Central Coast Local Health District (CCLHD) is urging people to be alert to lesser known signs of meningococcal disease.
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The warning comes after a Hunter women died from the disease at the weekend, and two Central Coast women were diagnosed earlier this year.
Authorities are concerned as the peak period for the disease is still more than a month away.
CCLHD acting director of public health Dr Katherine Todd said meningococcal disease could occur at any time of year, but cases normally started to increase towards the end of flu season when people's immune systems were weaker.
"Last year CCLHD reported two cases of meningococcal disease. It is a rare but serious bacterial infection that can cause death within hours so the more symptoms people know about, the better," Dr Todd said.
"Most cases occur in infants, young children, teenagers and young adults, although people of any age can be affected."
NSW Health's director of communicable diseases, Dr Vicky Sheppeard, said meningococcal could often mimic other common illnesses, so it was important to be aware nearer spring that nausea symptoms, vomiting, neck stiffness, joint pain, light sensitivity, or a sudden fever, could be something else.
"Most people normally associate meningococcal disease with a rash of red-purple spots or bruises but in some cases a rash doesn't appear, or it could be the last symptom to take shape," Dr Sheppeard said.
Meningococcal infection does not spread easily. It is spread by secretions from the nose and throat of a person who is carrying the bacteria.
Close and prolonged contact is needed to pass it on.
"It more commonly occurs in people aged between 15 to 24 years as they tend to be involved in more intimate social activities such as kissing," Dr Sheppeard said.
Vaccination is the best means of protection against meningococcal disease.
Vaccination for meningococcal disease types A, C, W and Y, is available on the National Immunisation Program for infants at 12 months of age and adolescents in year 10 at school.
Any adolescents aged 15 to 19 years who miss the vaccine in school are eligible for a free vaccine from their GP.
However, as there are several strains of meningococcal disease, and vaccination does not cover all strains, even vaccinated people need to be on the lookout for symptoms.
The latest Annual Immunisation Report shows vaccination rates in NSW are at their highest level ever, with close to 95 per cent of five year olds fully vaccinated.
The state government will invest around $130 million in the 2019-20 Immunisation Program Budget, including commonwealth and state vaccines.
For more information visit cclhd.health.nsw.gov.au
