If you were a Generation X baby or beyond, you were most likely told about toxic shock syndrome (TSS) when you learned about tampons during adolescence. Soon after, you probably forgot about it. Your mom would have told you not to worry to calm you down. After all, not many people know someone who has had TSS.
That is, until now.
We hate to be the bearers of bad news, but the talk of TSS is back. That’s because toxic shock syndrome has made a resurgence in headlines due to new cases of the illness.
According to The Washington Post, five new cases of tampon-oriented TSS have been reported in the state of Michigan in recent months. While the illness is still extremely rare, it’s a reminder of just how dangerous bacteria can be.
According to the Mayo Clinic, TSS is a potentially life-threatening issue related to bacterial infections often caused by staph, which is medically referred to as Staphylococcus bacteria. But it can also be seen in relation to group A streptococcus bacteria, which we would call strep.
The scary part of TSS is that it can be deadly. In fact, The Washington Post reports that TSS caused by S. aureus results in death 5 to 15 percent of the time. And when it comes to TSS related to strep, death is said to occur in about 30 to 70 percent of cases.
The recent development of TSS related to tampons is surprising because the most dangerous tampons haven’t been sold in years. These concerning tampons were pulled from shelves decades ago, which resulted in fewer cases of this health issue related to menstruation. That’s why we’ve forgotten about it.
TSS was prolific between 1980 and 1990. According to the Centers for Disease Control and Prevention (CDC), 55 cases of TSS were reported in May 1980. These infections were characterized by high fever and a rash that resembled a sunburn. Low blood pressure and organ function were affected. Further, 95 percent of these cases involved women, and 95 percent of the 40 women who gave their menstrual history were on their periods at the time the illness occurred.
In June of that year, a link between TSS and tampons was reported in three different studies. Researchers also discovered that women who used tampons frequently had a higher risk than those who rotated products.
At that time, another link was also uncovered. Researchers found that a brand of tampons called RelyPr elevated a woman’s risk of TSS. And the higher the tampon absorbency, the higher the risk. Consequently, the sale of these products ceased. In September of 1980, the manufacturers of RelyPr voluntarily pulled the tampons from the market.
In the following years, cases of TSS drastically dropped. Nearly 900 cases were reported in 1980, and more than 90 percent of these cases were linked to menstruation. But by 1989, just 61 cases were reported, and 74 percent of these occurrences were linked to menstruation. Deaths also decreased. In 1980, 5 percent of women with TSS associated with menstruation died. But in 1988 and 1999, no women died of the health issue.
However, today’s healthcare professionals are again stumped and scrambling for information. The Washington Post reports that four out of the five women affected by recent cases of TSS had used super-absorbency tampons made by Playtex and sold under the brand name Playtex Sport. That said, the fifth woman used a product called U, made by Kotex. This means that the illness is not related to just one product.
The other concerning factor is that no one really knows why tampons are associated with TSS at all. However, experts say there two theories regarding this link. According to NHS Choices, some experts think that tampons may create a bacteria-friendly environment. This might be particularly true if the most absorbent types of tampons are not changed in a timely manner. However, some other experts think that tampon fibers may actually scratch the vaginal wall, which creates a place where bacteria can enter the body.
That said, TSS does not only occur in tampon users. In fact, experts say that tampon-related TSS develops in less than 50 percent of cases, and a quarter of cases are said to occur in men. This is because TSS can develop as a result of cuts and burns, surgery, contraceptive methods (like sponges or diaphragms), and even viral infections like the flu or chicken pox.
So if TSS isn’t just a tampon-related issue, why does it occur at all?
According to NHS Choices, staph and strep bacteria normally reside on skin and in the nose and throat. They are usually harmless because antibodies protect the body. Unfortunately, some people don’t seem to have the antibodies needed to fight these invaders; the reason for this is not known.
When these bacteria are introduced into the body by way of a cut, burn, the throat, or vagina, toxins are released into the blood. Consequently, inflammation occurs, which results in a drop in blood pressure. Organs then begin fail, which almost always involves the kidneys. Tissues are also invaded, which can affect the skin and muscles.
When it comes to TSS, a number of symptoms may occur. The Mayo Clinic says that one such symptom can be a high fever that comes on suddenly. Low blood pressure, along with nausea diarrhea occur, and sometimes a sunburn-like rash develops, usually on the palms and soles of feet. Confusion, achy muscles, and redness of the eyes, mouth and throat, may also be seen. Headaches and seizures are possible.
If you suspect TSS, go to a doctor or emergency room immediately. This is very important if you have a cut or burn or if you have used tampons recently. Don’t wait. TSS is a critical health concern that can result in death.