They vary depending on how the disease was contracted, but symptoms usually occur within seven days. It begins as a raised itchy bump that resembles an insect bite, but soon turns into a painless ulcer, usually one to three centimetres in diameter, usually with a black center in the middle. Lymph glands in the adjacent area may swell. About 20 percent of untreated cases result in death. The employee at NBC who contracted anthrax in the October 2001 incident in the US has cutaneous anthrax.
Inhalation anthrax is usually fatal.
During the Ocotber 2001 incident in the US, an employee of a Florida tabloid publishing company contracted inhalation anthrax and died. Initial signs include nausea, loss of appetite, vomiting and fever, followed by abdominal pain, vomiting blood and severe diarrhoea. Between 25 percent and 60 percent of cases are fatal. Anthrax is global. It is more common in developing countries or countries without veterinary public health programs.