GLANDERS (FARCY) OUTBREAK IN DELHI-DIAGNOSIS , TREATMENT & CONTROL MEASURE
Compiled & Edited by-DR RAJESH KUMAR SINGH, JAMSHEDPUR, 9431309542
Glanders, a notifiable highly contagious disease primarily of equids, is a disease of high zoonotic importance. Caused by gram-negative bacillus, Burkholderia mallei, the disease was restricted to certain pockets of India with sporadic cases. Recently, a major outbreak of glanders has occurred in India in West Delhi. Following clinical signs and symptoms and laboratory investigations on serum, nasal swab and pus swab samples, it was confirmed as glanders among equines in New Delhi.
The Delhi Government has banned to-and-fro movement of horses in the Capital’s west district after reports that the equines are suffering from the glanders disease. The order was issued by Divisional Commissioner Manisha Saxena, who directed equine owners to get their animals checked at Government laboratory in Hisar and communicate the details of samples and results to the Revenue Department. As per the 2012 animal census, there are 2,694 horses in the national Capital.
Glanders is an infectious equine disease which causes suffering and inevitable death to equines, whilst threatening the livelihoods of the owners who depend on them. It is a zoonotic disease.
According to officials, samples were collected from 13 equines for surveillance of glanders at Sanjay Gandhi Animal Care Centre, Raja Garden in West Revenue District. Of these, seven samples have been found positive for glanders after confirmation by Compliment Fixation Test (CFT). The samples were sent to the National Research Centre on Equines (NRCE), Hisar.
Most of the owners use horses for livelihood purposes in Delhi. Horses are used for a light carriage or curricle drawn by two horses for transportation during marriage seasons. In Delhi, most of the horses are from marwari breeds. Some of the horses are also being used by horse riding schools.
Glanders is a scheduled disease (item No 11 under the category of “equine diseases”) under the “the Prevention and Control of Infectious and Contagious Diseases in Animals Act 2009”.
The order said, “In exercise of the power conferred by Sub-section (1) of Section 6 of the Prevention and Control of Infectious and Contagious Diseases in Animals Act 2009, with the object of preventing, controlling and eradicating the scheduled disease that affecting equines, the Delhi Government declares West Revenue district of Delhi, a controlled area in respect of glanders. In view of the presence of this scheduled disease in West Revenue district of Delhi, to-and-fro equine movement in the district (West) is hereby restricted for a period of three months”.
“All concerned are hereby advised to get their equines tested for glanders from NRCE, Hisar, the referral laboratory of Department of Animal Husbandry, Ministry of Agriculture and communicate the details of sent samples and results so obtained, to the Revenue Department”, it said.
The disease can successfully be controlled in the area by following strategies for prevention of spread of the disease to other areas in accordance with Glanders and Farcy Act, 1899. So , it has become necessary for us to refresh our knowledge related to Glanders.
What is Glanders (Farcy)?
Glanders is a zoonotic disease, which means the bacteria can also infect humans through body fluids of an infected horse. The bacteria can also gain access through cuts, abrasions in the skin, via the eyes, or by the inhalation of the organism. If the bacteria is inhaled, clinical signs will be seen 10-14 days after exposure. Glanders is a serious disease that is considered a bioterrorist threat, by the CDC. During World War I, World War II, and in the war in Afghanistan, the organism Burkholderia mallei was used as a weapon against civilians, soldiers, and their military horses. If you suspect that your horse has been infected by Glanders it is imperative that you immediate quarantine him, take safety precautions, and call a veterinarian immediately. Glanders, also called Farcy, is a very contagious disease caused by the bacterium Burkholderia mallei. Glanders, which is usually fatal, was once found worldwide. Fortunately, it has been eradicated in most countries. Glanders is now uncommon, the last reported case in the USA was in 2000.
Symptoms of Glanders (Farcy) in Horses
Deep ulcers and nodules inside the nasal passages Sticky yellow discharge Bloody discharge Watery eyes Swollen lymph nodes Sensitivity to light Diarrhea Coughing Swollen nostrils Fever Excessive sweating Skin rash with pustules Respiratory infection Labored breathing Weight loss Pneumonia
Causes of Glanders (Farcy) in Horses
Glanders is caused organism Burkholderia mallei which is transmitted by: The horse drinking from contaminated water Eating from contaminated food Close contact with an infected horse Exposure to infected objects such as grooming equipment, bits, and saddles Contaminated stall walls Scratching post infected with Glanders
Epidemiology
Glanders occurs rarely in humans and gets transmitted from infected animals by direct contact with body fluids through abrasions or cuts and mucosal surfaces such as nose and eyes. Symptoms include chest pain, muscle aches, swollen lymph nodes, fever with chills, cough, pulmonary abscesses, nasal discharge and septicemia.
Diagnosis of Glanders (Farcy) in Horses
The veterinarian will go over the medical history of the horse. The veterinarian will need to know what symptoms have you noticed, and when did they start. He will need to know if your horse has been in contact with other animals. The veterinarian will then perform a full physical examination. The horse’s physical exam may include: Listening to his heart, lungs and gastrointestinal tract with a stethoscope. Blood pressure Weight Rectal exam Checking the color of the gums Inspection of the sores and lesions Palpation of the limbs and muscles Palpation of lymph nodes Overall body condition of the horse
Diagnostic tests may include:
Complete blood count – Checks the count of platelets, red and white blood cells and helps determine if there is a bacterial infection Urinalysis – Checks for kidney function, crystals, blood or bacteria in the urine If the veterinarian suspects fluid in the lungs, chest x-rays will be recommended Take a culture from the lesion’s discharge Smears of the discharged examined under a microscope to confirm the bacteria Serological test can also confirm the bacteria
Treatment of Glanders (Farcy) in Horses
Once Glanders is confirmed the horse must be quarantined. The bacteria can stay alive, with the right conditions, for up to one month. Stalls, water troughs, grooming tools, and saddles must be thoroughly disinfected and cleaned. Antibiotics will be prescribed to the horse. The disease may be resistant to particular antibiotics, so the use of several different medications may be required. Skin lesions and sores will need to be cleaned with an antiseptic. Medicated ointment will need to be administered to the sores. It is important for the person caring for the horse to use gloves, mask, and eye covering. If the horse was around other animals, they too should be tested for Glanders. The organism Burkholderia mallei primarily infects horses, donkeys and mules. It is not as common, but Glanders can also be transmitted to goats, cows, dogs and cats.
Recovery of Glanders (Farcy) in Horses
The disease is usually fatal in donkeys and mules but horses have a better prognosis. Antibiotic treatment is essential for the horse’s recovery. A follow-up visit will be needed to check on the horse’s progress. Diagnostic tests will need to be retaken. Unfortunately, some horses that do survive Glanders become carriers of the disease. This means that they can infect other animals and humans. In cases where the horse is diagnosed a carrier to the disease, he will need to live the rest of his life in quarantine. Anyone handling the horse will need to take safety precautions, such as gloves, mask or face shield. Horses are very social animals and living under quarantine will make the horse very depressed. The veterinarian may suggest euthanasia. Currently there is no vaccine against Glanders.
Biological warfare and bioterrorism of glanders:
Burkhoideria mallei are a group B biothreat agent and
are a host-adapted pathogen (Chandler and Landrigan,
2004). Due to the high mortality rate in humans and the
small number of organisms required to establish
infection, it is regarded as a potential biological
warfare or bioterrorism agent along with closely related
B. pseudomallei, the causative agent of melioidosis.
During the 1st World War, large numbers of Russian
horses and mules on the Eastern Front was intentionally
infected with glanders by Germans (Wheelis, 1998;
Alibek and Handelman, 1999). This severely affected the
troop and supply convoys, artillery movement which are
dependent on horses and mules. Subsequently, the
human cases in Russia increased with the infections
during and after World War I (Bossi et al., 2004).
During World War II Japan intentionally infected
horses, civilians and prisoners of war with glanders at the
Pinfang Institute, China (Rega, 2007). In China, during
World War II, 30% of the tested horses were infected with
glanders, but human cases were rare. The -U.S. studied
this agent as a possible biological warfare weapon in
1943-44, but they did not weaponize it. The Soviet Union
is also interested in glanders as a potential biological
warfare agent after World War II. If this organism is
aerosolized during a biological attack or in a laboratory
accident, the morbidity rate could reach very high. Its use
as a biological weapon is now banned under the
international Convention on the Prohibition of the
Development, Production and Stockpiling of
Bacteriological and Toxin Weapons and on Their
Destruction (Rosebury and Kabat, 1947; Woods, 2005;
Wittig et al., 2006; Pawaiya and Chauhan, 2008).
PREVENTION AND CONTROL
No human or veterinary vaccines are available for
immunization/prevention of Glanders (Estes et al., 2010;
Burtnick et al., 2012). The immune evading strategy and
genomic fluidity of this complex pathogen have made the
use of live vaccine unsatisfactory (Nierman et al., 2004;
Romero et al., 2006). Efforts need to be made for
identifying broadly protective antigens, efficient vaccine
delivery/adjuvant systems and an exploring protection
from both acute and chronic infections which would
altogether pave way for the development of effective
vaccine for B. mallei (Bondi and Goldberg, 2008).
Experimentally, two live attenuated strains of B. mallei, a
capsule mutant and a branched-chain amino acid
auxotroph which is genetically engineered mutant of
B. mallei using newly constructed allelic exchange vector,
as vaccines in mice. The auxotrophic mutant was found to
enhance the Thl response and with a survival rate of 25%
for one month post-challenge in comparison to control
where none survived beyond five days (Ulrich et al.,
2005). The 6-deoxy-heptan Capsular Polysaccharide (CPS)
of B. mallei, having both a pathogenic determinant and a
protective antigen, is being exploited for developments of
novel vaccine against glanders (Burtnick et al., 2012).
Clinical and serological recovery is rare, recovered
animals are also not immune, so every animal positive for glanders should be destroyed and remaining animals
should be retested at intervals of 3 weeks until all reactors have been removed:
In case of death due to glanders, carcass should
not be opened. It must be buried or incinerated
(Khan et al., 2013)
• Adequate compensation to the owners for
destroying the horses
• Manure, bedding and feed residue should be burned
or buried
• Follow vigorous disinfection programme for
premises, feed and water trough etc
• The entire suspect, in contact animals must be
isolated, properly tested and positive animal should
be destroyed
• There should be restriction of the movement of
horses
• Strict isolation, proper hygiene and sanitation
procedures should be adopted
• Disinfection of surroundings of dead or i. nfected
animals should be done as B. tnallei is highly
susceptible to common disinfectants like
benzalkonium chloride, iodine, mercuric chloride in
alcohol, potassium permanganate, 1% sodium
hypochlorite, 70% ethanol and 2% glutaraldehyde. It
is less susceptible to phenolic disinfectants. It also
destroyed by heating to 55°C for 10 min or by
ultraviolet irradiation
• Contaminated material should be cleaned with a
solution of 1 part household bleach (0.5% sodium
hypochlorite solution) to 9 parts water
• Veterinarians, animal handlers and persons i. ncontact
with infected animals should follow appropriate
biosafety measures, wear gloves and masks during
animal handling
• Awareness programmes about the glanders need to
be carried out from time to time (Khan et al., 2013)
Employing the new generation developments and
progress in vaccineess and vaccinology, safer and effective
vaccines need to be focused for countering this important
disease having high zoonotic potential (Paul-Pierre, 2009;
Dhama et al., 2008, 20130. Judicious application of drugs
and alternative and novel/emerging therapeutic
modalities should also be kept in mind for treating
glanders (Mahima et al., 2012b; Dhama et al., 2013g, h;
Tiwari et al., 2013a, b, c). Nowadays, one health and one
medicine approach is being given due importance to
counter deadly pathogens, emerging/re-emerging
infectious diseases and their zoonotic threats which need to be applied from all aspects for combating glanders
Reference-On Request
