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Guided by :-         Submitted By :-
    Dr. Aulak sir   Dr.Laximan Sawant
                     (L-2011-V-91-M)
 It is 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.
GLANDERS
 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
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 between
1. Nasal
2. Cutaneous and
3. 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
Purulent mucous nasal
discharge in donkey
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” )
GLANDERS
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 extensive
the lip                   pyogenic granulomatous
                          pneumonia in a donkey
of a donkey.
GLANDERS
GLANDERS
 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: Humans
Complement fixation
 – More specific
 – Positive if titer is equal to or greater than
   1:20
   Chest radiograph- demonstrates
o bilateral bronchopneumonia,
o miliary nodules or
o   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-immunoelectrophoresis
3. Immunofluorescence
4. Compliment fixation and
5. ELISA

Compliment fixation and ELISA
   – Most reliable in horses
   – Cannot be used in donkey or mule
Prevention & Control
1. No vaccine is available for animal use
2. 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 adopted
4. 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
GLANDERS

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GLANDERS

  • 1. Guided by :- Submitted By :- Dr. Aulak sir Dr.Laximan Sawant (L-2011-V-91-M)
  • 2.  It is an acute to chronic disease characterized by pustular skin lesions , multiple abscess , necrosis in respiratory tract , pneumonia and sepsis .
  • 3. • 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.
  • 4.  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
  • 5. 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.
  • 7.  3rdCentury BC › Described by Aristotle  1664: Contagious nature recognized  1830: Zoonotic nature suspected  1891: Mallein test developed  1900: Control programs implemented
  • 8. 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
  • 9. History  World War II  Japanese infected horses, civilians and Prisoners of wars ’s  U.S. and Russia investigated its use as biological weapon
  • 11. 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.
  • 12.  Affects solipeds  Donkeys and mules  Acute form  Horses  Chronic form  Carnivores, humans and goats susceptible  Swine and cattle resistant
  • 13. Transmission: Humans  Direct contact with infected animals  Abraded skin  Mucous membranes  Inhalation  Person-to-person (rare)  Ingestion has never been recorded in humans
  • 14. Transmission: Animals  Ingestion: Major route  Inhalation: Less likely  Direct contact: Minor route  Enhanced by shared food and water facilities
  • 15. Who Is At Risk?  Veterinarians  Groomers  Horsemen  Butchers  Lab workers
  • 16. Clinical Signs :- ▫ Chronic form in horses ▫ Acute form in donkeys and mules Classical descriptions of glanders is distinguish between 1. Nasal 2. Cutaneous and 3. Pulmonary forms
  • 17. 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
  • 18. CONT…  Insome cases the septum may even be perforated.  Nasal lesions are accompanied by enlargement or sometimes rupture and suppuration, of regional lymph nodes
  • 20. 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.
  • 21. 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” )
  • 23. 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.
  • 24. 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
  • 25. • Lesions may also occur in the liver or spleen and, • In male animals , glanderous orchitis is a common lesion
  • 26. Gross Lesions-Necropsy  Ulcers, nodules, stellate scars in upper respiratory  Pneumonia  Firm rounded miliary nodules  Swollen lymph nodes and vessels
  • 27. Granulomatous lesion in An extensive the lip pyogenic granulomatous pneumonia in a donkey of a donkey.
  • 30.  Melioidosis  Strangles  Lymphangitis  Other forms of pneumonia  Gutter pouch empyema  Dermatophilosis  Dermatomycoses
  • 31. 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
  • 32. Diagnosis: Humans Complement fixation – More specific – Positive if titer is equal to or greater than 1:20  Chest radiograph- demonstrates o bilateral bronchopneumonia, o miliary nodules or o cavitating lesions.
  • 33. 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
  • 34. • Serological tests :- 1. Indirect hemagglutination, 2. Counter-immunoelectrophoresis 3. Immunofluorescence 4. Compliment fixation and 5. ELISA Compliment fixation and ELISA – Most reliable in horses – Cannot be used in donkey or mule
  • 35. Prevention & Control 1. No vaccine is available for animal use 2. 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
  • 36. 3. Public education – owners must be educated about 1. contagious nature of disease , 2. limitations of treatments 3. sanitary measures to be adopted 4. Disease notification – cases of Glanders should be reported to monitoring agencies
  • 37. 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