There is always the possibility of meningitis. The child could have appeared reasonably well at the airport terminal but have deteriorated rapidly in flight. To parents and others not familiar with the signs and symptoms of meningitis it is something which could have easily been missed. A grumpy child who then went to sleep may have seemed to be exactly that - a slightly nervous child, frightened of new, puzzling surroundings, who simply dropped off to sleep but was, in fact, unconscious. Not every case of meningitis produces the tell-tale petechial rash, nor is every case caused by meningococcus, there are other, nasty bacteria around. Small children with serious infections may not appear to have a raised temperature, they can often be very cold to touch as their peripheral circulation shuts down. Malaria is also a possibility. RIP