For years, parents have been warned to watch out for the characteristic red rash that can warn of deadly meningitis.

But health chiefs are now saying they need to be on guard for even earlier signs such as cold hands, severe leg pain and mottled skin.

These symptoms can all appear just eight hours after bacterial meningitis strikes and could give doctors a few crucial extra hours to start treatment and save lives.

Up until now a red rash, headache, stiff neck and sensitivity to light have all been regarded as the earliest warning signs.

But these can take up to 13 hours to develop and do not always give doctors enough time to act against the potentially fatal illness - the leading infectious cause of death in children in the UK.

At least four in 100,000 British children become ill with meningococcal disease, which includes septicaemia, or blood poisoning and 10 per cent of those die.

Last December, Helen Thompson, of Shipley, lost her 13-month-old son Joel to pneumococcal meningitis.

In October, the same strain of the disease killed eight-month-old Joshua Holmes, of Windhill.

Both mothers spoke to the T&A last year about the pain of dealing with their baby's sudden death.

Joel went from being a happy, smiley little boy to comatose in just two days. His mother had to make the heart-rending decision to turn off his life support.

Joshua's mother, Heather, had to make the same decision after he suffered a seizure and did not recover.

The warning to parents to look out for earlier signs of meningitis comes after a team of experts in Oxford set out to see if the disease could be detected before a rash appears.

The researchers' 15-month study looked at cases of children aged under 17 who contracted meningococcal disease, using questionnaires given to parents and medical records. Of the 448 children studied, 103 died.

The research found parents and doctors are "over reliant" on the classic symptoms which have often not appeared when the child first sees a GP. But in 72 per cent of the children earlier symptoms such as cold hands and leg pain developed in around eight hours.

Dr Suzanna Mathew, Consultant in Communicable Disease Control for the Health Protection Agency in Bradford, said: "While the effects can be very serious, meningococcal disease (including meningitis and septicaemia) is still quite rare and most patients recover.

"Nationally, the number of cases has fallen dramatically since the introduction of the meningitis C vaccination, but it is important to remember there are other strains for which we don't yet have a vaccine. Therefore, it remains important to be aware of the symptoms.

"The new research confirms our usual advice and that the most important thing is for parents to seek medical help straight away if they are concerned because their child is unwell."

She said symptoms can include:

l a high temperature and/or vomiting

l severe headache

l stiff neck, aching limbs and joints

l a dislike of bright lights

l drowsiness and/or a purple rash, which does not fade when pressed with a glass

l in small babies, refusal to feed and a high-pitched cry

l cold hands and feet

Those most at risk are babies, young children and young adults.

Denise Vaughan, chief executive of the Meningitis Research Foundation, which funded the study, said: "This important research has not only identified the early symptoms of septicaemia but the need for doctors to systematically look for those symptoms in sick children.

"We hope this will change the model of how meningitis and septicaemia are looked for and save lives."

l For immediate, 24-hour advice and information, call NHS Direct on 0845 4647.