What is glanders?
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Glanders is an infectious and life-threatening disease that mainly affects horses, donkeys or mules caused by the bacterium Burkholderia mallei. Glanders can be transmitted to humans. Susceptibility to glanders has also been demonstrated in camels, felines living in the wild, bears, wolves and dogs. Carnivores may become infected by eating infected meat. Guinea pigs and hamsters are highly susceptible. The infection is generally fatal. The incubation period varies from a few days to many months depending on the intensity of exposure.
Glanders has been recognised since antiquity. Hippocrates considered it to be a serious disease of equidae. The disease principally affected the cavalry and was a major zoonotic threat for veterinarians and stable hands. The worldwide prevalence of glanders has been considerably reduced through the actions of the Veterinary Services and national control programmes.
Glanders is an OIE-listed disease as described in the Terrestrial Animal Health Code of the World Organisation for Animal Health (OIE). As indicated in the OIE Terrestrial Animal Health Code any occurrence of glanders must be notifi ed to the OIE.

Where is the disease found?
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The disease has been eradicated in North America, Australia and Europe through testing and then eliminating any infected animals, coupled with import control measures. However, glanders remains sporadically reported in a number of Asian, African, Middle Eastern, and South american countries. In April 2010, Bahrain notified the first occurrence of the disease; in Brazil, the disease reappeared in 2009.

How is the disease transmitted and spread?
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The most common source of infection is ingestion of contaminated food or water. Contaminated aerosols (produced by coughing and sneezing), and contaminated fomites brought to the animals via grooming equipment and tack may also be a source of infection. The bacteria can also enter the body through contact with lesions or abrasions of the skin or through mucosa. In this case, a local infection with ulceration may develop spreading to other parts of the body in the course of the disease. Poor husbandry and feeding conditions as well as animal transport can be predisposing factors. Unsanitary conditions and over-crowded stables are risk factors

What is the public health risk associated with this disease?
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Glanders is a life-threatening zoonosis and no vaccines exist. It is a rare disease in humans with cases having occurred in veterinarians, other people working closely with horses, and laboratory workers. In addition to animals with clinical disease, asymptomatically infected animals pose a risk to humans. Humans are accidental hosts and human to human transmission is rare.
In humans the disease can take different forms such as: nasal, localized with nodules and abscesses, pulmonary, septicemia with disseminated or chronic infection, respectively. A cure is possible, however, if cases are treated rapidly with antibiotics; fatality rates for untreated infections are very high. Infection can occur through direct contact with infected animals, their secretions, and through indirect contact with contaminated fomites, food, soil, and water. Transmission to humans can be avoided by controlling the disease in animals, avoiding contact with infected animals, and by taking precautionary hygiene measures. Potentially contaminated material should only be handled in a laboratory using appropriate biosafety and biosecurity measures, in accordance with the rules laid down in the OIE Manual of Diagnostic Test and Vaccines for Terrestrial Animals.

What are the clinical signs of the disease?
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The disease causes nodules and ulcerations in the respiratory tract and lungs in animals. A skin form, known as‘farcy’, also occurs. Both acute and chronic forms of the disease have been described. Acute forms occur most frequently in donkeys and mules, with high fever and respiratory signs. In horses, glanders generally takes a more chronic course and they may survive for several years.
There are four recognised clinical presentations of glanders:
– Nasal,
– Pulmonary,
– Cutaneous,
– Asymptomatic carrier.
These different forms of glanders are usually referred to according to the location of the initial infection. The nasal and pulmonary forms tend to be more acute while the cutaneous form is a chronic process. Infl ammatory nodules and ulcers develop in the nasal passages and give rise to a sticky yellow discharge. Stellate scarring follows upon healing of the ulcers. The formation of nodular abscesses in the lungs is accompanied by progressive debility, coughing and may also be accompanied by diarrhoea. In the cutaneous form (“farcy’), the lymph vessels are enlarged; nodular abscesses form along their course, which then ulcerate and discharge yellow pus. Nodules are regularly found in the liver and spleen, leading to wasting and death.