chapter  8
6 Pages

Guides for Emergency Response: Biological Agent or Weapon: Glanders (includes Melioidosis)

Guides for Emergency Response: Biological Agent or Weapon: Glanders (includes Melioidosis) AGENT: Glanders: Th is illness is a contagious and destructive disease, especially of horses, caused by a bacterium of such animals. It is characterized by nodular lesions, especially of the respiratory mucosae and lungs. Glanders may occur in an acute localized form, as a septicemic rapidly fatal illness, or as an acute pulmonary infection. Combinations of these syndromes commonly occur in humans. A chronic cutaneous form with lymphangitis (infl ammation of the lymphatic vessels) and regional adenopathay (any disease or enlargement involving glandular tissue, especially involving lymph nodes) is also frequent. Aerosol infection from a biological warfare weapon containing B. mallei (glanders is a gram-negative bacillus, called B. mallei, with horses, mules, and donkeys serving as reservoirs) could produce any of these syndromes. Th e incubation period is from ten to fourteen days, depending on the inhaled dose and agent virulence. Th e septicemic form begins suddenly with fever, rigors, sweats, myalgia (muscular pain), pleuritic chest pain, photophobia, lacrimation, and diarrhea. Physical examination may reveal fever, tachycardia (rapid heart action), cervical adenopathy (any disease or enlargement involving glandular issue, especially one involving lymph nodes) and mild spenomegaly. Blood cultures are usually negative until the patient is moribund. Mild leukocytosis (an increase in the number of leukocytes in the circulating blood that occurs normally, or abnormally as in some infections) with a shift to the left or leucopenia (a condition in which the number of leukocytes circulating in the blood is abnormally low, mostly due to decreased production of new cells in conjunction with various infective diseases) may occur. Th e pulmonary form may follow inhalation or arise by hematogenous (arriving in the blood, or spread by the blood) spread. Systemic symptoms may occur. Chest radiographs may show miliary (resembling or suggesting a small seed or many small seeds) nodules (.5 to 1cm) and/or a bilateral bronchopneumonia, segmental, or lobal pneumonia and necrotizing (causing, associated with, or undergoing necrosis) nodular lesions.