The external form of the disease, which sometimes strikes people who handle infected fleeces, causes unpleasant sores. The pneumonic form is far more serious, killing more than 90 per cent of its victims if left untreated. As few as 8000 spores per person reliably causes a lethal infection. The spores cross the epithelial lining of the lungs and travel to the lymph nodes, where they germinate, multiply, and then spread to the other tissues, releasing toxins as they go. The first symptoms include vomiting, fever, a choking cough and laboured breathing.
Antibiotics can cure patients in the earlier stages of the disease.
Without antibiotics, death from haemorrhage, respiratory failure or toxic shock follows within a few days. The OTA report emphasised that, for the most part, transforming B. anthracis into a weapon is a low-tech procedure. Zilinskas emphasises that making an anthrax weapon capable of murder on this scale is not a trivial undertaking. But while it may be much more difficult than building a fertiliser bomb, the problems are far from insurmountable. You have to dry it somehow, adjust the particle size, load it into a canister, and spray it.