Children given the all-clear after a suspected meningococcal infection may still be at risk of the disease, a Hawke's Bay health chief has warned.
Medical Officer of Health Dr Lester Calder said though cases of the disease were rare in the region, it was still important to be vigilant and for parents to understand the urgency required should there be a risk.
"People need to understand the symptoms. The important thing is a rash which spreads rapidly over the body, and the baby or child or adult will become rapidly ill."
His comments follow the death of Wellington schoolgirl Amanda Crook-Barker this week.
The 12-year-old is the third fatal meningococcal case this year. She died on Monday evening after falling ill that afternoon.
Dr Calder said it would be unwise for parents to relax, even if their child had been cleared by a doctor.
"Sometimes the disease is not that easy to diagnose in the early stages.
"If the doctor considers it not to be meningococcal disease, but things are getting worse, go back to the doctor."
Meningococcal disease, which mainly affects infants and teenagers aged 15 to 19 years, is caused by bacteria spread through spit. Thirty-eight cases of meningococcal disease have been reported nationally between January 1 and July 31, according to Environmental Science and Research figures, none of which were in Hawke's Bay.
People infected with the bacteria can deteriorate rapidly and often exhibit flu-like symptoms.
Those who survive are sometimes left with serious disabilities as amputation of limbs can be necessary when fighting the illness.
Dr Helen Petousis-Harris of the Immunisation Advisory Centre recommended being vaccinated against the disease, especially those in the high-risk age groups.
There were two main types of vaccines available in New Zealand which could be purchased from GPs.
Both protect against the most prevalent strain "C" of the disease, which accounts for about 50 per cent of cases.
The most effective of the pair - conjugate vaccines - can be administered in infants at any age and works for about 10 years.
But at a cost of more than $100, it is often an expense many Kiwi parents struggle to afford.
From 2004 to 2008, an outbreak of Meningococcal B saw the MeNZB vaccine added to New Zealand's immunisation schedule for a short period. It has since been removed as the "B" strain does not pose a major threat.
Dr Petousis-Harris warned that none of the vaccines available in New Zealand and overseas provided full protection from meningococcal disease.
The polysaccharide vaccines, which cost about $30, last for about four years and only work in infants over the age of 2.
It was important people immunise their children as early as possible, then consider a "booster" shot during their teenage years, Dr Petousis-Harris said.
"You tend to see infants becoming susceptible after six months.
"They are really vulnerable because at that time they haven't started making their own protection against diseases."
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