Table 1 Case definition for invasive meningococcal disease, used for notification to the national level in the Netherlands (OSIRIS)

A person with at least one of the following symptoms:

 • Fever

 • Neck stiffness

 • Petechiae

 • Septic shock

 • Septic arthritis

In combination with at least one of the following laboratory criteria:

 • Detection of N. meningitidis by culture of normally sterile material (e.g. blood or cerebrospinal fluid (CSF))

 • Detection of gram-negative diplococci in CSF, blood or biopsy of petechiae

 • Detection of DNA of N. meningitidis by PCR of normally sterile material (e.g. blood or CSF)