Guided by :- Submitted By :- Dr. Aulak sir Dr.Laximan Sawant (L-2011-V-91-M)
Itis an acute to chronic disease characterized by pustular skin lesions , multiple abscess , necrosis in respiratory tract , pneumonia and sepsis .
• It is called “glanders” when the principal lesions are seen in the nostrils, submaxillary glands and lungs &• It is called “farcy” when lesions are on the surface of limbs or body.
Horse , donkey , mules are principle animals affected by disease Sheep , goats , dogs and cats become infected only if they come in contact with infected animals or if they eat their meat . Cattle and pigs are immune Man is also susceptible for glanders
Etiology :- Burkholderia mallei Gram negative bacillus Non motile Non sporulating rod Also known as Pseudomonas mallei, Malleomyces mallei and Actinomyces mallei. predominatantly exists in infected hosts but may remain viable for several months in warm moist environments.
3rdCentury BC › Described by Aristotle 1664: Contagious nature recognized 1830: Zoonotic nature suspected 1891: Mallein test developed 1900: Control programs implemented
History World War I Suspected use as biological agent to infect Russian horses & mules ○ Affected troops and supply convoys Large number of human cases Were repoted in Russia during and after WWI
History World War II Japanese infected horses, civilians and Prisoners of wars ’s U.S. and Russia investigated its use as biological weapon
Epidemiology Endemic Parts of Africa, the Middle East, and Asia Sporadic cases South and Central America Glanders was once widespread throughout the world but it has been eradicated from many countries by test and slaughter programs.
Affects solipeds Donkeys and mules Acute form Horses Chronic form Carnivores, humans and goats susceptible Swine and cattle resistant
Transmission: Humans Direct contact with infected animals Abraded skin Mucous membranes Inhalation Person-to-person (rare) Ingestion has never been recorded in humans
Transmission: Animals Ingestion: Major route Inhalation: Less likely Direct contact: Minor route Enhanced by shared food and water facilities
Who Is At Risk? Veterinarians Groomers Horsemen Butchers Lab workers
Clinical Signs :- ▫ Chronic form in horses ▫ Acute form in donkeys and mules Classical descriptions of glanders is distinguish between1. Nasal2. Cutaneous and3. Pulmonary forms
NASAL FORM OF GLANDERS:- Characterized by unilateral or bilateral nasal discharge. The yellowish-green exudate is highly infectious. The nasal mucosa has nodules and ulcers. These ulcers may coalesce to form large ulcerated areas
CONT… Insome cases the septum may even be perforated. Nasal lesions are accompanied by enlargement or sometimes rupture and suppuration, of regional lymph nodes
CUTANEOUS FORM OF GLANDERS:- Multiplenodules may develop in the skin of the legs or other parts of the body . Thesenodules may rupture, leaving ulcers that discharge a yellowish exudate to the skin surface and heal slowly.
CONT… Cutaneous lymphatic vessels in the region become involved. They become distended and firm by being filled with a tenacious, purulent exudate .(referred to as "Farcy pipes” )
PULMONARY FORM OF GLANDERS:- lesions in the lungs develop along with nasal and cutaneous lesions or there may be the sole manifestation of the disease (typical of latent cases). The lung lesions begin as firm nodules or as a diffuse pneumonic process.
CONT… The nodules are gray or white and firm, surrounded by a hemorrhagic zone, and may become caseous or calcified. Clinical signs in animals with lung lesions may range from inapparent infection to mild dyspnea, or severe coughing
• Lesions may also occur in the liver or spleen and,• In male animals , glanderous orchitis is a common lesion
Gross Lesions-Necropsy Ulcers, nodules, stellate scars in upper respiratory Pneumonia Firm rounded miliary nodules Swollen lymph nodes and vessels
Granulomatous lesion in An extensivethe lip pyogenic granulomatous pneumonia in a donkeyof a donkey.
Melioidosis Strangles Lymphangitis Other forms of pneumonia Gutter pouch empyema Dermatophilosis Dermatomycoses
Diagnosis: Humans Isolation of Burkholderia mallei Blood, sputum , urine or skin lesions Gram negative bacilli Safety pin appearance Agglutination tests May be positive after 7-10 days High background titer in normal sera makes interpretation difficult
Diagnosis: HumansComplement fixation – More specific – Positive if titer is equal to or greater than 1:20 Chest radiograph- demonstrateso bilateral bronchopneumonia,o miliary nodules oro cavitating lesions.
Diagnosis: Animals o Isolation of Burkholderia mallei – Blood, sputum , urine or skin lesions o Mallein test Intra palpebral or conjunctival injection Swelling 1-2 days later
• Serological tests :-1. Indirect hemagglutination,2. Counter-immunoelectrophoresis3. Immunofluorescence4. Compliment fixation and5. ELISACompliment fixation and ELISA – Most reliable in horses – Cannot be used in donkey or mule
Prevention & Control1. No vaccine is available for animal use2. Identification and elimination of foci of infection i. Surveillance and monitoring of equine herds especially in endemic areas ii. Positive animals should be slaughtered immediately & carcass should be disposed off by incineration or deep burial iii. In-contact & exposed animals should be segregated , Re- tested to detect and destroy the positives according to The Glander & Farcy Act XIII, 1899
3. Public education – owners must be educated about 1. contagious nature of disease , 2. limitations of treatments 3. sanitary measures to be adopted4. Disease notification – cases of Glanders should be reported to monitoring agencies
Treatment :-• Antibiotics may be effective but treatment is not generally recommended, as infections can be spread to humans and other animals, and treated animals may become asymptomatic carriers