent complications and transmission. While there is no cure for glanders, various antibiotics have been used to manage the infection.

• Sulfadiazine: This antibiotic has been found to be effective in treating humans infected with glanders [8]. It is often given as a primary treatment method.
• TMP-SMX (Trimethoprim/Sulfamethoxazole): This sulfa-based drug is considered the drug of choice for preventing illness after contact with glanders [6].
• Sodium sulfadiazine: In animal studies, sodium sulfadiazine has been shown to effectively treat acute glanders in hamsters [9].

However, it's essential to note that some strains of B. mallei have proven resistant to antibiotics [4]. Additionally, treatment can be risky even in endemic areas and may not always be allowed outside these regions [5].

Challenges in Treatment

The effectiveness of antibiotic treatment for glanders is often limited by the bacterium's resistance to various medications. Long-term treatment with a combination of antibiotics has been shown to eliminate the agent from the organism, but this approach can have its own set of challenges [3].

Differential Diagnosis of Glanders

Glanders, a disease caused by the bacterium Burkholderia mallei, can be challenging to diagnose due to its similarity with other infectious diseases. The differential diagnoses for glanders include:

• Infectious diseases causing fever, headache, muscle pain: These symptoms are common in various infections, making it essential to consider glanders as a possible diagnosis.
• Pneumonia, abscesses, or skin involvement: Glanders can manifest with these symptoms, which can also be present in other conditions such as melioidosis, strangles, and ulcerative lymphangitis.
• Melioidosis: This disease, caused by Burkholderia pseudomallei, can have similar symptoms to glanders, including pneumonia and abscesses.
• Strangles: A highly contagious respiratory infection in horses, which can cause fever, lethargy, and swelling of the lymph nodes.
• Ulcerative lymphangitis: A condition characterized by inflammation of the lymphatic vessels, which can lead to skin lesions and abscesses.
• Pseudotuberculosis: A bacterial infection that can cause symptoms similar to glanders, including fever, diarrhea, and abdominal pain.
• Epizootic lymphangitis: A disease caused by Histoplasma capsulatum, which can manifest with symptoms such as fever, cough, and skin lesions.

Key Points

• Glanders is a zoonotic disease, meaning it can be transmitted from animals to humans.
• The disease primarily affects horses, donkeys, and mules, but rare cases have been reported in humans.
• A definitive diagnosis of glanders requires isolation of the organism and positive identification.
• Radiology may reveal abscesses or other lesions associated with glanders.

References

1. [5] Glanders is a disease caused by the bacterium Burkholderia mallei, which mainly affects horses, donkeys, and mules.
2. [3] Differential Diagnosis: Pulmonary glanders and melioidosis – include mycoplasma pneumonia, Legionnaire's disease, psittacosis, plague...
3. [8] Signs of glanders must be distinguished from melioidosis, strangles, lymphangitis, ulcerative lymphangitis, and other forms of pneumonia.
4. [9] Diagnostics. The definitive diagnosis of glanders requires isolation of the organism and positive identification.

Note: The numbers in square brackets refer to the context numbers provided for each reference.