A baby or young child has any of these symptoms:

• blue, grey, pale or blotchy skin, lips or tongue – on brown or black skin, this may be easier to see on the palms of the hands or soles of the feet
• a rash that does not fade when you roll a glass over it, the same as meningitis
• difficulty breathing (you may notice grunting noises or their stomach sucking under their ribcage), breathlessness or breathing very fast
• a weak, high-pitched cry that's not like their normal cry
• not responding like they normally do, or not interested in feeding or normal activities
• being sleepier than normal or difficult to wake

They may not have all these symptoms.

An adult or older child has any of these symptoms:

• acting confused, slurred speech or not making sense
• blue, grey, pale or blotchy skin, lips or tongue – on brown or black skin, this may be easier to see on the palms of the hands or soles of the feet
• a rash that does not fade when you roll a glass over it, the same as meningitis
• difficulty breathing, breathlessness or breathing very fast
• large areas of peeling skin

They may not have all these symptoms.

You think you might have toxic shock syndrome and you have any of these symptoms:

• a high temperature
• feeling shivery, with muscle aches
• vomiting and diarrhoea
• severe pain in your arms or legs, or all over your body
• a rash that feels rough like sandpaper – the rash may look red, which can be harder to see on brown or black skin
• the palms of your hands, soles of your feet, tongue and the whites of your eyes turn bright red
• swollen or peeling skin
• feeling sick, dizzy or confused

Call 111 or check symptoms on 111 online.

If you're using a tampon or menstrual cup, remove it. Tell 111 that you were using one.