Glanders

Testing for glanders
This image shows a veterinary 1st. Lt. R.F. Okershauser making a Mallein test for Glanders.

Written by Ryan Converse and Lexie Cook

Glanders is a contagious and highly fatal zoonotic disease. It affects horses, donkeys and mules as well as humans and is characterized by the formation of nodules and ulcerations in the upper respiratory tract and lungs. The disease is caused by Burkholderia mallei, a gram-negative bacteria (Sharma et el., 2015). The illness has been documented since the Middle Ages. It was serious enough during the Seven Years War (1754-1763) that the first veterinary school was created solely to observe its effects on the cavalry (Sharrer 1995). It was first observed in the horses, but it soon became apparent that humans can catch it as well. It is very difficult to cure, and even if cured, animals and humans alike are not immune to the disease afterwards. Also, certain individuals can show little severity in their symptoms but still be able to transmit the disease to others that may be more susceptible (Sharrer 1995).

Glanders became a serious public health issue in London in the late 19th century, when large numbers of horses were diagnosed with glanders and had to be slaughtered to prevent the spread of the disease to other horses and to humans. In 1879, the Medical Officer of Health for Kensington reported that 997 horses had to be destroyed because of glanders and the related disease farcy. He reported that the specific mode of transmission was not clear. It might be spread directly from an infected horse to another horse,

“but the occurrence of case after case in the same stable is quite as suggestive of
aerial infection as of the conveyance of virus from horse to horse by contact, or through the medium of polluted stable fittings, sponges, buckets, &c.” (Kensington 1879)

He blamed the spread of glanders on lack of proper sanitation in stables.

The spread of glanders points, I think, to the insufficiency of the processes usually
adopted for cleansing and disinfecting premises, and which obviously were insufficient to destroy the specific virus. (Kensington 1879).

He recommended in particular that “horses should be separately watered each from its own bucket, and not suffered to use a common drinking trough even in the
stable yard.” (Kensington 1879)

The report of the Medical Officer of Health for the London City Council in 1913 offered similar conclusions about the spread of glanders, linking it specifically to horses owned by poorer Londoners, who were less able to provide sanitary and healthy conditions for their horses, and who, because they depended upon the horses for their livelihoods, were deeply reluctant to report cases of suspected glanders. Citing an earlier report he stated:

equine glanders is more prevalent in stables where only few horses are kept, that in such cases the “horses, often badly fed and overworked, and so offering little resistance to infection, are still liable to constitute a serious source of infection, both to other horses and to man,” and that “the men who own these horses would be, and in fact are, if they suspect themselves to be suffering from any infectious disease, very loth to draw attention to themselves and interfere with their freedom.” (London County Council 1913).

A report from a year earlier by the London City Council MOH noted that almost all of the human infections from glanders came from people working in close proximity with horses.  (London County Council 1912). According to multiple sources, infections were difficult to avoid for horses or humans in close proximity to affected horses. In 1903 the London City Council had to deal with a situation in St. Pancras. The water troughs for the horses had managed to become compromised. This was a dangerous situation, and they had to be closed because of the risk to the horses (St Pancras 1903). The disease was easily transmitted from horses to humans. A death of a parishioner in the City of Westmentster occurred due to contact with a stable with apparent glanders (Chelsea 1903). In 1904 two deaths were recorded in relations to glanders. One death was of a trainer who had been near a slaughtered glandered horse, and the other was a horse owner (London County Council 1904). In 1905, the London City Council reported 6 deaths around the metropolitan area of London. However, 3 of those deaths were reported with no evidence of glanders in the horses so there must have been some other form of transmission that they did not know about (London County Council 1905).

An account from 1860 of a human glanders patient given by a doctor by the name of James Morrison reveals the symptoms that human patients suffered. Morrison’s patient was a veterinarian who had previously performed an autopsy on two horses that had died of glanders. He hadn’t taken the right precautions and began displaying the symptoms. Only a few hours after exposure, he experienced nausea, vomiting, and then a severe pain in the front of his head. This head pain continued and was followed by a thick discharge from the nose. More chronic issues were wakefulness, constipation, night sweats, and deafness. The doctor also mentioned the treatment plan that he gave the patient. He prescribed iron with some quinine and porter to allow for a generous diet with little digestive stress. To aid sleep, he gave 3 grams of cannabis. Then in December, after five months of suffering, a hemorrhage appeared. It went away, then reappeared that following June. The patient finally died later that month (James 1860). Another treatment given by someone else was “cod liver oil, phosphate of lime, vegetable tonics, and blood roots (Glanders In Horses 1859).” There were variations in all of the treatments because no one really knew what to do.

Of course, public health officials to measures to contain the transfer of the disease from horses to humans. The Diseases of Animals Acts from 1894 to 1911 were enacted in an attempt to suppress highly contagious diseases among animals and man. However, apart from swine fever, the primary focus was directed on prevention of glanders because the disease was causing the most trouble and expense in London. The London City Council had noted that it was the largest expense to the council in the year of 1920 (London County Council 1920). An account in 1907 given by the MOH for St. Pancras gave guidelines for what to do in the case of an infected animal.

LONDON (NOTIFICATION OF GLANDERS) ORDER OF 1907.
The Board of Agriculture and Fisheries, by virtue and in exercise of the powers vested in them under the Diseases of Animals Acts, 1894 to 1903, and of every other power enabling them in this behalf, do order, and it is hereby ordered, as follows :—
Application of Order.
1. This Order applies to the administrative County of London and to the City of London.
Notice of Disease.
2.—(1.) Every person having or having had in his possession or under his charge any diseased or suspected horse, ass, or mule shall with all practicable speed give notice of the fact of the horse, ass, or mule being or having been so diseased or suspected, either to an inspector of the local authority, or to a constable of the police force for the police area wherein the diseased or suspected horse, ass or mule is or was.
(2.) Every person licensed to slaughter horses who has in his possession a carcase of any diseased or suspected horse, ass, or mule shall with all practicable speed give notice of that fact, either to an inspector of the local authority, or to a constable of the police force for the police area wherein the carcase is.
(3.) A constable receiving a notice shall forthwith give information of the receipt by him of the notice to an inspector of the local authority.
(4.) A veterinary surgeon employed to examine any horse, ass, or mule, or the carcase of any such animal, on becoming aware that the animal is diseased, or was diseased when it died or was slaughtered, shall with all practicable speed give notice of the fact to an inspector of the local authority.
(5.) An inspector of -the local authority who receives information of the existence or suspected existence of disease shall forthwith report the fact to the local authority, and also to the medical officer of health of the sanitary district in which the animal died or was slaughtered or in which the carcase was at the time of the notice.                                                                                                                                          (6.) Where the notice of disease relates to a carcase of an animal that has died or been slaughtered in the district of a Local Authority other than the local authority which receives the notice, the latter shall forthwith inform the other local authority of the receipt of the notice.
(7.) This Article shall be substituted for Article 3 (Notice of Disease) of the Glanders or Farcy Order of 1907 in the application of that Order to the administrative County of London and to the City of London.(St Pancras 1907)

Despite such strong efforts, the problem consisted until almost 1939. No one really knew how to cure it and no one really knew what to do with it. it was luckily eradicated after causing a lot of drama in the world. The main preventive measures were good care of the animals that were susceptible. According to more recent documentation, glanders has been eliminated in almost all industrialized countries, including the United States, where there have been no reported human or animal cases since World War II. (meliodosis in Gabon, 2012-13)

L0019355 Engraving: treatment of glanders; c. 1790
Treatment of glanders. Engraving Circa 1790. Credit: Wellcome Library, London.

Primary Sources

City of London 1864

Kensington 1879

Chelsea 1903

St Pancras 1903

London County Council 1905

St Pancras 1907

St Pancras 1909

Finsbury 1910

London County Council 1912

London County Council 1913

London County Council 1920

Morrison, James. “Case of Chronic Glanders in the Human Subject.” The Ohio Medical and Surgical Journal (1848-1878) 13, no. 2 (Nov 01, 1860): 144.

“Glanders in Horses.” The New England Farmer; a Monthly Journal (1848-1871) 11, no. 6 (06, 1859): 267.

Secondary Sources

Sharrer, G. Terry. “The Great Glanders Epizootic, 1861-1866: A Civil War Legacy.” Agricultural History 69, no. 1 (1995): 79-97.

Sharma, A. K., P. S. Dhaliwal, S. S. Randhawa, S. N. S. Randhawa, K. Dua, S. Sharma, and B. K. Bansal. 2015. “Report on Glanders in Horses in Punjab Between 1999 and 2014.” Veterinary Practitioner 16, no. 2: 210-211.

Henry, Ronnie. 2015. “Glanders.” Emerging Infectious Diseases 21, no. 1: 47.
“Prevalence-dependent use of serological tests for diagnosingglanders in horses.” BMC Veterinary Research 5, 32-37.