Respiratory infection in humans is relatively rare and presents as two stages . It infects the lymph nodes in the chest first , rather than the lungs themselves , a condition called hemorrhagic mediastinitis , causing bloody fluid to accumulate in the chest cavity , therefore causing shortness of breath . The first stage causes cold and flu-like symptoms . Symptoms include fever , shortness of breath , cough , fatigue , and chills . This can last hours to days . Often , many fatalities from inhalational anthrax are when the first stage is mistaken for the cold or flu and the victim does not seek treatment until the second stage , which is 90 % fatal . The second ( pneumonia ) stage occurs when the infection spreads from the lymph nodes to the lungs . Symptoms of the second stage develop suddenly after hours or days of the first stage . Symptoms include high fever , extreme shortness of breath , shock , and rapid death within 48 hours in fatal cases . Historical mortality rates were over 85 % , but when treated early ( seen in the 2001 anthrax attacks ) , observed case fatality rate dropped to 45 % . Distinguishing pulmonary anthrax from more common causes of respiratory illness is essential to avoiding delays in diagnosis and thereby improving outcomes . An algorithm for this purpose has been developed
2001 anthrax attacks
2001 anthrax attacks
Anthrax