We studied case-fatality rates (CFRs) among cases of meningococcal disease (MCD) admitted to Makkah (Saudi Arabia) hospitals during the period 1988–97. Of 483 cases, 431 (89·2%) were due to strains of serogroup A, 31 (6·4%) to serogroup W135, 16 (3·3%) to serogroup C, and 5 (1·0%) to serogroup B. Eighty-one patients died (case fatality rate (CFR)) 16·8%, 95% CI 13·5%, 20·4%). The CFR in infections due to serogroup A strains was 14·8%, and for other serogroups it was 32·7% (95% CI 20·3%, 47·1%). The CFR of MCD due to N. meningitidis serogroup A increased steadily with age (P < 0·05). Seeking first medical help at a foreign Hajj medical mission and being treated in a non-specialized hospital were associated with a higher case fatality rate.
