By Maneka Sanjay Gandhi

Glanders, also known as farcy, is an infectious, usually fatal, disease that occurs in horses, mules and donkeys. It was first described by the Greeks in 450–425 BC and by the Romans in 400–500 AD. Donkeys are prone to develop acute forms of glanders while horses are more likely to develop chronic and latent diseases. Mules get both, chronic as well as latent infections. Other animals such as dogs, cats, camels, hamsters, guinea pigs and goats can contract it. It is spread by contaminated food or water which has the Burkholeria mallei bacteria in it. Horses get glanders by close contact with infected horses through shared water and feed troughs and by nuzzling. The bacteria can also be spread by brushes, halters or harnesses. It has been eradicated from North America, Australia, and most of Europe. It exists in India, Iraq, Turkey, Pakistan and the United Arab Emirates.

What happens when a horse gets glanders? There are two forms which occur after a two week incubation period: In the acute form the animal starts coughing, gets very high fever, and an infectious yellow green nasal discharge, followed by respiratory failure, septicaemia and death within days. The long term form of the disease is common in horses. The horse gets ulcers and growths on the skin and in the nose. The horse may have enlarged lymph nodes and nodules on the skin. In some cases they may look like long, hard ropes under the skin specially on the legs. Severe coughing can also occur. Infected animals may live for a few years and spread the bacteria widely before dying. The glanders bacteria can survive in a contaminated area for more than 1 year.

Glanders can be passed on to humans through contact with infected animals, consuming food or water contaminated by the nasal discharge of the animal. 

How serious is it for us? The mortality rate for the pulmonary form of glanders has been reported to be 90-95% without treatment and up to 40% with treatment. The disease can affect the skin, lungs or the entire body. Signs may include fever, chills, muscle aches, and chest pain; pneumonia can rapidly develop. Nodules or ulcers may occur in the skin or the nose, eyes, or mouth. Swollen lymph nodes may also be apparent. Infections, involving the mucous membranes in the eyes, nose and respiratory tract, will cause increased mucus production from the affected sites. Conjunctivitis, weeping, allergy to light, swelling of the nose and face, coughing  and headaches are common. Pneumonia, pulmonary abscesses can occur. The chronic form of glanders involves abscesses within the muscles of the arms and legs or in the spleen or liver. A glanders node may appear as a single blister, gradually developing into a weeping ulcer. Symptoms can develop one to five days after infection. Ultrasonography may reveal multiple, small abscesses in both the liver and the kidney.  There is no treatment regimen beyond trying out different antibiotics

Due to the high mortality rate in humans and the small number of organisms required to establish infection, B. mallei is regarded as a potential weapon for bioterrorism. It was one of the first biological warfare agents used in the 20th century, DuringWorld War I, glanders was believed to have been spread deliberately by German agents to infect Russian horses and mules on the Eastern Front. Human cases in Russia increased with the infections during and after WWI. 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. The Japanese deliberately infected horses, civilians, and prisoners of war with B. mallei at the Pinfang (China) Institute during World War II. The former Soviet Union was also alleged to have used B. mallei against opposition forces in Afghanistan between 1982 and 1984. The U.S. studied this agent as a possible biological weapon in 1943–44, but did not weaponize it. Together with the high rate of infectivity through breathing contaminated air, and resistance to many common antibiotics, this bacteria has been classified as a category B priority pathogen by the United States National Institute of Health and Centre for Disease Control.

There is no vaccine for glanders. Prevention and control depend on early detection and elimination of affected animals, as well as complete quarantine and rigorous disinfection of the area involved. The risk to people working in a contaminated area is high. Especially vulnerable are veterinarians, farriers, transport workers, soldiers, farmers, horse handlers and stable hands. Subclinical infections in horses and mules also pose a hidden risk to humans who sit on the horses or handle them. The care of glanders-infected individuals has led to the infection of other family members.

Why am I telling you this? Because we are in the middle of a glanders epidemic. From 2006 to now the ICA National Research Centre on Equines has found hundreds of cases in 9 states. The whole of North India (especially Uttar Pradesh) is swarming with horses. They are the main transporters of human beings and goods. Not a single veterinary hospital exists for them, so if they fall ill they are simply abandoned. There are 15,000 horses in Katra which are used daily by tourists to Vaishno Devi. Glanders has been found in these mules and horses. The advisories were published in April 2015 in the local newspapers. No one has paid attention. The director of the Animal Husbandry Department of Jammu has written to me today that, while they have repeatedly found horses with glanders, they have not isolated or euthanized any. Reason? “The owners of the horses are poor people living on the money earned by these horses when used to transport men and materials. In absence of any provision for adequate compensation, the department was facing tremendous opposition from the owners with regard to euthanizing infected animals.” This is shocking. Infected horses are still used and kept with other horses. In the meantime if people die, no problem.  All the water is serviced by one river in Katra. All the dead horses are thrown into the water. They urinate and defecate into it. They are washed with its waters. How many people in Jammu are sick? How many of the animal owners are sick? How many pilgrims have carried back the glanders infection with their Prasad?

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