The early phase of meningococcal disease.

In a prospective case control study in Norway during the winter 1981-1982, 115 patients with systemic meningococcal disease were compared with 61 patient controls. Initially, skin bleedings, reduced general condition and consciousness, and body pain were seen more often, but irritability less often in meningococcal patients than in the patient controls. The meningococcal patients presented symptoms typical of infectious diseases in general. Symptoms that correlated with a poor prognosis of the meningococcal disease were reduced consciousness, cyanosis, and early diarrhea. The mean time interval from start of the meningococcal disease until admission to hospital was 34 hours. No deaths occurred when less than six hours elapsed before it was decided to admit the patient. All fatal cases were admitted by the first doctor who saw the meningococcal patient. Contact with the family doctor does not seem to have reduced the risk of death. To avoid unnecessary delays, access to hospitals should be facilitated, and efforts should be made to shorten the time interval before patients with relevant symptoms are seen by a doctor.