A somewhat confusing report in Lebanon’s The Daily Star describes an outbreak of disease at Beirut’s Hippodrome (racetrack) that has resulted in the deaths of 21 horses; 2 from disease and 19 that were euthanized as part of the outbreak response.

It’s not specifically stated in the report, but the commentary about glanders, a highly infections disease caused by the bacterium Burkholderia mallei, suggests that glanders has been diagnosed or is strongly suspected. The two affected horses had been imported from Syria, which has been the source of other glanders outbreaks, and the disease is present in multiple countries in the region, so it’s a likely cause. The reason for euthanasia of the 19 "healthy" (presumably exposed) horses is unclear. Hopefully it was done because they were identified as infected, however the report suggests that euthanasia preceded diagnosis.

Little information was provided about the response, beyond culling, with only a statement that "all relevant procedures had been taken." Additionally, a quarantine and testing requirement for horses entering Lebanon was announced by the mayor (presumably, a federal body has mandated this since I doubt the mayor of Beirut can set national importation policy). Measures for controlling glanders outbreaks are fairly well described and involve extensive investigation of horse contacts and movement, screening of potentially exposed horses, euthanasia of positive horses, quarantine of potentially exposed farms and use of stringent infection control practices. Hopefully a proper response is being undertaken here.

Beirut’s mayor stated that there was "no possibility that the disease could be spread to humans," but that isn’t consistent with glanders since this is a potentially serious disease in people as well. Two grooms that worked with the first two horses were tested and so far are negative and healthy. The likelihood of someone getting infected from an infected horse isn’t great, but it’s a very nasty disease so care must be taken and investigation of human contacts is important.

The Agriculture Ministry will apparently release its "all-clear" report in 6 months (assuming no more cases crop up). Let’s hope that things truly are "all clear" in 6 months, with a subsequent report (presumably after official confirmation that the outbreak is over) thereafter. More details about the extent of testing and the results would be nice in the short term, to get a better understanding whether this is truly just a case of a couple of infected horses being imported with no transmission outside of the initial group, but political issues often limit the information flow in glanders outbreaks.

Image: Beirut Hippodrome (click for source)