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The CDC has released a list of possible agents -- and the early symptoms of disease.


The most deadly form of this disease comes from anthrax spores inhaled into the lungs. Early symptoms are very much like those of the flu: fever, headache, shortness of breath, a cough, and chest discomfort. These symptoms may seem to get better -- but 2 to 4 days later, the symptoms get much worse. Breathing becomes very difficult, the cough is very bad, and chills accompany the fever.

The most common form of this disease comes from anthrax spores that grow on the skin -- most often on the hands, arms, and/or face. There is swelling followed by an itchy, fluid-filled bump. After a day or two, this gets bigger and becomes a painless, open ulcer. Tissue in the middle of the ulcer dies and dries into a sunken black area surrounded by swollen skin and purplish bumps.


Pneumonic plague begins with fever, chest pain, and a cough that brings up dark material or blood.


Early symptoms of this deadly food poison are drooping eyelids, weakened jaw clench, difficulty swallowing or speaking, blurred vision, and trouble breathing. Nausea and vomiting accompany botulism poisoning when the germ is eaten, but these symptoms may not occur if the germ or its poisonous byproducts are inhaled.


Smallpox begins with the flu-like symptoms of muscle aches and fever. After a few days, a rash develops. This rash looks different than the rash of chicken pox. Chicken pox rash is usually most prominent on the body, and spreads in groups of bumpy lesions over the next few days, so there are bumps at different stages of development. Smallpox rash is most prominent on the face, arms, and legs, and its bumpy lesions all develop at the same time.


The inhaled form of tularemia begins with a sudden, flu-like disease. This gets more serious over the next few days as breathing becomes painful.

Hemorrhagic fever (can be caused by the Ebola or Marburg virus, among others):

These extremely deadly diseases begin with sudden fever, headache, and muscle pain. Other symptoms include nausea and vomiting, abdominal pain, diarrhea, chest pain, cough, and sore throat. Usually there is a bumpy red rash on the body. Bleeding disorders occur as the disease gets worse.

2001 WebMD Corporation. All rights reserved.


Panic -- The Real Enemy
What the CDC Says You Should Know About Bioterror

To date, all recent anthrax attacks have come via contaminated letters or packages. Here's what to do if you receive a letter or package that you suspect contains anthrax or any other dangerous germs:

Do not shake or empty the envelope or package. Do not try to clean up any spilled powder or fluid.

Put the envelope or package into a plastic bag or other container to prevent the contents from leaking out. If you can't find a container, cover the envelope or package with clothing, paper, or a trash can -- and DON'T remove this cover.

Leave the room and close the door. Keep other people from entering the room.

Wash your hands with soap and water.

Call the local police and report the incident. If you are at work, call your building security officer and/or your supervisor.

Make a list of all the people who were in the room when you opened the letter or package. Give this list to the police -- and to local public health authorities.

Remove contaminated clothing and put it into a plastic bag that can be sealed. Give the bag of contaminated clothing to the police.

Shower with soap and water as soon as you can. Do not use bleach or disinfectant on your skin.

Do not start taking antibiotics until told to do so by your doctor or by health authorities.


Many bioterror diseases begin with the same symptoms as the flu. To reduce your worry -- and the very real chance of getting ill this winter -- the CDC recommends that people get their flu vaccine this year.

Another good idea is for people to wash their hands regularly -- and properly. Use soap and warm water to scrub the hands for as long as it takes to say the ABCs. And remember to use a paper towel to turn off the faucet, and to open the door as you leave a public restroom.


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