Family gathered to farewell Jacob at Ruakaka on Friday. Some family members will face Howe's funeral tomorrow in Tuakau.
Dr Clair Mills, Northland District Health Board's medical officer of health, said Howe had gone to Starship Hospital to visit baby Jacob on August 15. Howe was found to have contracted meningococcal disease two days later.
Mills said the time difference was outside the normal 24-hour period in which the disease was contracted. It was unknown whether the victims had contracted the same strain of the disease, she said.
Mills confirmed the two cases "could possibly be linked", but an answer relied on tests being done by the ESR laboratory in Wellington.
"I'm interested in finding out as well but I can't make the laboratory work any faster. We can't exclude it at the moment. But we can't conclude anything either. There will be some discussion about whether there is any possibility they are linked."
Mills said health authorities were also investigating family connections between the people who had contracted meningitis. Staff in Auckland and Northland had worked to establish or dismiss a link. "The question of how they contracted it is yet to be resolved."
The death of Jacob had been "horrendous for the whole family", said Whangarei doctor Cassandra Winton, who works with Jacob's grandmother.
The 1-year-old had very close contact with several family members, all of whom would have been at risk. But only Josie contracted the disease, she said.
It was spread through contact such as coughing. To contain the spread, once a case was confirmed, all close contacts were treated with penicillin and separated from other people. Meningitis could have a devastating effect if contracted, said Winton. "It's just an awful disease - kids lose their fingers and limbs. It's very disfiguring."
The four Northland cases were not yet an epidemic, but she said "it may be becoming that way".
THE DISEASE
* Meningococcal disease is a serious bacterial infection spread through coughing, sneezing and kissing.
* Symptoms include a high temperature, headache, vomiting, sleepiness, a stiff neck, sensitivity to light, joint and muscle pains and a rash. Sufferers can die within hours of feeling unwell.
* An immunisation programme between 2004 and 2007 put a stop to New Zealand's last epidemic of the disease - but there have been four new cases in Whangarei this month.
* Last month, Fulton Hogan NZ chief executive Bill Perry, 48, died suddenly from the disease in Christchurch.
* The Ministry of Health says one in five people carry meningococcal bacteria in their nose and throat without getting sick.
- additional reporting Abby Gillies
