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Meningococcus

13 October 2026

Meningococcus is a bacterium that can cause meningitis and bloodstream infections. The disease is rare but can progress rapidly and become life-threatening. It can occur at any age, but infants are at increased risk.

Symptoms may include:
  • Fever.
  • Headache.
  • Vomiting.
  • Stiff neck.
  • Infants may also experience feeding difficulties, unusual drowsiness, abnormal crying, and irritability.

If you notice symptoms that may indicate meningococcal disease, seek medical attention immediately. Do not wait for a rash to appear.

The bacterium spreads through close contact with respiratory secretions. Following exposure to an infected person, the Health Bureau identifies people at risk and, when necessary, provides instructions for preventive antibiotic treatment.

Two vaccines can help reduce the risk of disease:
  1. Bexsero vaccine: Recommended in Israel for infants and toddlers starting at 2 months of age. It protects against most strains of meningococcal group B.
  2. MenACWY vaccine: Protects against 4 other groups of meningococcal bacteria.

Meningococcus (Neisseria meningitidis) is a bacterium that can cause meningitis, bloodstream infections, and other infections. The disease is rare, but when the bacteria enter the bloodstream or the fluid surrounding the brain and spinal cord, it can become life-threatening within hours.

The bacteria can be present in the nose and throat of healthy people without causing illness. This is known as "carriage." The disease can occur at any age, but infants, young children (especially those under 2 years old), and teenagers are at increased risk.

Warning Signs That Require Immediate Medical Attention

Meningococcal disease can worsen rapidly, so it is important to recognize the warning signs as early as possible.

Not all symptoms need to appear together. Even one severe symptom, or a combination of symptoms that raises suspicion of the disease, requires immediate medical attention.

These are the warning signs to watch for:

In infants and toddlers

  • Fever accompanied by unusual drowsiness, difficulty waking up, refusal to eat, or unusual, persistent crying.
  • Significant limpness or stiffness of the body.
  • A bulging or tense fontanelle (the soft spot between the bones of a baby's skull), especially when accompanied by fever or changes in behavior.

In older children

  • Fever accompanied by a severe headache, stiff neck, or sensitivity to light.
  • Confusion, unusual drowsiness, or difficulty waking up.
  • Severe body aches, especially when accompanied by fever and a rapid deterioration in overall condition.

At any age

  • A red or purple rash that does not fade when pressed.
  • Severe difficulty breathing, seizures, or unresponsiveness.

Important to Remember

Important to Remember

Meningococcal disease can worsen rapidly, so it is important to recognize the warning signs as early as possible. Not all symptoms need to appear together. Even one severe warning sign, or a combination of symptoms that raises suspicion of the disease, requires immediate medical attention.

Symptoms

In the early stages of the disease, symptoms may resemble those of the flu or other common childhood illnesses, but the condition can worsen within hours. Symptoms vary depending on age and the type of infection that develops:

  • Infants and toddlers

    • Fever.
    • Decreased appetite or feeding difficulties.
    • Vomiting.
    • Irritability, restlessness, or unusual crying.
    • Decreased activity.

  • Older children

    • Fever, sometimes with sudden onset.
    • Headache.
    • Nausea and vomiting.
    • Muscle and joint pain.
    • Sensitivity to light (discomfort even from ordinary room lighting, keeping the eyes closed, and reluctance to open them unless the room is darkened).

When a bloodstream infection develops, additional symptoms may include:

  • Chills.
  • Cold hands and feet.
  • Severe body aches.
  • Rapid breathing.
  • Rash.

Symptoms do not necessarily appear together or in a particular order. If any of the warning signs described at the beginning of this article appear, or if the child's condition worsens rapidly, seek immediate medical attention.

Please note

Please note

In infants up to 2 months old, a fever above 38°C requires immediate medical attention, even if there are no other symptoms.

What causes the disease and the different groups of bacteria

There are several groups of meningococcal bacteria, which differ in the structure of their outer capsules. The main groups that cause disease worldwide are A, B, C, W, X, and Y. In Israel, group B is the most common, while groups A, C, W, and Y are less common.

Distinguishing between these groups is important because available vaccines protect against different groups of the bacteria.

How the bacteria spread

Meningococcal bacteria spread from person to person through nasal and throat secretions from people who are sick or carry the bacteria. Transmission occurs mainly through close or prolonged contact, such as between family members living in the same household, or through direct contact with saliva, such as kissing or sharing drinking utensils.

The bacteria do not spread easily through brief, casual contact. Therefore, simply being in the same room as someone who is sick is not always considered an exposure that requires preventive treatment.

The incubation period, meaning the time between infection and the onset of symptoms, is usually 3–4 days but can last up to 10 days.

At-risk groups

The disease can occur at any age, but certain groups are at increased risk:

  • Infants and young children: Especially babies under one year of age.
  • Adolescents and young adults.
  • People with certain medical conditions: For example, people who do not have a spleen or whose spleen does not function properly, people with certain immune system deficiencies, or those taking medications that suppress specific immune system functions.
  • People exposed to someone with the disease: Particularly through close or prolonged contact.
  • People staying in settings where the risk of infection is higher: For example, certain crowded living environments or regions of the world with higher rates of disease, such as parts of sub-Saharan Africa.

What to Do After Exposure to an Infected Person

When a case of invasive meningococcal disease is identified, it is important to identify people who were exposed to the infected person to prevent further infections. In Israel, the Health Bureau conducts an epidemiological investigation and determines who needs preventive antibiotic treatment.

Steps to Take After Exposure:

The Health Bureau identifies people who had close contact with the infected person. In daycare centers and preschools, the nature of contact between the infected person and the children and staff is assessed to determine who is considered a close contact.

People identified as close contacts will receive preventive antibiotic treatment as soon as possible, in accordance with medical guidelines. The treatment is intended to reduce the risk of developing the disease and transmitting the bacteria to others. Children who have previously been vaccinated may also need preventive treatment after exposure.

After exposure, it is important to watch for symptoms in accordance with Health Bureau guidelines. If symptoms suggestive of the disease appear, seek immediate medical attention, even if preventive antibiotic treatment has already been given.

If you learn of a meningococcal disease case at your child's school or daycare and have not received instructions, you can contact your HMO or Health Bureau for guidance. If warning signs appear, do not wait for the epidemiological investigation to be completed.

Diagnosis

If meningococcal disease is suspected, urgent medical evaluation is required. To make a diagnosis, a healthcare provider may order several tests:

  • Blood tests: To identify the bacteria and assess the severity of the infection.
  • Lumbar puncture (spinal tap): A procedure in which a sample of the fluid surrounding the brain and spinal cord is collected to check for meningitis.
  • Additional laboratory tests: For example, molecular tests to identify the bacteria.

If there is a strong suspicion of meningococcal disease, antibiotic treatment is started as soon as possible, without waiting for test results.

Treatment and Possible Complications

Invasive meningococcal disease is treated in a hospital with antibiotics, usually given intravenously. Depending on the severity of the disease, treatment may also include fluids, breathing support, and admission to an intensive care unit.

Despite the availability of antibiotic treatment, the disease can be life-threatening. Even with appropriate treatment, the mortality rate is 5%–10%.

Long-term complications may occur even after recovery, including hearing loss, nervous system damage, developmental delays, movement difficulties, and sometimes damage to the limbs.

 

Prevention: Meningococcal Vaccines

Vaccination is one of the main ways to reduce the risk of meningococcal disease. It is important to know that there are several groups of meningococcal bacteria, and different vaccines protect against different groups.

  • Bexsero vaccine – Meningococcal group B

    The Bexsero vaccine protects against most strains of meningococcal group B, the most common group in Israel. The vaccine is recommended for infants and toddlers starting at 2 months of age. It is not included in the routine immunization schedule and is not administered at Family Care Centers. It is available through HMOs with a doctor's referral. It is worth checking whether your supplemental health insurance offers coverage or discounts. The number of doses and vaccination schedule depend on the age at which vaccination begins.

    Full information about the Bexsero vaccine

  • MenACWY vaccine – Groups A, C, W, and Y

    This vaccine protects against 4 other groups of meningococcal bacteria but does not protect against group B. In Israel, it is not part of the routine immunization schedule for infants. It may be recommended for people in certain medical risk groups and for travelers to destinations where meningococcal disease is more common or vaccination is required. Whether vaccination is needed and when it should be given depend on age, medical condition, and travel destination.

    Information about vaccinations for international travelers on the Ministry of Health website

These are the warning signs to watch for:

  • Avoid sharing drinking utensils and toothbrushes.
  • Wash your hands regularly.
  • Avoid close contact with people who are sick.

If you know you have been exposed to someone with the disease, it is important to follow the instructions of the Health Bureau.

Not necessarily. The need for preventive treatment depends on the nature of the exposure to the infected child. The Health Bureau conducts an epidemiological investigation, identifies close contacts, and determines who needs treatment. If your child develops symptoms that may indicate the disease, seek immediate medical attention, even if you have not yet received instructions.

Not necessarily. The Bexsero vaccine, which protects against group B meningococcal disease, is not included in Israel's routine immunization schedule. It is recommended for infants and toddlers starting at 2 months of age and is available through HMOs with a doctor's referral.

No. The Bexsero vaccine is designed to protect against most strains of group B meningococcal bacteria. It does not protect against other meningococcal groups and does not guarantee complete protection against all group B strains. Therefore, even vaccinated children may need preventive antibiotic treatment after exposure to an infected person.

Yes, although it is rare. Recovering from meningococcal disease does not guarantee protection against all groups of meningococcal bacteria. If the disease occurs again, a medical evaluation of the immune system may be recommended.

If you learn that your child has been in contact with someone with meningococcal disease, contact your HMO or the Health Bureau as soon as possible, even if several days have passed since the exposure. Preventive antibiotic treatment is most effective when given as soon as possible after exposure. The need for treatment will be determined based on the nature of the exposure and how much time has passed.