The reemergence of glanders as a zoonotic and occupational infection in Iran and neighboring countries

Abstract

Glanders is a zoonotic infection, and because of recent outbreaks among Equidae family, the possibility of its reemergence among human populations is a crisis. The causative agent is Burkholderia mallei, a Gram-negative, aerobic and highly contagious bacterium causing severe impacts with low infectious dose transmitted via direct contact to respiratory secretions, skin exudates of animals and fomite. Despite high mortality rate, no proper vaccination has been developed to hinder the infection spread. The disease is more prevalent in Australia and Southeast Asia, but has been eradicated in developed countries. Glanders’ clinical signs include pulmonary and disseminated infection depending upon type of infection. Recent reports and outbreaks from Iran and neighboring countries among horses in 2011 and 2017 (Pakistan, Afghanistan and Kuwait), mules in 2008, 2011 and 2017 (Pakistan and Turkey), donkeys and horses in 2011–2015 (Pakistan) and tiger and camels in 2011 (Iran and Bahrain) is a concern. Animal importation or exportation; particularly by healthy carriers is a key route of B. mallei spread. Thus, infection control strategies, accurate and screening before animals’ import, prevention of animal contacts and development of prompt diagnostic approaches and proper therapeutic strategies are essential. Different forms of glanders have emerged or re-emerged in various animals. The factors leading to the re-emergence of the infection mostly include no specific symptoms and anti-B. mallei antibodies, lack of early diagnosis and vaccination strategies, housing conditions, contact with infected and carrier animals and low infectious dose. Sporadic and endemic remote cases have remained in Asia and Middle Eastern countries. Control strategies should focus on surveillance; identify healthy carriers, quarantine and elimination of all infected animals.

Serological surveillance and clinical investigation of glanders among indigenous equines in India from 2015 to 2018

“…The presence of glanders in India, Pakistan (Ghori et al, , ), Bangladesh (Rahman et al, ), Middle East (Kianfar et al, ) and other developing countries in South America poses a huge challenges to veterinary authorities as well as risk to global equine population. Several risk factors contributing to prevalence of glanders in India have been identified during the surveillance.…”

“…The presence of glanders in India, Pakistan (Ghori et al, 2018(Ghori et al, , 2017, Bangladesh (Rahman et al, 2018), Middle East (Kianfar et al, 2019) and other developing countries in South America Considering persistence outbreaks of glanders, targeted surveillance of occupationally exposed/in-contact humans is also included in the plan. For rapid and efficient execution of surveillance activities, twotier serodiagnosis approach has been adopted in this programme.…”

Most important bacterial and parasitic zoonotic diseases in Iran

“…This pathogen is transmitted to humans through direct contact with infected animals and enters into host body through respiratory secretions, inhalation, and cutaneous exudates [40]. Naturally, Glander disease has been eradicated in many countries but has still remained in several regions of Africa, the Middle East, South America, and Eastern Europe [41]. Nowadays sporadic and endemic cases have remained in Asia and Middle Eastern countries.…”

“…Afterward, four African lions and one Siberian tiger died in Tehran zoo with clinical signs of the disease in 2012 [43]. Recent prevalence of disease in horses of Iran and neighboring countries in 2011 and 2017 (Afghanistan, Pakistan, and Kuwait), donkeys and horses in 2011–2015 (Pakistan), mules in 2008, 2011 and 2017 (Pakistan and Turkey), and tiger and camels in 2011 (Iran and Bahrain) gives a massive concern about Glander , s distribution [41]. Recent studies show that different clinical forms of Glanders have emerged or re-emerged in various animals [41].…”

A Review of Glanders Regarded Iraq and Surrounding Countries

“…(18,26). Due to the failure to eradicate the infection in its early stages in 2010, it is argued that continuous care and preventive measures should be taken even after the onset of the infection (35).…”