Karen O’Donoghue brings her four-year-old son into the pharmacy, where technician Vicky is doing some paperwork.

“Oh hello Jacob,” says Vicky, addressing the young boy. “Are you excited about starting school in a couple of weeks?”

“He is, yes,” replies Karen, as Jacob sits down heavily in the chair by the pharmacy counter. “But whether he’ll be able to is a different matter. He’s not been very well, and I’m starting to worry that there’s something really wrong.”

“What’s been happening?” asks Vicky.

“He had this really sore throat, and I thought it was related to his hayfever so I upped his antihistamine liquid a bit,” explains Karen. “But then his temperature went up and he started complaining that his head hurt and his tummy felt funny. I’m giving him paracetamol, but now he’s got this terrible rash, look.”

Karen pulls up Jacob’s t-shirt and Vicky sees that the skin is rough and red, particularly in the folds of his neck and armpits. She continues: “Has he got something from not brushing his teeth properly? Look at this tongue, it’s a disgrace!”

Vicky kneels down and asks to see inside Jacob’s mouth. As he reluctantly opens it, she sees that his tongue has a white coating and, looking at his face, she notices that he seems flushed.