National MP Shane Reti has accused the Ministry of Health of taking its eye off the ball over a deadly meningococcal outbreak in Northland, missing seven "red flags" which could have seen action taken earlier.

A programme to urgently vaccinate 22,500 young children and teenagers in Northland began today after the Government announced it last week to fight an outbreak of the virulent and deadly MenW strain.

Director-General of Health Ashley Bloomfield appeared before the Health Select Committee today where he faced questions about the Ministry's of Health's response to the outbreak.

Reti said there were seven red flags that indicated that there was a flare-up of meningococcal disease in May.

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They were that the numbers of cases of meningococcal disease almost doubled since the beginning of the year; in April the percentage of all new cases that were menW was 50 per cent and in May it was 100 per cent; from April the public health monthly surveillance data noted meningococcal disease was a trend; in May a Northland DHB clinician outlined his concerns to staff; in May the DHB contacted the ministry and requested a vaccination campaign; in May a clinician presented at a GP conference in Russell on meningococcal disease and said "I fear for deaths this winter"; and the ministry's own immunisation update in which meningococcal disease came under the heading "Outbreaks".

"I'm contending there were seven glaring red flags in May and the ministry took its eye off the ball," Reti, a Northland GP, told Bloomfield.

"I don't think the ministry took its eye off the ball. What I can say is that as soon as soon as we had advice that was confirmed by a specially convened technical advisory group that there was a community outbreak in Northland, we took very quick action," said Bloomfield.

Reti claimed in Parliament last week that Health Minister David Clark and the ministry knew in May that there was an outbreak of meningitis in Northland, and New Zealand.

"Initially at the beginning of the year it was general strains of meningitis. We're interested in meningococcal W. Well, in April the Ministry was first flagging that 50 per cent of their cases in April were actually meningococcal W, and the following month it was 100 per cent.

"So way back in May, the Minister and the ministry knew that there was an outbreak for meningitis in Northland and in New Zealand. In fact, the two first deaths occurred at least as early as March," Reti told Parliament last week.

He said, quoting ministry figures, that there were four cases of meningitis. That doubled in February to 10 cases. It doubled again in March to 22, with two deaths.

In April the figure rose to 29 and in May it was 39, according to the ministry's website, Reti said.

Northland DHB chief executive Nick Chamberlain told the Health Select Committee today although the DHB was pushing for a vaccination campaign in May, it knew it had to wait until it reached community outbreak status, which occurred in October.

Reti said four of the "red flags" applied to Northland DHB.

Chamberlain said Northland DHB could not predict an outbreak in the region in May but felt, from the trends, a nationwide campaign would be necessary at some stage.

"We were always really aware that we had to hit that [outbreak] level," he said.

Once it was triggered the outbreak status at the end of October a decision to initiate a vaccination campaign was made "reasonably quickly", he said.