Scientists in the UK say they have identified the early signs of meningitis and blood poisoning which should improve detection of the disease and save lives.
The characteristic rash is the most well-known meningitis symptom, but cold hands, severe leg pain and very pale skin can also be early warning signs of bacterial meningitis.
In many developed countries bacterial meningitis is the leading infectious cause of death in children.
It is estimated that at least four in 100,000 British children will become ill with meningococcal disease, which also includes septicaemia, or blood poisoning, and 10% of those infected will die.
In many cases, children are only admitted to hospital after their condition is initially misdiagnosed.
It seems doctors often mistake the disease for a common virus.
A team of experts at the University of Oxford carried out research in order to find out if the potentially fatal condition could be detected before the characteristic rash appears.
Dr Matthew Thompson and his team identified the early symptoms after analysing questionnaires filled in by parents of 448 children with meningitis.
One hundred and three of the children had died.
They found that 72 percent of children had early signs of infection, and while most had no symptoms in the first 4-6 hours they were close to death after 24 hours.
It was found that the classic symptoms of the illness did not appear until 13-22 hours after infection.
The average time for admission to hospital was 19 hours.
Leg pain, cold hands and feet and abnormal skin colour develop within 12 hours after infection and long before the more classic signs of the illness such as a rash, headache, stiff neck, sensitivity to light and impaired consciousness.
Dr Thompson says that doctors and parents should be able to identify children with this potentially fatal infection at an earlier stage and before they get really ill.
Meningitis is a bacterial infection of the lining that surrounds the brain and spinal cord, and is spread by sneezing, coughing, kissing and living in close quarters such as dormitories and military barracks.
The disease can cause brain damage, hearing loss and learning disability.
As a rule patients are treated with antibiotics.
According to the World Health Organisation, about 5-10 percent of patients die from the illness, usually within 24-48 hours after symptoms begin.
Dr Thompson said GPs in particular need to move away from the "traditional" signs on which there is an over-reliance.
The Meningitis Research Foundation, which funded the study, says they hope it will change the model of how meningitis and septicaemia are looked for in primary care and thereby save lives.
The report is published by The Lancet medical journal.