Toxic Shock Syndrome

Overview :

TSS first came to the attention of the public in the 1970s. Shortly after the introduction of a super-absorbent tampon, young women across the United States experienced an epidemic of serious but unexplained symptoms. Thousands went to emergency rooms with high fever, vomiting, peeling skin, low blood pressure, diarrhea, and a rash resembling sunburn. The only thing they had in common was that they all were menstruating at the time they felt sick, and all were using tampons, especially super-absorbent products.

At its height, the epidemic affected 15,000 people in the United States each year between 1980 and 1984; 15% of the women died. Since the offending products were taken off the market, the number of TSS cases has declined sharply. As of 1998, only about 5,000 cases are diagnosed annually in the United States, 5% of which are fatal. The decline most likely is due to tampon manufacturers discontinuing the use of some synthetic materials, and the removal from the market of the brand of tampon associated with most cases of TSS. Today, most of these products are made with rayon and cotton.

In spite of TSS' association with menstruating women, the disease can affect anyone of either sex or any age or race. The infection may occur in children, men, and non-menstruating women who are weakened from surgery, injury, or disease, and who cannot fight off a staphylococcal infection. New mothers also are at higher risk for TSS.

Most cases reported in the recent past, however, still involve menstruating women under age 30. TSS still occurs in about 17 out of every 100,000 menstruating girls and women each year; more than half of these cases are related to tampons. Between five and 10% of patients with TSS die.

Streptococcal toxic shock syndrome (STSS)

A new type of toxic shock syndrome is caused by a different bacteria, called Group A streptococcus. This form of TSS is called streptococcal toxic shock syndrome, or STSS. Officially recognized in 1987, STSS is related to the strain of streptococcus nicknamed the "flesh-eating bacterium." STSS affects only one or two out of every 100,000 Americans. It almost never follows a simple strep throat infection.