By direct contact with nasal or throat secretions of a carrier or ill person. The organism cannot be spread simply by being in the same room with an infected person. Rarely, transmission occurs by sharing eating utensils, glassware, cigarettes, or toothbrushes, but can occur when people sleep near each other or share a household. Although most people exposed to the meningococcal bacteria do not become ill, others can develop fever, cough, runny nose, intense headache, stiff neck, and unusual skin lesions. There may be a fine spotty pink rash that progresses to dark patches.
Some people develop infections of the blood or brain, which can be fatal.
Even with treatment, about 10 percent of severe cases are fatal. Up to 25 percent of patients who recover have chronic damage to the nervous system. Symptoms appear two to ten days after exposure. A person can transmit the disease from the time they are first infected until bacteria are no longer present in discharges from the nose and throat. The contagious period varies according to treatment.