title: Bichat guidelines for the clinical management of glanders and melioidosis and bioterrorism-related glanders and melioidosis.
abstract: Glanders and melioidosis are two infectious diseases that are caused by Burkholderia mallei and Burkholderia pseudomallei respectively. Infection may be acquired through direct skin contact with contaminated soil or water. Ingestion of such contaminated water or dust is another way of contamination. Glanders and melioidosis have both been studied for weaponisation in several countries in the past. They produce similar clinical syndromes. The symptoms depend upon the route of infection but one form of the disease may progress to another, or the disease might run a chronic relapsing course. Four clinical forms are generally described: localised infection, pulmonary infection, septicaemia and chronic suppurative infections of the skin. All treatment recommendations should be adapted according to the susceptibility reports from any isolates obtained. Post-exposure prophylaxis with trimethoprim-sulfamethoxazole is recommended in case of a biological attack. There is no vaccine available for humans.
authors.affiliation: Task Force on Biological and Chemical Agent Threats, Public Health Directorate, European Commission, Luxembourg. philippe.bossi@psl.ap-hop-paris.fr
authors.forename: Philippe
authors.initials: P
authors.lastname: Bossi
authors.forename: Anders
authors.initials: A
authors.lastname: Tegnell
authors.forename: Agoritsa
authors.initials: A
authors.lastname: Baka
authors.forename: Frank
authors.initials: F
authors.lastname: Van Loock
authors.forename: Jan
authors.initials: J
authors.lastname: Hendriks
authors.forename: Albrecht
authors.initials: A
authors.lastname: Werner
authors.forename: Heinrich
authors.initials: H
authors.lastname: Maidhof
authors.forename: Georgios
authors.initials: G
authors.lastname: Gouvras
mesh_terms: D023482:Bioterrorism / Q000517:prevention & control* / Q000706:statistics & numerical data; D003140:Communicable Disease Control / Q000458:organization & administration*; D004196:Disease Outbreaks / Q000517:prevention & control / Q000706:statistics & numerical data; D005060:Europe; D005062:European Union; D005896:Glanders / Q000175:diagnosis* / Q000453:epidemiology / Q000628:therapy*; D006801:Humans; D008554:Melioidosis / Q000175:diagnosis* / Q000453:epidemiology / Q000628:therapy*; D011159:Population Surveillance / Q000379:methods