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What are the symptoms*? 12

Early symptoms of meningococcal disease are difficult to distinguish from those of more common but less serious illnesses. This lack of distinct IMD-specific early symptoms often results in initial misdiagnosis.
It also leads to delays in taking appropriate and potentially life-saving treatment options.
Intervention often does not occur until identification of later symptoms that are IMD-specific, such as:

  • Haemorrhagic rash (i.e., rash associated with bleeding under the skin surface)
  • Neck stiffness

IMD can progress from non-specific symptoms in the first 0–8 hours to close to death by 24 hours: 1

Early signs and symptoms are non-specific and can resemble other, less serious conditions

N. meningitidis replicates rapidly in the body, classic meningitis symptoms appear such as cold hands/feet, haemorrhagic rash, neck stiffness, photophobia, meningism, bulged fontanelle (in infants < 1 year of age)

May progress from non-specific symptoms to death within 24 hours:

Breathing difficulty




Septic shock

Multi-organ failure


*signs and symptoms are age-dependent 1


  1. Thompson MJ, et al., Clinical recognition of meningococcal disease in children and adolescents Lancet. 2006;367(9508):397–403
  2. Rosenstein NE, et al., Meningococcal disease, N Engl J Med. 2001;344(18):1378–1388

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