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Glanders Classification and external resources ICD-10 A24.0 ICD-9 024 DiseasesDB 5222 eMedicine emerg/884 MeSH D005896 Glanders (from Middle English glaundres or Old French glandres, both meaning glands)[1] (Latin: Malleus German: Rotz) (also known as "Equinia," "Farcy," and "Malleus"[2]:282) is an infectious disease that occurs primarily in horses, mules, and donkeys. It can be contracted by other animals such as dogs, cats and goats. It is caused by infection with the bacterium Burkholderia mallei, usually by ingestion of contaminated food or water. Symptoms of glanders include the formation of nodular lesions in the lungs and ulceration of the mucous membranes in the upper respiratory tract. The acute form results in coughing, fever and the release of an infectious nasal discharge, followed by septicaemia and death within days. In the chronic form, nasal and subcutaneous nodules develop, eventually ulcerating. Death can occur within months, while survivors act as carriers. Glanders is endemic in Africa, Asia, the Middle East, Central and South America. It has been eradicated from North America, Australia and most of Europe through surveillance and destruction of affected animals, and import restrictions. Burkholderia mallei is able to infect humans and is therefore classed as a zoonotic agent. Transmission occurs by direct contact with infected animals and entry is through skin abrasions, nasal and oral mucosal surfaces, or by inhalation. The mallein test is a sensitive and specific clinical test for glanders. Mallein (ATCvet code: QI05AR01), a protein fraction of the glanders organism (Burkholderia mallei), is injected intradermo-palpebrally or given by eye-drop. In infected animals, the eyelid swells markedly in 1 or 2 days. Biological warfare use Due to the high mortality rate in humans and the small number of organisms required to establish infection, Burkholderia mallei is regarded as a potential biological warfare (BW) or bioterrorism agent, as is the closely related organism, Burkholderia pseudomallei, the causative agent of melioidosis. During World War I, Glanders was believed to have been spread deliberately by German agents to infect large numbers of Russian horses and mules on the Eastern Front.[3] Other agents attempted to introduce the disease in the United States and Argentina. This had an effect on troop and supply convoys as well as on artillery movement, which were dependent on horses and mules. Human cases in Russia increased with the infections during and after WWI. The Japanese deliberately infected horses, civilians, and prisoners of war with B. mallei at the Pinfang (China) Institute during World War II. The U.S. studied this agent as a possible BW weapon in 1943–44 but did not weaponize it. U.S. interest in Glanders (Agent LA) continued through the 1950s, except it had an inexplicable tendency to lose virulence in the lab, making it difficult to weaponize. The Soviet Union is also believed to have been interested in B. mallei as a potential BW agent after World War II. References ^ "glanders". American Heritage Dictionary of the English Language: Fourth Edition. Bartleby.com. 2000. http://www.bartleby.com/61/18/G0141800.html. Retrieved 2007-05-13.  ^ James, William D.; Berger, Timothy G.; et al. (2006). Andrews' Diseases of the Skin: clinical Dermatology. Saunders Elsevier. ISBN 0-7216-2921-0.  ^ Woods, Lt. Col. Jon B. (ed.) (April 2005). USAMRIID’s Medical Management of Biological Casualties Handbook (6th ed. ed.). U.S. Army Medical Institute of Infectious Diseases, Fort Detrick, Maryland. pp. 67. . External links CDC article on the bioterrorism threat of glanders Animal health aspects of glanders Center for Biosecurity Agent Fact Sheet Burkholderia mallei genomes and related information at PATRIC, a Bioinformatics Resource Center funded by NIAID Notes On Glander Disease in Horse v · d · eInfectious diseases · Bacterial diseases: Proteobacterial G− (primarily A00–A79, 001–041, 080–109) α Rickettsiales Rickettsiaceae/ (Rickettsioses) Typhus Rickettsia typhi (Murine typhus) · Rickettsia prowazekii (Epidemic typhus, Brill–Zinsser disease, Flying squirrel typhus) Spotted fever Tick-borne Rickettsia rickettsii (Rocky Mountain spotted fever) · Rickettsia conorii (Boutonneuse fever) · Rickettsia japonica (Japanese spotted fever) · Rickettsia sibirica (North Asian tick typhus) · Rickettsia australis (Queensland tick typhus) · Rickettsia honei (Flinders Island spotted fever) · Rickettsia africae (African tick bite fever) · Rickettsia parkeri (American tick bite fever) · Rickettsia aeschlimannii (Rickettsia aeschlimannii infection) Mite-borne Rickettsia akari (Rickettsialpox) · Orientia tsutsugamushi (Scrub typhus) Flea-borne Rickettsia felis (Flea-borne spotted fever) Anaplasmataceae Ehrlichiosis: Anaplasma phagocytophilum (Human granulocytic anaplasmosis, Anaplasmosis) · Ehrlichia chaffeensis (Human monocytic ehrlichiosis) · Ehrlichia ewingii (Ehrlichiosis ewingii infection) Rhizobiales Brucellaceae Brucella abortus (Brucellosis) Bartonellaceae Bartonellosis: Bartonella henselae (Cat scratch disease) · Bartonella quintana (Trench fever) · either henselae or quintana (Bacillary angiomatosis) · Bartonella bacilliformis (Carrion's disease, Verruga peruana) β Neisseriales M+ Neisseria meningitidis/meningococcus (Meningococcal disease, Waterhouse-Friderichsen syndrome, Meningococcal septicaemia) M- Neisseria gonorrhoeae/gonococcus (Gonorrhea) ungrouped: Eikenella corrodens/Kingella kingae (HACEK) · Chromobacterium violaceum (Chromobacteriosis infection) Burkholderiales Burkholderia pseudomallei (Melioidosis) · Burkholderia mallei (Glanders) · Burkholderia cepacia complex · Bordetella pertussis/Bordetella parapertussis (Pertussis) γ Enterobacteriales (OX-) Lac+ Klebsiella pneumoniae (Rhinoscleroma, Klebsiella pneumonia) · Klebsiella granulomatis (Granuloma inguinale) · Klebsiella oxytoca Escherichia coli: Enterotoxigenic · Enteroinvasive · Enterohemorrhagic · O157:H7 · O104:H4 (Hemolytic-uremic syndrome) Enterobacter aerogenes/Enterobacter cloacae Slow/weak Serratia marcescens (Serratia infection) · Citrobacter koseri/Citrobacter freundii Lac- H2S+ Salmonella enterica (Typhoid fever, Paratyphoid fever, Salmonellosis) H2S- Shigella dysenteriae/sonnei/flexneri/boydii (Shigellosis, Bacillary dysentery) · Proteus mirabilis/Proteus vulgaris · Yersinia pestis (Plague/Bubonic plague) · Yersinia enterocolitica · Yersinia pseudotuberculosis Pasteurellales Haemophilus: H. influenzae (Haemophilus meningitis, Brazilian purpuric fever) · H. ducreyi (Chancroid) H. parainfluenzae (HACEK) Pasteurella multocida (Pasteurellosis) · Actinobacillus (Actinobacillosis) Aggregatibacter actinomycetemcomitans (HACEK) Legionellales Legionella pneumophila/Legionella longbeachae (Legionellosis) · Coxiella burnetii (Q fever) Thiotrichales Francisella tularensis (Tularemia) Vibrionales Vibrio cholerae (Cholera) · Vibrio vulnificus · Vibrio parahaemolyticus · Vibrio alginolyticus · Plesiomonas shigelloides Pseudomonadales Pseudomonas aeruginosa (Pseudomonas infection) · Moraxella catarrhalis · Acinetobacter baumannii Xanthomonadales Stenotrophomonas maltophilia Cardiobacteriales Cardiobacterium hominis (HACEK) Aeromonadales Aeromonas hydrophila/Aeromonas veronii (Aeromonas infection) ε Campylobacterales Campylobacter jejuni (Campylobacteriosis, Guillain-Barré syndrome) · Helicobacter pylori (Peptic ulcer, MALT lymphoma) · Helicobacter cinaedi (Helicobacter cellulitis) M: BAC bact (clas) gr+f/gr+a(t)/gr-p(c)/gr-o drug(J1p, w, n, m, vacc)