Symptoms of sepsis, such as cold hands, severe leg pain and very pale skin can all be early warning signs of bacterial meningitis, parents are being advised.
Thousand's of children's lives will be saved the world over after meningitis researchers identified new early-warning signs for parents, which could speed diagnosis and treatment.
Until now, parents have been warned to look out for their child having a headache, stiff neck, sensitivity to light and a pinprick rash as signs of meningitis. But these symptoms can occur as late as two hours from the child being critically ill or even dying, leaving little time for treatment.
Now research has highlighted three new earlier symptoms of the infection - leg pain, cold hands and feet, and an abnormally pale, mottled skin colour - which together, or separately with other signs such as fever, can be indicators of the condition.
In developed countries such as the UK, bacterial meningitis is the leading infectious cause of death in children. At least four in 100,000 British children will become ill with meningococcal disease - which also includes septicemia, or blood poisoning, and 10 percent of those infected die. In many cases, children are only admitted to hospital after their condition is initially misdiagnosed.
These number runs into thousands worldwide.
Dr Matthew Thomson, from Oxford University, who led the research, said, "This disease develops so quickly in children - from the child becoming ill to being dead within 24 hours," he said. "The sooner a child can be spotted and admitted to hospital, higher the chances of survival."
Dr Thompson led a team investigating children who contracted the most dangerous, bacterial form of meningitis. Most had only non-specific symptoms in the first four to six hours, but were close to death 24 hours after infection. Classic symptoms developed late, after an average of 13 to 22 hours. However, 72 per cent of the children developed identifiable early sepsis (infection) symptoms in just eight hours on average.
Almost three out of four parents noticed the onset of symptoms such as cold hands and feet, leg pain, and abnormal pallor up to 19 hours before their children were admitted to hospital.
The researchers analysed patient questionnaires and scoured medical records. Of the 448 children surveyed, all aged 16 or younger, 103 died and 345 survived. Only half the children were sent to hospital the first time they saw a doctor. In many cases, children were admitted to hospital only after an initial misdiagnosis, the research found.
Generally, primary-care clinicians are over-reliant on the classic symptoms of rash, headaches, stiff neck, light sensitivity and impaired consciousness to diagnose a meningococcal disease in children. The research team felt.
Often children were seen by a local GP who had never encountered a case of meningitis outside hospital.
Dr Thompson warned that the research was in the early stages, but recommended that all parents be informed of the new warning signs.
The new warnings relate to the early signs of meningococcal disease, which can lead to meningitis as well as septicaemia and blood poisoning.
Vaccination can protect children against meningitis C, but other strains, most commonly meningitis B, kill children and adults indiscriminately.
How Meningitis strikes
·Sensitivity to light
·Severe leg pain which prevents the child standing or walking
·Cold hands or feet - when the child is running a temperature
·Very pale, blue or dusky skin around the lips