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Cutaneous anthrax most common, most survived

ATLANTA, Georgia (CNN) -- A fourth person, this one in New York, has tested positive for anthrax exposure. The news comes two weeks to the day after a Florida man died from a different form of the potentially fatal disease.

The woman in New York, an NBC employee who works in Rockefeller Center, is believed to have contacted the less severe, and seldom fatal form of anthrax known as cutaneous anthrax. The Centers for Disease Control notified New York authorities Friday that a biopsy confirmed the diagnosis.

On September 25, the woman had contact with a letter or package with a white powdery substance and began experiencing symptoms of cutaneous anthrax three days later. The powder subsequently tested negative for anthrax. But the woman continued having symptoms of the disease and developed fever and a lesion. Those conditions led doctors to biopsy the sore.

Anthrax is an infectious, potentially fatal disease caused by a spore-forming bacterium known as Bacillus anthracis. Anthrax occurs naturally in animals and in soil.

Anthrax infections take three forms: cutaneous, inhalation and intestinal.

Cutaneous, or an anthrax skin infection, is the most common and least severe form of the disease. A person may develop this milder form when the contaminant enters the skin through a cut or abrasion. Within 24 to 48 hours, an itchy red bump that resembles a bug bite develops, with a characteristic black area in the center where the skin is dying. Death is rare with proper antibiotic treatment.

Inhalation anthrax, the type that killed a Florida man 14 days ago, began with symptoms resembling a cold. But this form of the disease is usually fatal as the inhaled anthrax spores began producing toxins that kill tissues in the chest cavity and cause bleeding in the lungs.

Intestinal anthrax occurs when people ingest foods contaminated with the bacterium. Vomiting, loss of appetite, nausea, abdominal pain, diarrhea and vomiting of blood are all symptoms of that form of the disease. The mortality rate is between 25 to 60 percent. The death rate varies among the three forms because of how the spores enter a body, according to Dr. Richard Spertzel, an anthrax expert.

"It produces ulcers on the skin, but with the others, you are essentially starting with the organism well into the body, and it's the creation of toxins in the body as the organism grows and divides," Spertzel said.

Penicillin and Cipro are the antibiotics used to treat the disease. However, if treatment commences after the onset of symptoms of inhalation or intestinal anthrax, survival chances drop drastically.


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