ANTHRAX:

• Not contagious.
• A toxin.
• Cutaneous, Inhalation and GI symptoms.
• Hemorrhagic lymphadenitis, mediastimitis, meningitis.
• Two Stages: 1) Severe flu-like symptoms, multi-system…hours to days; 2) Fever, SOB, sweats, SHOCK, with lymphedema (especially chest), with or without meningitis.
• Treatment: Prophylaxix, if in the area (Quinolones, …); IV Pcn, Doxy, Cipro, prolonged.
• Possible delayed recurrence. 

• CONTAGIOUS.
• Viremia.
• Nodes and Spleen
• 12-14 day incubation
• Symptoms and signs: high fever, prostration, headache, backache, abdominal pains, delirium, rash – mouth and centrifugal and in various stages of development; if hemorrhagic = faster course to death.
• Treatment: symptomatic (+- antibiotics) and supportive.  VACCINATION.

• Not contagious.
• A toxin.
• Food-borne, or wound, intestinal or inhalation.
• Blocks acetylcholine, +- abdominal symptoms and signs: progressive paralysis, beginning with cranial nerves, symmetrical, descending, flaccid.
• Onset: hours to a day.  Weeks to months duration.
• Treatment: equine antitoxin; supportive; ?antibiotics for secondary infection.

• Bubonic, Septicemic, Pneumonic.
• Animal source: fleas and droplet spread.
• Severe respiratory sx. 1-6 days after exposure; painful bubos; acral gangrene (“Black Death”); Plague pharyngitis; possible meningitis.
• Fever, SOB, cough, hemoptysis; severe pneumonia; GI sx. 
• Treatment: Streptomycin’ Gentamycin; Tettracycline; Doxycycline; Cipro: Sulfa Drugs…

TULAREMIA:

• Mainly Pneumonic.  Also eyes, skin and glands.
• Abrupt after 3-5 days exposure.
• URI, Pleuro-pneumonia, high fever.
• Treatment: Streptomycin or Gentamycin, IM or IV; or Doxy. Or Cipro, po.
  

VIRUSES...

CHEMICALS:

• Pulmonary: Phosgene Gas.
• Vesicants: Nitrogen Mustard; Cyanide (odor of almond)
• Nerve Gas: Sarin… 
• RICIN: Cough and pulmonary edema and / or GI bleed and hepato-renal failure. 

NUCLEAR ATTACK. 

ETC...