The symptoms of toxic shock syndrome (TSS) normally begin with a sudden high fever (body temperature rises above 38.9C/102F).

Other symptoms then rapidly develop, normally in the course of a few hours. They may include:

• flu-like symptoms including headache, muscle aches, sore throat and cough
• nausea and vomiting
• diarrhoea 
• fainting or feeling faint
• dizziness or confusion

A widespread sunburn-like skin rash may also occur, with the whites of the eyes, lips and tongue becoming more red than usual.

One or two weeks after the rash appears, it is common that the skin begins to shed in large sheets, especially from the palms of the hands and soles of the feet.

People with streptococcal TSS may also have the symptoms of a serious streptococcal infection. For example, pain in the muscles, abdominal pain (such as after childbirth) or cough.

When to seek medical advice

If you develop a sudden fever and one or more of the other symptoms listed above, it is still extremely unlikely that you have TSS. However, symptoms like these should never be ignored. Contact your GP, local out-of-hours service or NHS 111 immediately.

If you are wearing a tampon, remove it straight away. Also tell your GP or doctor if you have been using a tampon, recently suffered a burn or skin injury, or if you have a skin infection such as a boil or a blister that has become infected.