Several patients are admitted after a being exposed to a substance that was rele

1 -- Inhalation anthrax carries the highest mortality rate. The patient initially exhibits influenza-like symptoms such as fever, nonproductive cough, headache, and malaise that advance to respiratory distress, mediastinal widening, and hemodynamic collapse in 3 to 5 days. Death may occur shortly thereafter. Untreated patients die in 2 to 3 days. Smallpox spreads by direct contact or by inhalation of respiratory droplets. Symptoms include a high fever, headache, and malaise, followed by a vesicular/pustular rash appearing simultaneously on the face and extremities. A dirty bomb will cause radiation sickness. Nuclear detonation causes thermal burns.