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[Glanders--a potential disease for biological warfare in humans and animals]
Ofer Lehavi1, Orna Aizenstien, Lior H Katz
1Department of Radiology, Tel Aviv Medical Center.
Abstract:
Infection with Burkholderia mallei (formerly Pseudomonas mallei) can cause a subcutaneous infection known as "farcy" or can disseminate to condition known as Glanders. It is primarily a disease affecting horses, donkeys and mules. In humans, Glanders can produce four types of disease: localized form, pulmonary form, septicemia, and chronic form. Necrosis of the tracheobronchial tree and pustular skin lesions characterize acute infection with B. mallei. Other symptoms include febrile pneumonia, if the organism was inhaled, or signs of sepsis and multiple abscesses, if the skin was the port of entry. Glanders is endemic in Africa, Asia, the Middle East, and Central and South America. Glanders has low contiguous potential, but because of the efficacy of aerosolized dissemination and the lethal nature of the disease, B. mallei was considered a candidate for biological warfare. During World War I, Glanders was believed to have been spread to infect large numbers of Russian horses and mules on the Eastern front. The Japanese infected horses, civilians and prisoners of war during World War II. The USA and the Soviet Union have shown interest in B. mallei in their biological warfare program. The treatment is empiric and includes mono or poly-therapy with Ceftazidime, Sulfadiazine, Trimethoprim + Sulfamethoxazol, Gentamicin, Imipenem etc. Aggressive control measures essentially eliminated Glanders from the west. However, with the resurgent concern about biological warfare, B. mallei is now being studied in a few laboratories worldwide. This review provides an overview of the disease and presents the only case reported in the western world since 1949.
Insights
Glanders, a disease caused by Burkholderia mallei, affects equids and can cause severe illness in humans. This review covers its history, symptoms, and treatment, highlighting its potential as a biological weapon.
Area of Science:
- Veterinary Medicine
- Infectious Diseases
- Bacteriology
Context:
- Burkholderia mallei causes Glanders and Farcy, primarily in horses, donkeys, and mules.
- Human Glanders presents in localized, pulmonary, septicemic, and chronic forms, with acute infections showing necrosis and pustular lesions.
- The disease is endemic in Africa, Asia, the Middle East, and Central/South America.
Purpose:
- To provide a comprehensive overview of Glanders, a zoonotic disease.
- To discuss the historical significance of Burkholderia mallei as a biological warfare agent.
- To review current understanding of Glanders, including its clinical manifestations and treatment.
Summary:
- Burkholderia mallei infection leads to Glanders or Farcy in equids, with potential for severe human disease including pneumonia and sepsis.
- Historically, Glanders was a concern during WWI and WWII due to its use as a biological weapon.
- Treatment involves empirical antibiotic therapy, and control measures have reduced its prevalence in the West, though research continues.
Impact:
- Understanding Glanders is crucial for veterinary public health and biodefense strategies.
- The review highlights the re-emerging concern of Burkholderia mallei as a potential bioterrorism agent.
- Presents a rare case of Glanders in the Western world since 1949, offering insights into its continued relevance.