CBRNE - Glanders and Melioidosis Follow-up

Updated: Aug 16, 2015
  • Author: Paul P Rega, MD, FACEP; Chief Editor: Duane C Caneva, MD, MSc  more...
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Follow-up

Deterrence/Prevention

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  • Biosafety level 3 containment practices are required for laboratory staff when working with cases of glanders and melioidosis.
  • In countries where glanders is endemic in animals, identification and elimination of the disease in the animal population prevents disease in humans.
  • In areas where melioidosis is endemic, persons who have chronic illnesses that lead to an immunocompromised state should avoid contact with soil and standing water. Wearing boots and gloves during agricultural work is advised.
  • No vaccine is available for glanders.
  • No vaccine is currently approved for melioidosis. However, because of the disease's resistance to multiple antibiotics (ie, beta-lactams, aminoglycosides, macrolides, polymixins) and the frequency of relapses (13-26%), the research for a viable vaccine (eg, live-attenuated, inactivated whole cell, recombinant subunit) continues. Although live-attenuated vaccines seem to be the most effective in mice, this strategy is unlikely to be effective in humans. [19]
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Prognosis

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  • Untreated patients with septicemia have fatal outcomes. Before antibiotics, the death rate for septicemic disease was 95%. It is greater than 50% for septicemic disease and 20% for localized disease despite treatment. Overall, the mortality rate is 40%.
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Patient Education

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